Compared with other contraceptive methods, voluntary male and female sterilizations are highly effective and convenient. While female sterilization is the most popular contraceptive method in the United States and worldwide, male sterilization (vasectomy) is widely available in only a few countries, despite the fact that it is easier to perform than female sterilization. Articles provide an overview of these two highly effective and safe sterilization methods, including recent research on safety issues and long-term effectiveness.

In this issue

Contraceptive Update: Contraceptive Needs after Age 40

As they pass the age of 40, women and men continue to be fertile and sexually active, and up to half of women are able to become pregnant well into their fifth decade. Pregnancy-related health risks, however, increase substantially for this age group, compared with younger women. The advantages and disadvantages of various contraceptive methods, including sterilization, are discussed.

Female Sterilization Safe, Very Effective

Female sterilization is free from side effects associated with most temporary methods, does not interfere with sexual intercourse, and does not require routine follow-up care or prescription refills. However, because this method is permanent and requires surgery, it is not appropriate for every women who needs contraception.

Female Sterilization Occlusion Techniques

Female sterilization prevents pregnancy by occluding or mechanically blocking the fallopian tubes, using one of several occlusion techniques.

Vasectomy Offers Many Advantages

Despite its many advantages, vasectomy (male sterilization) is widely available in only a few countries. While vasectomy is safe and very effective, incorrect information and unfounded fears often limit its use, even in countries where the procedure is readily available.

Time to Azoospermia May Be Longer than Often Assumed

Vasectomy takes weeks to become effective, since sperm remain in a man's reproductive tract longer after the procedure. Recent small studies suggest that it may take longer than previously thought for sperm to disappear completely.

Search for Nonsurgical Sterilization Continues

For years, scientists have worked to develop nonsurgical female and male sterilization methods that would be inexpensive and easy to administer. While some experimental methods are under study, none are likely to be widely available in the near future.

Counseling Encourages Voluntary Choice

Because male and female sterilizations are permanent, it is especially important to counsel clients interested in these methods. Counseling serves many purposes, including careful consideration by clients at risk of regretting the procedure later in life.

Opinion: Voluntary Sterilization -- Six Lessons Learned

A review of sterilization services in more than 50 countries during the past 25 years highlights important ways to assure quality voluntary sterilization services. Lynn Bakamjian and Pamela Beyer Harper of AVSC International list six important lessons: focus on the client, assure informed choice, support providers with training and other needs, build ownership in the community, use technology that is appropriate for the setting, and offer services within an integrated reproductive health program.

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