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.
POP QUIZ:
What are the three 100% effective ways of preventing pregnancy?
|
If you guessed vasectomy or tubal ligation, give yourself
zero points. 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: http://www.fhi.org/en/fp/fpother/conferences/vascet/vasectomymtg.html
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]
Regrets
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
http://members.cox.net/longjl/Sterilization_Reversal_Book.shtml. 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
.
ENDNOTES
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:
- Women having tubals have a higher hysterectomy rate than non-sterilized
controls, and higher also than "vasectomy" wives, but "vasectomy " wives
also have higher rates than nonsterilized controls (something not mentioned
or emphasized but clearly present in the data).
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
- Women having tubal ligation place themselves at risk for menstrual
disorders (these include PMS by their very nature), but "vasectomy" wives
are also at increased risk for these compared to nonsterilized controls.
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
- Women whose partners are Vasectomized can suffer increased allergy
rates, even anaphylaxis (the most serious or deadly kind of allergy).
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.
- Vasectomy Causes Advanced Atherosclerosis in Monkeys.
1. Alexander et al. Science, 201, 538-541. Vasectomy increases the
severity of diet-induced atherosclerosis in Macaca fascicularis.
- Vasectomy May Cause Atherosclerosis in Man.
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.
- Vasectomy Causes Atherogenic Lipid Profile, Affecting Adversely
both LDL and HDL as well as Triglycerides, even in the prestigious Framingham
Cohort.
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.
- When circulating immune complexes (CICs) and coronary heart disease
(CHD) events are measured, both the vasectomized and the CHD men have elevated
CIC levels, suggesting vasectomy may elevate CICs and in this way mediates
CHD events.
1. Alexander et al. AM J Reprod Immunol Microbiol 1986 Oct; 12 (2): 38-44.
- Vasectomy increases CHD risk factors and CHD events, such as hospitalization
for heart attacks, angina, etc.
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.
- Vasectomy Increases the Risk of Infections and Parasites (1.8X),
endocrine, nutritional, and metabolic disease (1.3X), diseases of blood and
blood-forming organs (1.3X), respiratory diseases (1.7X), genitourinary diseases
(1.2 to 1.4X), "symtoms and ill defined conditions (ICD 780-796)" (1.3X),
accidents, poisoning, and violence (1.2X), acute myocardial infarction (1.2
to 1.3X), other ischemic heart disease (1.3X), but especially, arthritis
and and rheumatism (1.8X), and autoimmune disease (3.0X).
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
- Vasectomy may prove in future studies to Harm Blood Pressure
1. Alexander et al. Int J Epidemiol. 1981, 10 (3) 2127-22. Sep. Evaluation
of Blood Pressure in Vasectomized and Nonvasectomized Men.
- Vasectomy has been reported to increase rates of prostate cancer,
lung cancer, and testicular cancer.
1. Rosenberg et al. Am J Epidemiol. 140 (5): 431-8, 1994. Sept 1 The Relation
of Vasectomy to the Risk of Cancer
- Vasectomy can be seen as a hostile (interpersonally) act, and leads
to depression, pychiatric illness, and "hostility against oneself."
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.
- Some authorities consider fibromyalgia an autoimmune disease.
1. Taylor et al. Rhematology 200; 39:620-23. Lupus patients with fatigue
- is there a link with fibromyalgia syndrome?