The NFP files

The Downside
of Sterilization

Out of desperation, you may be considering getting cut open and having your plumbing plugged to destroy your fertility, probably forever. You may be afraid of the alternatives: side effects, sickness or death from the Pill and/or the IUD;  the abortion causing effects of the IUD and the Pill; fear of unplanned pregnancies resulting from the less effective barrier methods, perhaps fear of exercising sexual self-control. After you see the rest of our website on natural family planning, we hope you will see sterilization as drastic, unwise, and completely unnecessary, since Natural Family Planning is very effective, safe, and reversible. We wouldn't recommend it for your cat. But you are smarter than your cat. 

What are the three 100% effective ways of preventing pregnancy?

Vasectomy or tubal ligation? Nope! Vasectomy has a failure rate of .15, or 15 pregnancies per 10,000 woman-years of exposure.[1] (Notes are at the end of this piece.) Recannulation, the reestablishment of a vas deferens by internal healing processes, occurs in one instance per thousand, and sometimes the urologist misses a rare third vas deferens. More often pregnancies result from the failure to wait until two negative sperm counts are obtained before considering oneself sterile. And it takes over 22 weeks for sperm counts to go to zero, according to recent research:

Tubal ligation has an overall failure rate of .04, or four pregnancies per 10,000 woman-years.[2]  (It's happened to someone we know personally.) But when pregnancy occurs, an ectopic pregnancy occurs about half the time, which can be very serious.[1]

The only 100% effective sterilization surgeries are male castration (removal of the testicles) and female castration (removal of the ovaries). The other 100% effective way is complete abstinence. Everything else has a failure rate.

Health Risks of Vasectomy

Painful sperm granulomas (a lump that forms in the blocked vas deferens) are a common side effect of vasectomy, but there is more concern in the medical community about the long term effects on the immunological system, which can cause serious health problems many years after the surgery. Up until recently, vasectomy has simply been assumed to be medically safe. But "You just don't operate on a million men a year without looking for effects. You don't just rely on impressions."[3] The director of a research laboratory has noted that "the medical community has made virtually no serious objection to mass vasectomy. Since information already exists suggesting possible adverse delayed sequelae, this acceptance poses cause for concern."[4]  

What happens to the sperm? After a vasectomy the sperm production is the same as before, around 50,000 spermatozoa every minute.[5] They pile up in the epiditimus and it can blow out, like putting too much air in a tire. [33] Wherever they go, they still have no normal exit, so these cells have to be either consumed by destroyer cells (macrophages) or degenerate and produce antigens which cause antibodies to be produced that will remove the sperm from the system.[6] These antigens frequently will infiltrate into the bloodstream and other cells throughout the body begin to manufacture antibodies against the sperm. These are "anti-sperm autoantibodies."[7]  

Antibodies are the way we immunize ourselves to specific diseases from the outside environment. Antigens are merely the triggering mechanism the body needs in order to produce the right antibodies for its defense. An allergic reaction in which the body becomes highly sensitive to a particular kind of food cell is an example of this mechanism's effect. When the body generates its defenses to ward off cells of its own making, as after a vasectomy, the body becomes "auto-immune,"--allergic to itself. Several studies have found such antibodies generated in response to sperm antigens in 55% to 75% of patients within two years after vasectomies.[8] It occurs 3% naturally.

Auto-immunity has been implicated in multiple sclerosis, diabetes mellitus, rheumatoid arthritis some types of hepatitis, Addison's disease (malfunctioning adrenal glands) and lupus erythematosis.[10]

One study concluded that the immunologic response to sperm antigen that often accompanies vasectomy can exacerbate atheroclerosis.[11] Atherosclerotic diseases, such as coronary thrombosis, pulmonary embolism, thrombophlebitis, arteritis, and angina pectoris, are aggravated by high cholesterol intake, which accurately describes the diet of American males.[12]

Dr. Roberts' analysis of his own patients found a high correlation between systemic diseases and men with fairly recent vasectomies. He noted sudden occurrences of thrombophlebitis, pulmonary embolism, lymph node enlargements, joint inflammation, severe narcolepsy (uncontrollable sleeping), hypoglycemia, diabetes mellitus, hormonal imbalances, liver
dysfunctions, skin eruptions, inflammation of the heart lining, inflamed prostate glands, pulmonary fibrosis, allergic disorders, acute multiple sclerosis, and altered blood coagulation.[13] According to Roberts, "Their patterns of response suggest a cause-and-effect relation between vasectomy and various disorders, especially in light of the fact that the majority had enjoyed good health before surgery ."[14]

Your doctor will probably have a pamphlet saying how safe vasectomy appears to be, and quote a 1992 British Medical Journal study that found no significant difference in health problems within less than 10 years after vasectomy, and saying all those other studies (scroll down this page!) don't prove anything either. The fact remains that no one has done any kind of animal or human "double blind" study to see what the effect of vasectomy is on the male body. Would you like to be a guinea pig, given that the operation is unnecessary?

Health Risks of Tubal Ligation

 There are two common forms of tubal ligation: the mini-laparotomy and laparoscopy. A mini-laparotomy involves making a small incision in the abdomen and exploring for the Fallopian tubes which conduct the eggs from the ovaries to the uterus. After the tubes are found, a portion of each is removed, and the ends are tied. In laparoscopy the woman's abdomen is first blown up with gas. A fiberoptic light is inserted by puncturing the abdominal wall, and an instrument either chops the tubes or burns them shut with electricity. It is common to have it done after delivering a baby, when the woman is most distressed about having another immediately, although she has to then recuperate from both the ligation and the delivery.

The procedure itself is reasonably safe, but it is still surgery. Complications can occur, such as perforation of the bowel leading to massive infection of the abdominal cavity, injuries from poorly administered anesthesia, pulmonary embolism, and cardiac deviations if gas is used.[15]

The real damage occurs later. There are significant increases in gynecological problems experienced by women who have tubal ligations. A follow up study of 374 patients with tubal ligations revealed that 43% had subsequent gynecological treatment for such conditions as menorrhagia (heavy menstrual bleeding), menstrual disturbances requiring hormonal treatments, cervical erosion, ovarian tumors, and recanalization of the Fallopian tubes requiring a second operation.[16]

A 1979 British study found a 40% increase in menstrual blood loss, and 26% of the women with tubal ligations reported increased menstrual pain. It was also discovered that women who had been using the birth control pill before their tubal ligation reported a higher incidence of these complaints than did other patients.[17]

There is an increased incidence of women with tubal ligations undergoing subsequent hysterectomy because of severe menstrual problems. Of the patients followed in the study cited above, 18.7% returned for a hysterectomy.[18] A study by James G. Tappan found a 40.7% incidence of menorrhagia and suggested that cystic degeneration of the ovary as a result of an interruption of the uterine artery might account for this.[19] In any case, the figure of a 40% increase in menstrual problems as the result of tubal ligation seems standard. In addition, the rate of cervical cancer experienced by one group of 489 women three and a half years after tubal ligation was three and a half times the normal rate.[20]

Pelvic venous congestion (and even thrombosis) can be a problem after tubal ligation. Also, medical authors have described all types of derangements of reproductive hormones as a consequence of TL, including most prominently PMS and progesterone deficiency (producing migraines, hot flashes, night sweats, and swelling). TL thus also explains part of the rise in hormone replacement therapy over recent years. The health risks of HRT have just come to light in 2002.

More references to tubal problems here.

Psychological Side Effects of Sterilization

A 1966 study of vasectomy patients and their wives by Dr.  Frederick Ziegler found "striking adverse changes and reduced marital satisfaction in husband and wife notwithstanding general satisfaction with the procedure itself."[21] A standard personality disorder test found that over 40% of a vasectomy study group experienced personality disturbances between their first testing and that of a year later, after the operation.[22]

Since it takes longer than the time frames of most follow-up studies to encounter the full effects of a sterilization operation, it is difficult to gauge the true psychological stress involved.  Complicating the findings of those attempts[23] that have been made to understand the real effect of sterilization on mental health is what Dr. Helen Wolfers calls "the need to proselytize" for these surgeries.[24].

Any person contemplating sterilization is, or should be, told that the operation is relatively irreversible. Only about 33% of vasectomy and tubal reversals are functionally successful.[25] When a person takes such an irrevocable course of action, it is psychologically difficult for him or her to admit that a mistake has been made. This explains why the number of those willing to recommend or express satisfaction with sterilization is always higher than the number of patients who have no complaints about the actual results of their own operation. As Dr. Wolfers explains this discrepancy in the questionnaires received from patients, "The need to convince ourselves is served by convincing others."[26]

Thus, a study of 1,191 vasectomized participants in a sterilization campaign in India revealed decreased sexual desire appearing in 53% of those surveyed. But 92% of that same group expressed satisfaction with the operation.[27]  Removing the fear of pregnancy probably accounts for a lot of the satisfaction with the operation. Of course, this is unnecessary and you can postpone pregnancy as long as you want, forever if need be, through NFP while improving your marital relationship.

Social Consequences of Sterilization

There is a crying need for research on the social consequences of sterilization. It has been suggested that men who believe themselves to be truly sterilized may feel more inclined toward marital infidelity. Vasectomy may also play an important part in aggravating the tendency of some middle-aged men to discard their middle aged wives in favor of younger women.[28]  The same goes for women. "Now that my husband's been fixed, I need to be more careful".  

Another concern is the implication of viewing one's body as a machine that can be disconnected if one of its functions is no longer necessary. This has grave consequences. Cats and dogs are spayed in order to suit the convenience of their masters. But who are the masters in the human social order?

Sterilization attacks the integrity of the human person.  While this may sometimes be justified as a punishment for crime, the evil of sterilization may not be forced upon anyone as a matter of social policy. However, the Nazis sterilized those considered unfit by Nazi standards, and Indira Gandhi launched a massive coerced sterilization drive that finally brought about a revolt of the masses and led to her electoral defeat. In the United States, Margaret Sanger, the foundress of Planned Parenthood, advocated sterilization of the poor[29] and there have been other attempts to use sterilization for forced population control.[30] Have you   been led to think you have no other choice?

The Moral View of Sterilization

Before 1930, no Christian Church accepted sterilization or any form of contraception as morally acceptable. The Catholic Church and some Protestant Churches teach that deliberate sterilization is an immoral form of birth control. "Equally to be excluded (as morally permissible), as the teaching authority of the Church has frequently declared, is direct sterilization, whether perpetual or temporary, whether of the man or of the woman" (Humanae Vitae. 14).[31]


Some of the most heartbreaking letters received by the Couple to Couple League come from couples who have the deepest sorrow and bitter regrets about a sterilization operation. Another sad place is the alt.infertility newsgroup. One poor fellow has given up trying to regain fertility after a reversal, and is considering another vasectomy so they aren't surprised with a child in their 50's. (Not a good idea. The vasectomy, that is! Besides, after age 50, only 1 in 25,000 women get pregnant.)  One e-mail we got recently was from a 30 year old who had a tubal at age 22 and deeply regrets it now.

Reversals are possible. The cost can be in the thousands, with no guarantee of success, or how long it will take to regain fertility, or other complications such as drugs needed to regain mobility. One vasectomy reversal patient describes the pain: "Remember the vasectomy? [It's] the difference between a mosquito bite and an alligator. 2 weeks with codeine and an ice bag."  The chances of vasectomy reversal success go down with time, probably due to the increased antibodies attached to the sperm. Tubal ligation reversal is not easy, cheap or effective,either. It's worth trying, but it is way better not to get sterilized in the first place!

"Sterilization Reversal, A Generous Act of Love", a new book from OneMoreSoul , features the intimate personal stories of 20
couples who reversed their sterilization. These stories make clear that sterilization reduces intimacy, damages the marriage, is rarely taught as intrinsically evil, and often leads to deep regret. The book also has thorough, clear explanations of the theological arguments aggainst sterilization. Associated with the book is a web-based sterilization reversal discussion group where you can learn about and discuss sterilization and reversals, at  Mainly Catholics, they discuss the spiritual emptiness caused by sterilization, the joy of reversal, and the Church's teachings on both. Everybody is welcome, although there are many more Protestant anti-sterilization groups and websites.


If you have a most serious reason to avoid pregnancy, the Sympto-Thermal Method of Natural Family Planning (NFP) offers a realistic and moral alternative. It's completely safe, and can be reversed to increase your fertility any time you want. Plus, it can help improve your relationship, increase marital satisfaction, and increase bodily health awareness. 

As we said above, no methods are 100% effective except total abstinence. However, one study showed that a temperature-only form of NFP had an unplanned pregnancy rate even less than that for vasectomy and tubal ligation.[32] (The difference in abstinence required between the normal rules and super-conservative rules is usually a few days or so.) If the usual 99% method effectiveness rate is OK (which we've used successfully for 21 years), you can use any of the normal rules. 

For more information on NFP, go to one of our other pages such as the "Info" page .


1. Robert A. Hatcher, et. al., "Contraceptive Technology  (New York, Irvington)  This book is revised about every 3 years,  so the page numbers change, but you can look up these references in the index. Hatcher is the standard reference on family planning.

2. Ibid.

3. Harold Lear quoted in "Vasectomies Beget Baby Doubts," "National Observer" January 20, 1973. 15

4. H. J. Roberts, "Is Vasectomy Safe? (West Palm Beach, Florida, Sunshine Academic Press, 1979). 18

5. Ibid.

6. Nancy J. Alexander and Thomas B. Clarkson, "Effect of vasectomy on diet-induced atherosclerois," "Vasectomy Immunologic and Pathophysiologic Effects in Animals and Man" Irwin H. Lepow and Ruth Crozier, eds (New York
Academic Press, 1979.) 122

7. Nancy J. Alexander quoted in "Vasectomy" John Fried (New York, "Saturday Review" 1972) 52-53

8. K S K Tung, "Human sperm antigens and antisperm antibodies" "Clinical Experiences in Immunology" (1975); 20, 93-104. R. Ansbacher et al "Sperm antibodies in vasectomized men," "Fertility and Sterility 22 629. Rudi Ansbacher "Vasectomy, sperm antibodes," "Fertility and Sterility, 24 788-792. Nancy J. Alexander, B. J. Wilson and G. D. Patterson, "Vasectomy Imnmunologic effects in rhesus monkeys and men." "Fertility and Sterility" 25 149. S. Shulman, E. Zappi, U Ahmed and J. E. Davis, "Immunologic consequences of vasectomy," "Contraception" 5(4) 269-278 (April 1972)

10. Fried. 46

11. Nancy J. Alexander and Thomas B. Clarkson, "Effect of vasectomy on diet-induced atherosclerosis. 154

12. Enos. Holmes and Beyer (1953) reported some degree of coronary atherosclerosis in 77.3% of United States combat casualties in Korea. McNamara and associates (1971) found comparable evidence of atherosclerosis in 45% of 105 American soldiers killed in Vietnam The mean age was 22.1 years in both studies.

13. Ibid. 37-86

14. Ibid. 39

15. D. B. Scott and D. G Julian. "Observations on cardiac arrhythmias during laparoscopy" "British Medical Journal" 1:411 (1972)

16. M. J. Muldoon, "Gynaecological Illness after sterilization" "British Medical Journal" (January 8, 1972). 84-85. Table III.

17. S. Lawson, R. A. Cole and A. A. Templeton. "The effect of laparoscopy sterilization by diathermy or silastic bands on post post-operative pain, menstrual symptoms and sexuality." "British Journal of Obstetrics and Gynecology" 66: 659 663 (August.  1979). This updates J. R. Neil's follow up of 454 women in 1975.  which found an incidence of between 22% to 39%
of the study experiencing menstrual problems after their tubals. J. R. Neil. et al . "Late complications of sterilization by laparoscopy and tubal ligation, a controlled study" "The Lancet" (October 11. 1975) 699-700

18. Muldoon Table II.

19. James G. Tappan, "American Journal of Obstetrics and Gynecology," 115:8. 1056

20. Ibid.

21. F. J. Ziegler, D. A. Rodgers, S. A. Kriegsman. "Effect of vasectomy on psychological functioning" "Psychosomatic Medicine" 28:50. (1966)

22. H. Edey "Psychological aspects of vasectomy," "Medical Counterpoint" (January, 1972). 19

23. Ziegler. op cit Helen Wollers. "Psychological aspects of vasectomy," "British Medical Journal" 4:297.(1970). For an excellent review of this topic see John Fried's "Vasectomy" (New York. "Saturday Review Press" 1972).

24. Wollers quoted in Fried. 97

25. H. Y. Lee. "Clinical experience of vasovasostomies," "Korean Journal of Fertility and Sterility" 2(1):2-20 (December. 1975)

26. Fried, loc. cit.

27. K. Dandekar. "Alter-effects of vasectomy," Artha Vijnana" (Gokhale Institute of Politics and Economics. Poona. India) 5:212.  (1963).

28. The psychological forces which might be responsible for this distressing phenomenon are described superbly in George Gilder's "Sexual Suicide" (New York Quadrangle. 1973)

29. Margaret Sanger "Pivot of Civilization (New York Brentano's.  1922) 124-145  
Sanger expresses an especially strong paranoia that "subhumans irresponsibly copulating will overpopulate the earth and contaminate the gene-pool."

30. Sterilization as a tool of the state has a long history in America. In the mid-1890's castration was used on the feeble- minded. In Kansas in 1899 a 19-year-old boy was castrated at the Indiana Reformatory because of his addiction to masturbation. 1907 marked Indiana's sterilization of the criminal and unfit elements in the state. Fifteen states enacted similar
sterilization laws between 1907 and World War I. The eugenics movement touted the social benefits of involuntary sterilization into the 1930's. In 1974 two Alabama sisters age 12 and 14 were sterilized without their consent at a Montgomery birth control clinic.

31. Pope Paul VI. Encyclical letter "Humanae Vitae" dated July 28, 1968.14

32. B. Vincent et al "Methode Thermique a et Contraception," "Approches medicale et psychologique" (Paris Masson, 1967) 52- 73

33. Sherman Silber, M.D., "How To Get Pregnant With The New Technology", book about vasectomy reversal.
(c) 2003 The Couple to Couple League International, Inc. This information is adapted from CCL's brochure "Sexual Sterilization: Some Questions and Answers". Revised, embellished and polished by Jim Van Damme.

A few more references in medical literature regarding problems with sterilization:
(Thanks to the Edith Stein Foundation )
1. Hillis et al. Obstet. Gynecol. 1998; 91: 241-6 Higher Hysterectomy Risk for Sterilized than Non Sterilized Women: Findings from the U.S. Collaberative Review of Sterilization

 2. Stergachis et al. JAMA 1990; 264: 2893-2898. Tubal Sterilization and the Long-Term Risk of Hysterectomy

1. Visvanathan et al. Journal of Women's Health and Gender-Based Medicine. Vol. 9, Number 5, 2000.  Tubal Ligation, Menstrual Changes, and Menstrual Symptoms.

2. Shy et al. Am Journal Obstet Gynecol. 1992; 166:1698-1706. Tubal Sterilization and Risk of Subsequent Hospital Admission for  Menstrual Disorders

1.  Ebo et al. Allergy 1995: 50: 747-750.  Human seminal plasma anaphylaxis (HSPA): Case Report and Literature Review

2.  Friedman et al. JAMA 1984; 251: 2684-2687.  Successful Long-Term Immunotherapy for Human Seminal Plasma Anaphylaxis. 1. Alexander et al. Science, 201, 538-541.  Vasectomy increases the severity of diet-induced atherosclerosis in Macaca fascicularis.
1. Campbell et al. British Journal of Urology (1983), 55, 430-433. Vasectomy and Atherosclerosis: An Association in Man?

2.  Fahrenbach et al. J. Androl 1980; 1:299-303. Effect of Vasectomy on the Retinal Vasculature of Men.
1. Hubert et al. AM J Epidemiol. 1987 May; 124 (5): 812-31. Life-style correlates of risk factor change in young adults: an eight-year study of coronary heart disease risk factors in the Framingham offspring.

2. Ritchey et al. The Journal of Urology Vol 133, Jan. 1985. Effect of Vasectomy On High Density Lipoproteins.
1. Alexander et al. AM J Reprod Immunol Microbiol 1986 Oct; 12 (2): 38-44.
1. Mullooly et al. J Clin. Epidemiol. Vol 46, No.1, 101-109, 1993, Vasectomy, Serum Assays, and Coronary Heart Disease Symptoms and Risk Factors.

2. Goldacre et al. N Engl J Med. 1983; 308: 805-8. Cardiovascular Disease and Vasectomy.

3. Petitti et al. Journal of Urology. 1983; 129 (4): 760-2 Apr. Vasectomy and the Incidence of Hospitalized Illness.
1. Petitti et al. Journal of Urology 1983; 129 (4): 760-2 Apr. Vasectomy and the Incidence of Hospitalized Illness. (On  autoimmune disease the authors couldn't exclude a factor of 42X).

2. Roberts, HJ. Is Vasectomy Worth the Risk? West Balm Beach, FLA; Sunshine Sentinel Press, 1993.

3. Bigazzi, PE. Reproductive Immunology 1981, pg. 461-476
1. Alexander et al. Int J Epidemiol. 1981, 10 (3) 2127-22. Sep. Evaluation of Blood Pressure in Vasectomized and Nonvasectomized Men.
1. Rosenberg et al. Am J Epidemiol. 140 (5): 431-8, 1994. Sept 1 The Relation of Vasectomy to the Risk of Cancer
1. Luo et al. Contraception, 1996; 54 (6): 345-57, Dec. Psychological Long-term Effects of Sterilization on Anxiety and Depression

2. Erickson: The Psychological Significance of Vasectomy In therapeutic Abortion. Edited by H. Rosen. New Yourk: Julian Press, Inc. 1954.
1. Taylor et al. Rhematology 200; 39:620-23. Lupus patients with fatigue - is there a link with fibromyalgia syndrome?

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