Sterilization (medicine)
Sterilization | |
---|---|
Background | |
Type | Sterilization |
First use | Ancient |
Failure rates (first year) | |
Perfect use | under 1% |
Typical use | under 1% |
Usage | |
Duration effect | Permanent |
Reversibility | Difficult and expensive, semen samples required following vasectomy |
Clinic review | None |
Advantages and disadvantages | |
STI protection | None |
Benefits | Permanent methods that require no further user actions |
Risks | Operative and postoperative complications |
Sterilization (
There are multiple ways of having sterilization done, but the two that are used most frequently are
In some cases, sterilization can be reversed but not all. It can vary by the type of sterilization performed.[1]
Methods
Surgical
Surgical sterilization methods include:
- laparoscopic approach to cut, clip or cauterizethe fallopian tubes.
- Bilateral salpingectomy in females, also known as tubal removal. Both fallopian tubes are surgically removed. When done for contraceptive purposes, the ovaries are left in place. This method is considered more effective than tubal ligation, as there is no chance of tubal reconnection or clip failure, and also prevents cancer of the fallopian tubes and can reduce risk of ovarian cancer.
- seminal vesicles and prostate). Although the term vasectomy is established in the general community, the correct medical terminologyis vasoligation.
- Hysterectomy in females. The uterus is surgically removed, permanently preventing pregnancy and some diseases, such as uterine cancer.
- Castration in males. The testicles are surgically removed. This is frequently used for the sterilization of animals, but rarely for humans. It was also formerly used on some human male children for other reasons; see castrato and eunuch.
Transluminal
- The Essure procedure was one such transluminal sterilization technique. In this procedure, polyethylene terephthalate fiber inserts were placed into the fallopian tubes, eventually inducing scarring and occlusion of the tubes.[2]
In April 2018, the FDA restricted the sale and use of Essure. On July 20, 2018, Bayer announced the halt of sales in the US by the end of 2018.
- .
Thermal
Fahim [4][5][6] et al. found that heat exposure, especially high-intensity ultrasound, was effective either for temporary or permanent contraception depending on the dose, e.g. selective destruction of germ cells and Sertoli cells without affecting Leydig cells or testosterone levels.
Pharmacological
In the 1977 textbook Ecoscience: Population, Resources, Environment, on page 787, the authors speculate about future possible oral sterilants for humans.
In 2015,
There have been hoaxes involving fictitious drugs that would purportedly have such effects, notably progesterex.
See also
Chemical, e.g. drug-based methods are available, e.g. orally-administered Lonidamine[8] for temporary, or permanent (depending on the dose) fertility management. Boris[9] provides a method for chemically inducing either temporary or non-reversible sterility, depending on the dose, "Permanent sterility in human males can be obtained by a single oral dosage containing from about 18 mg/kg to about 25 mg/kg".
Voluntary sterilization
Motivations for voluntary sterilizations include:
Lifestyle
Because of the emphasis placed on childbearing as the most important role of women, not having children was traditionally seen as a deficiency or due to fertility problems.
Financial
Economic incentives and career reasons also motivate women to choose sterilization. With regard to women who are voluntarily childless, studies show that there are higher "opportunity costs" for women of higher socioeconomic status because women are more likely than men to forfeit labor force participation once they have children. Some women stated the lack of financial resources as a reason why they remained
Physiological
Physiological reasons, such as genetic disorders or disabilities, can influence whether couples seek sterilization. According to the Centers for Disease Control and Prevention, about 1 in 6 children in the U.S. had a
National examples
United States
Sterilization is the most common form of contraception in the United States when female and male usage is combined. However, usage varies across demographic categories such as gender, age, education, etc. According to the
Correspondingly, female sterilization was the leading method among currently and formerly married women; the pill was the leading method among cohabiting and never married women. 59% of women with three or more children used female sterilization. Thus, women who do not intend to have more children primarily rely on this method of contraception in contrast with women who only aim to space or delay their next birth. Regarding education, "[l]ess-educated women aged 22–44 years were much more likely to rely on female sterilization than those with more education." For example, female sterilization was used among 55% of women who had not completed high school compared with 16% of women who had graduated from college.[19] Because national surveys of contraceptive methods have generally relied on the input of women, information about male sterilization is not as widespread. A survey using data from the 2002 National Survey of Family Growth found similar trends to those reported for female sterilization by the Centers for Disease Control and Prevention in 2006–2008. Among men aged 15–44 years, vasectomy prevalence was highest in older men and those with two or more biological children. Men with less education were more likely to report female sterilization in their partner. In contrast to female sterilization trends, vasectomy was associated with white males and those who had ever visited a family planning clinic.[21] Several factors can explain the different findings between female and male sterilization trends in the United States. Women are more likely to receive reproductive health services. "Additionally, overall use of contraception is associated with higher socioeconomic status, but for women, use of contraceptive tubal sterilization has been found to be related to lower socioeconomic status and lack of health insurance." This finding could be related to Medicaid-funded sterilizations in the postpartum period that are not available to men.[21]
Promoted sterilization
Compulsory
Compulsory sterilization refers to governmental policies put in place as part of human population planning or as a form of eugenics (changing hereditary qualities of a race or breed by controlling mating) to prevent certain groups of people from reproducing. An example of forced sterilization that was ended within the last two decades is Japan's Race Eugenic Protection Law, which required citizens with mental disorders to be sterilized. This policy was active from 1940 until 1996, when it and all other eugenic policies in Japan were abolished.[22] In many cases, sterilization policies were not explicitly compulsory in that they required consent. However, this meant that men and women were often coerced into agreeing to the procedure without being of a right state of mind or receiving all of the necessary information. Under the Japanese leprosy policies, citizens with leprosy were not forced into being sterilized; however, they had been placed involuntarily into segregated and quarantined communities.[22] In America, some women were sterilized without their consent, later resulting in lawsuits against the doctors who performed those surgeries. There are also many examples of women being asked for their consent to the procedure during times of high stress and physical pain. Some examples include women who have just given birth and are still being affected by the drugs, women in the middle of labor, or people who do not understand English.[23] Many of the women affected by this were poor, minority women.[24]
In May 2014, the
- women, especially in relation to coercive population control policies, and particularly including women living with HIV, indigenous and ethnic minority girls and women. Indigenous and ethnic minority women often face "wrongful stereotyping based on gender, race and ethnicity".
- people with disabilities, often perceived as sexually inactive. women with intellectual disabilities are "often treated as if they have no control, or should have no control, over their sexual and reproductive choices". Other rationales include menstrual management for the benefit of careers.
- intersex persons, who "are often subjected to cosmetic and other non-medically indicated surgeries performed on their reproductive organs, without their informed consent or that of their parents, and without taking into consideration the views of the children involved", often as a "sex-normalizing" treatment.
- transgender persons, "as a prerequisite to receiving gender-affirmative treatment and gender-marker changes".
The report recommends a range of guiding principles for medical treatment, including ensuring patient autonomy in decision-making, ensuring non-discrimination, accountability and access to remedies.[25]
Incentivizing
Some governments in the world have offered and continue to offer economic incentives to using
National examples
Singapore
Singapore is an example of a country with a sterilization incentive program. In the 1980s, Singapore offered US$5000 to women who elected to be sterilized. The conditions associated with receiving this grant were fairly obvious in their aim at targeting low income and less educated parents. It specified that both parents should be below a specified educational level and that their combined income should not exceed $750 per month.[27] This program, among other birth control incentives and education programs, greatly reduced Singapore's birth rate, female mortality rate, and infant mortality rate, while increasing family income, female participation in the labor force, and rise in educational attainment among other social benefits. These are the intended results of most incentivizing programs, although questions of their ethicality remain.
India
Another country with an overpopulation problem is
China
When the
Criminalization
Poland
In Poland, reproductive sterilisation of men or women has been defined as a criminal act since 1997[32]: 19 and remains so as of 5 September 2019[update], under Article 156 §1, which also covers making someone blind, deaf or mute, of the 1997 law.[33]: 64 The original 1997 law punished contraventions with a prison sentence of one to ten years[32] and the updated law as of 5 September 2019[update] sets a prison sentence of at least 3 years.[33] The prison sentence is a maximum of three years if the sterilisation is involuntary, under Art. 156 §2.[32][33]: 64
Effects
The effects of sterilization vary greatly according to gender, age, location, and other factors. When discussing female sterilization, one of the most important factors to consider is the degree of power that women hold in the household and within society.
Physical
Understanding the physical effects of sterilization is important because it is a common method of contraception. Among women who had interval tubal sterilization, studies have shown a null or positive effect on female sexual interest and pleasure.[34] Similar results were discovered for men who had vasectomies. Vasectomies did not negatively influence the satisfaction of men and there was no significant change in communication and marital satisfaction among couples as a result.[35] According to Johns Hopkins Medicine, tubal sterilizations result in serious problems in less than 1 out of 1000 women. Tubal sterilization is an effective procedure, but pregnancy can still occur in about 1 out of 200 women. Some potential risks of tubal sterilization include "bleeding from a skin incision or inside the abdomen, infection, damage to other organs inside the abdomen, side effects from anesthesia, ectopic pregnancy (an egg that becomes fertilized outside the uterus), [and] incomplete closing of a fallopian tube that results in pregnancy."[36] Potential risks of vasectomies include "pain continuing long after surgery, bleeding and bruising, a (usually mild) inflammatory reaction to sperm that spill during surgery called sperm granuloma, [and] infection." Additionally, the vas deferens, the part of the male anatomy that transports sperm, may grow back together, which could result in unintended pregnancy.[37]
Psychological
It can be difficult to measure the psychological effects of sterilization, as certain psychological phenomenon may be more prevalent in those who eventually decide to partake in sterilization. The relationships between psychological problems and sterilization may be due more to
Familial
Women in the household
Some people believe that sterilization gives women, in particular, more control over their
Relationship with spouse
In countries that are more entrenched in the traditional patriarchal system, female sterilizations can inspire abusive behavior from husbands for various reasons.[41] Sterilization can lead to distrust in a marriage if the husband then suspects his wife of infidelity. Furthermore, the husband may become angry and aggressive if the decision to be sterilized was made by the wife without consulting him. If a woman marries again after sterilization, her new husband might be displeased with her inability to bear him children, causing tumult in the marriage. There are many negative consequences associated with women who hold very little personal power. However, in more progressive cultures and in stable relationships, there are few changes observed in spousal relationships after sterilization. In these cultures, women hold more agency and men are less likely to dictate women's personal choices. Sexual activity remains fairly constant and marital relationships do not suffer, as long as the sterilization decision was made collaboratively between the two partners.[39]
Children
As the Chinese government tried to communicate to their people after the population boom between 1953 and 1971, having fewer children allows more of a family's total resources to be dedicated to each child.[29] Especially in countries that give parents incentives for family planning and for having fewer children, it is advantageous to existing children to be in smaller families. In more
Community and beyond
In countries with high population rates, such as China and India, compulsory sterilization policies or incentivizes to sterilization may be implemented in order to lower birth rates.[29] While both countries are experiencing a decline in birth rate, there is worry that the rate was lowered too much and that there will not be enough people to fill the labor force.[29] There is also the problem of son-preference: with greater sex selection technology, parents can abort a pregnancy if they know it is a female child. This leads to an uneven sex ratio, which can have negative implications down the line. However, experiencing a lower population rate is often very beneficial to countries. It can lead to lower levels of poverty and unemployment.[29]
See also
References
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- ^ Drugs.com --> Quinacrine. Retrieved on August 24, 2009
- ^ Fahim, M. S., et al. "Heat in male contraception (hot water 60 °C, infrared, microwave, and ultrasound)." Contraception 11.5 (1975): 549-562.
- ^ Fahim, M. S., et al. "Ultrasound as a new method of male contraception." Fertility and sterility 28.8 (1977): 823-831.
- ^ Fahim, M. S., Z. Fahim, and F. Azzazi. "Effect of ultrasound on testicular electrolytes (sodium and potassium)." Archives of andrology 1.2 (1978): 179–184.
- ^ Hesman Saey, Tina (December 7, 2015). "DNA editing shows success in mosquito sterilization". Science News. Retrieved October 5, 2016.
- ^ Lonidamine analogues for fertility management, WO2011005759A3 WIPO (PCT), Ingrid Gunda GeorgeJoseph S. TashRamappa ChakrsaliSudhakar R. JakkarajJames P. Calvet
- ^ United States Patent US3934015A, Oral male antifertility method and compositions
- ^ a b c Gillespie, Rosemary. 2003. "Childfree and Feminine: Understanding the Gender Identity of Voluntary Childless Women". Gender and Society. 17(1): 122–136.
- ^ Forsyth, Craig J. 1999. "The Perspectives of Childless Couples". International Review of Modern Sociology. 29(2): 59–70.
- ^ a b c Kelly, Maura. 2009. "Women's Voluntary Childlessness: A Radical Rejection of Motherhood?". Women's Studies Quarterly. 37(3/4): 157–172.
- ^ 2010. "Fertility of American Women: 2008". American Community Survey. United States' Census Bureau.
- ^ Gold, Rachel Benson and Barry Nestor. 1985. "Public Funding of Contraceptive, Sterilization, and Abortion Services". Family Planning Perspectives. 17(1): 25–30.
- ^ a b Sonfield, Adam, and Rachel Benson Gold. 2005. "Methodology for Measuring Public Funding for Contraceptive, Sterilization, and Abortion Services, FY 1980–2001". The Alan Guttmacher Institute.
- ^ "Developmental Disabilities Increasing in US". Centers for Disease Control and Prevention. 2011.
- ^ a b Park, Jennifer M., Hogan, Dennis P. and Frances K. Goldscheider. 2003. "Child Disability and Mothers' Tubal Sterilization". Perspectives on Sexual and Reproductive Health. 35(3): 138–143.
- ^ Rowley, Peter T. "Genetic Screening: Marvel or Menace?". 1984. Science. 225(4658): 138–144.
- ^ a b 2010. "Use of Contraception in the United States: 1982–2008". Vital and Health Statistics. 23(29)
- ^ a b Zite, Nikki and Sonya Borrero. 2011. "Female Sterilisation in the United States". The European Journal of Contraception and Reproductive Health Care. 16: 336–340.
- ^ a b Anderson, John E. et al. 2010. "Contraceptive Sterilization Use Among Married Men in the United States: Results from the Male Sample of the National Survey of Family Growth". 82(3): 230–235
- ^ a b Matsubara, Yôko. "The Enactment of Japan's Sterilization Laws in the 1940s: A Prelude to Postwar Eugenic Policy." The History of Science Society of Japan. 8.2 (1998): 187–201.
- ^ Kluchin, Rebecca M. "Locating the Voices of the Sterilized." The Public Historian. 29.3 (2007): 131–44.
- ^ Pierson-Balik, Denise A. 2003. "Race, Class, and Gender in Punitive Welfare Reform: Social Eugenics and Welfare Policy". Race, Gender, & Class. 10 (1): 11–30.
- ^ Eliminating forced, coercive and otherwise involuntary sterilization, An interagency statement, World Health Organization, May 2014.
- ^ a b Mauldon, Jane Gilbert. "Providing Subsidies and Incentives for Norplant, Sterilization and Other Contraception: Allowing Economic Theory to Inform Ethical Analysis." The Journal of Law, Medicine & Ethics. 31.3 (2003): 351–64.
- ^ Singh, K., O. A. C. Viegas, and S. S. Ratnam. "Balance in Family Planning". World Health Forum. 10 (1989): 344–49.
- ^ Enke, Stephen. "The Gains to India from Population Control: Some Money Measures and Incentive Schemes." The Review of Economics and Statistics. 42.2 (1960): 175–81.
- ^ a b c d e f g h i j STOLC, Phyllis E W. "Seeking Zero Growth: Population Policy in China and India". Graduate Journal of Asia-Pacific Studies. 6.2 (2008): 10–32.
- ^ a b "Total population, CBR, CDR, NIR and TFR of China (1949–2000)". China Daily.
- ^ The Economist Online (June 16, 2012). "Consequences of the one-child policy: Perils of motherhood". The Economist.
- ^ a b c "553 Ustawa z dnia 6 czerwca 1997 r. – Kodeks karny" [553 Law of 6 June 1997 - Criminal code] (PDF). Sejm. 1997-06-06. Archived (PDF) from the original on 2019-09-30. Retrieved 2019-09-30.
- ^ a b c "Ustawa z dnia 6 czerwca 1997 r. – Kodeks karny – Opracowano na podstawie t.j. Dz. U. z 2018 r. poz. 1600, 2077, z 2019 r. poz. 730, 858, 870, 1135, 1579" [Law of 6 June 1997 - Criminal code – Updated on the basis of Dz. U. 2018 parts 1600, 2077, and Dz. U. 2019 parts 730, 858, 870, 1135, 1579] (PDF). Sejm. 2019-09-05. Archived (PDF) from the original on 2019-09-30. Retrieved 2019-09-30.
- ^ Costello, Caroline et al. 2002. "The Effect of Interval Tubal Sterilization on Sexual Interest and Pleasure". The American College of Obstetricians and Gynecologists. 100(3): 511–517.
- ^ Hofmeyr, Doreen G. and Abraham P. Greeff. 2002. "The Influence of a Vasectomy on the Marital Relationship and Sexual Satisfaction of the Married Man". Journal of Sex and Marital Therapy. 28:339–351.
- ^ "Tubal Ligation". Johns Hopkins Medicine.
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- ^ Rao, Vijayendra. "Wife-Beating in a Rural South India Community." Social Science and Medicine. 44.8 (1997): 1169–1181.
External links
- Cat's sterilization (video)
- Vasectomy Information —The website of newsgroup alt.support.vasectomy.
- All About Vasectomy & Finding a Doctor. Latest advances, videos etc
- My Vasectomy in Words and Pictures —One man's personal experience.
- Vasectomy Reversal Resource
- Female Sterilization Options – /mk.nkl/cvas1.html Is Vasectomy the Right Method For Me?] and * * * Is Female Sterilization the Right Method For Me?
- No-Scalpel Vasectomy: The NSV Book
- Video: The NSV Procedure (graphic)