Too old for surgical sterilization?

June 25, 2022 2:07 PM

I'm in my late 40s. Is this too old for a tubal ligation to prevent pregnancy?

I can't take hormonal birth control, and rely entirely on condoms for birth control. I have a small stash of Plan B (I've only had to take it a couple times in my life due to the condom breaking).

At the gyn last year she measured my hormones and told me "You likely couldn't get pregnant even if you wanted to." (And seemed taken aback when I let out a little cheer.)

Although I'm awash in perimenopausal symptoms, I still have a (more or less) monthly period.

It seems like surgical sterilization would be overkill at my age. But I might? have another few years where I could have a whoops surprise pregnancy? My mother was a full seven years older than I am now when she became fully menopausal.

I live in a red state.

Is anyone else my age thinking these thoughts?

posted by Sockrates to Health & Fitness (11 answers total)

I can't advise on surgical, and I apologize for making a suggestion you might already know, but with everything going on and knowing answers to questions like these get read by many people and there's a LOT of people seeking various information about this topic right now: Have you considered a non-hormonal IUD? It would last ten years and is as effective as tubal litigation.
posted by foxfirefey at 3:22 PM on June 25, 2022 [4 favorites]

I’m 40 and am thinking these thoughts! I have a copper IUD set to expire at 45, my previous plan was just to replace it at that age to get me through to 55. Now I think I might as well go ahead with a bilateral salpingectomy just to be absolutely sure. I know too many women in my mother’s generation with “miracle” babies in their 50s to take a chance.
posted by stellaluna at 3:28 PM on June 25, 2022 [4 favorites]

If you don't have any health conditions absolutely precluding it, you can have this done. At worst, in the USA, I would expect you might need to pay cash/do a payment plan and might need to do some doctor shopping. This will depend on if your regular gyn will assist in this care and whether your insurance will pay for it. Additionally, certain religiously affiliated hospital chains will not do it on-site and may/may not have restrictions on what your gyn can discuss for non-medically indicated contraception options. Your local gyn or your local Planned Parenthood should be able to discuss various tubal ligation techniques and non-surgical options as well.

If the goal is only to prevent pregnancy, vasectomy for your partner may also be an option and certainly would be less invasive and less expensive.

If you are outside of the USA, I defer entirely to others for the best approach.
posted by beaning at 4:11 PM on June 25, 2022 [1 favorite]

My mother did precisely this when she was your age. I remember her telling me that while it was unlikely for exactly the same kinds of reasons that you put forward, she was still technically capable of getting pregnant and she did NOT want to have any surprises in her late 40s. I myself am thinking of doing the same thing -- my copper IUD will expire in a couple of years and I absolutely do not want even a ghost of a chance, no way.
posted by pleasant_confusion at 5:03 PM on June 25, 2022 [5 favorites]

If you have a period you can get pregnant until proven otherwise. It does not seem you want to prove otherwise. I think it is very reasonable to discuss contraceptive options further, which include non-hormonal options like surgical sterilisation or copper IUDs.
posted by chiquitita at 9:11 PM on June 25, 2022 [2 favorites]

I don’t know what their specific circumstances were, so I wish I could give more detail that I can’t. But over the course of my life I’ve known a handful of women who got tubal ligations at your age.
posted by The Underpants Monster at 9:31 PM on June 25, 2022

I had Essure done at the age of 49. No complications, but others have reported that the implants were nothing but trouble.

If I had known about the procedure of bilateral salpingectomy, in which the Fallopian tubes are removed, I would have chosen it instead. No risk of ectopic pregnancy and no complication risk from the Essure implants.
posted by Sheydem-tants at 10:24 PM on June 25, 2022

Certainly people do get pregnant in their forties, but considering what your gyn said about your hormone levels, and how (relatively) close you are to the finish line, and considering that abortion remains legal in many states as well as Mexico and Canada and that abortion pills will continue to cross state lines, and also considering the cost and risks of surgery — I personally would stock up on Plan B, consider obtaining abortion pills as a Plan C, look into copper IUDs; and maybe start saving some emergency money in case I had to take an out of state trip.
posted by hungrytiger at 12:42 AM on June 26, 2022 [3 favorites]

CNM/NP here (TINMA, etc). Menopause is one year without periods, so if you’re still having a period, you’re still ovulating and can still get pregnant (although the chance ultimately is low).

Many women 45 and up choose a Mirena because the hormone (progestin) can be used as part of HRT in menopause (if that’s a road you go down) and helps with a lot of perimenopausal period changes (periods getting heavier and longer). If you put a Mirena in after 45, you can generally leave it until 55 (unless using as HRT, when it should be replaced every four years). This is also offered to people considering sterilization because it’s less invasive and statistically as effective as a tubal.

That said, you are not at all too old to be sterilized. Sounds like you are quite sure you don’t want kids or pregnancies, so there is no reason not to do a tubal if you want. Good luck to you.
posted by stillmoving at 5:28 AM on June 26, 2022 [1 favorite]

I am in my mid-40s and had a bilateral salpingectomy last month. While I wish I could have had it done much, much sooner, 40s is definitely not too late. This made extra sense for me to do as well, since tube removal greatly reduces your risk of ovarian cancer (which runs in my family). Yet another reason why a procedure like this is a healthcare issue and not simply an age-bound reproduction issue.
posted by iamkimiam at 5:58 AM on June 26, 2022 [4 favorites]

I had a tubal ligation about 10 years ago, when I was 45. I may have been perimenopausal at the time, but I can't recall. I had no effects and it was a very simple procedure.
posted by sundrop at 7:44 AM on June 26, 2022