Risks of NOT Getting a Vasectomy

The purpose of this page is to explain the risks to one’s partner of NOT getting a vasectomy.

Risks of the following Hormonal Contraceptives

Birth Control Pills
Blood clots – 0.03% per year
BUT for women a history of clots, the risk substantially increases.

Daily contraceptive pills combine estrogen and progestin to prevent pregnancy. With perfect use, the failure rate is 0.3%; however, the typical use failure rate is 8%. Due to the high rate of misuse/discontinuation of oral contraceptive pills, about 1,000,000 unplanned pregnancies occur each year as a result.

Healthy women who do not smoke cigarettes have almost no chance of having a severe side effect from taking oral contraceptives. For most women, more problems occur because of pregnancy than will occur from taking oral contraceptives.

The most common birth control implant is the 1 rod Implanon. 1 inch long Implanon is inserted into the arm under the skin and releases progestin.

Irregular bleeding is the most common side effect, espeically in the first 6-12 months of use. After one year, 1 out of 3 women who use the birth control implant will stop having periods completely. Some women have longer heavier periods. Some women have increased spotting and light bleeding between periods.
1% or more: bleeding irregularies, emotional lability, weight increase, headaches, acne, and/or depression
>5% of users: headache, vaginitis, weight increase, acne, breast pain, abdominal pain, pharyngitis, leukorrhea, influenza-type symptoms, dizziness, dysmenorrhea,
back pain, emotional lability, nausea, pain, nervousness, depression, hypersensitivity, insertion site pain

The Ring
Common adverse reactions experienced by 2-14% of users

The Nuvaring® is a soft ring about an inch in diameter that is inserted in the vagina 3 weeks out of the month and taken out for the remaining week of the month. The ring releases constant, low hormone levels (a combination of estrogen and progestin) that are systematically absorbed via the vaginal mucosa. Typical use results in a 9% failure rate.

Common side effects include: vaginal infections/irritation, vaginal secretion, headaches, weight gain, nausea. Other possible side effects include vomiting, change in appetite, abnormal cramps/bloating, breast tenderness/enlargement, irregular vaginal bleeding/spotting, changes in menstual cycle, temporary infertility after treatment, fluid retention (edema), spotty darkening of the skin (particularly on the face), rashes, weight changes, depression, intolerance to contact lenses,decreased libido, nervousness, dizziness, and loss of scalp hair. Severe risks include blood clots, stroke/heart attack, high blood pressure, heart disease, gallbladder disease, liver tumors, and lipid metabolism and inflammation of the pancreas.

Birth control patch
Unpleasant side effects in over 2.5% of users (See below)
The birth control patch (Generic name: Norelgestromin, Brand name: Ortho Evra®) is applied on the skin three weeks of the month and removed for the remaining week of the month. It releases a combination of estrogen and progestin. With perfect use, the failure rate is 0.3%, while the typical use failure rate is 8%.

Potential side effects include blood clots, heart attack, gallbladder disease, liver tumors, and cancer of the reproductive organs and breasts. Like pregnancy, hormonal birth control methods increase the risk of serious blood clots. Women who use Ortho Evra® have a greater risk than nonusers of having gallbladder disease. In rare cases, combination oral contraceptives can cause benign but dangerous liver tumors.

Adverse reactions reported by >2.5% of users: breast symptoms, dysmenorrhea, vaginal bleeding/menstrual disorders, nausea, abdonimal pain, vomiting,
diarrhea, headaches, dizziness, migraines, application site disorder, fatigue, psychiatric disorders, acne, pruritus, vaginal yeast infections, weight gain

Adverse reactions reported by <2.5% of users: Abdominal distention, fluid retention, cholecystitis, blood pressure increase, lipid disorders, muscle spasms, insomnia, increased/decreased libido, galactorrhea, genital discharge, premenstrual syndrome, uterine spasms, vulvovaginal dryness, pulmonary embolism, chloasma, dermatitis contact, erythema, skin irritation. http://www.rxlist.com/ortho-evra-side-effects-drug-center.htm The Shot
Unpleasant side effects (below) – 5%
The shot (Brand name: Depo-Provera®) is a form of progesterone, and is a contraceptive that is injected every 13 weeks, or 90 days.

Common side effects include: nausea, stomach cramping/bloating, dizziness, headache, tiredness, breast tenderness, decrease in breast size, acne, hair loss, or irritation/pain at injection site, decreased sex drive, hot flashes, joint pain.

Serious side effects include: heavier/longer periods, sudden numbness/weakness, sudden/severe headache/confusion, chest pain, coughing, wheezing, pain/swelling in the legs, fever, nausea, upper stomach pain, swelling in hands/ankles/feet, symptoms of depression.

Adverse reactions that were reported by more than 5% of subjects included: headache (16.5%), abdominal discomfort (11.2%), increased weight >10 lbs at 24 months (37.7%), nervousness (10.8%), dizziness (5.6%), libido decreased (5.5%), menstrual irregularities – bleeding at 12 months (57.3%), bleeding at 24 months (32.1%), amenorrhea at 12 months (55%), amenorrhea at 24 months (68%).

Adverse reactions that were reported between 1-5% of subjects included: Asthenia/fatigue (4.2%), backache (2.2%), dysmenorrhea (1.7%), hot flashes (1.0%), nausea (3.3%), bloating (2.3%), edema (2.2%), leg cramps (3.7%), arthralgia (1.0%), depression (1.5%), insomnia (1.0%), acne (1.2%), no hair growth/alopecia (1.1%), rash (1.1%), leukorrhea (2.9%), breast pain (2.8%), vaginitis (1.2%).

Mirena® IUD
Perforation of the uterus: 0.1%
Expulsion sometimes unnoticed and resulting in unplanned pregnancy: 2-10%

The Mirena® IUD, or the Levanorgestrel intrauterine device is inserted into the uterus, contains progestin only, and lasts from 5-7 years. This IUD prevents fertilization by damaging or killing sperm and making the mucus in the cervix thick and sticky, so sperm can’t get through to the uterus. It also keeps the lining of the uterus (endometrium) from growing very thick. Typical use of the Mirena® IUD results in 0.2% failure rate.

Both IUDs pose the risks of perforation and expulsion. Perforation of the uterus by the IUD occurs in about 1/1000 women. About 2 to 10 out of 100 IUDs are pushed out (expelled) from the uterus into the vagina during the first year. When an IUD is expelled, a woman is no longer protected against pregnancy. Expulsion can occur without detection.

Paragard® IUD
Perforation of the uterus: 0.1%
Expulsion sometimes unnoticed and resulting in unplanned pregnancy: 2-10%

The Copper T IUD (Brand name: Paragard®) does not contain hormones and lasts between 10-12 years. It can be used as emergency contraception. Copper is toxic to sperm. It makes the uterus and fallopian tubes produce fluid that kills sperm. Typical use of the Paragard® IUD results in 0.8% failure rate.

Both IUDs pose the risks of perforation and expulsion. Perforation of the uterus by the IUD occurs in about 1/1000 women. The copper IUD may increase menstrual bleeding or cramps. About 2 to 10 out of 100 IUDs are pushed out (expelled) from the uterus into the vagina duringthe first year. When an IUD is expelled, a woman is no longer protected against pregnancy. Expulsion can occur without detection.

Risks of Pregnancy

Pregnancy-induced hypertension (PIH) (high blood pressure) – 6-8%

3 types: (1) Chronic hypertension: Women who have high blood pressure (over 140/90) before pregnancy, early in pregnancy (before 20 weeks), or carry it on after delivery. (2) Gestational hypertension: High blood pressure that develops after week 20 in pregnancy and goes away after delivery. (3) Preeclampsia: Both chronic and gestational hypertension can lead to this severe condition after week 20 of pregnancy.

Effects of condition: Hypertension can prevent the placenta from getting enough blood. If the placenta doesn’t get enough blood, your baby gets less oxygen and food. This can result in low birth weight. Most women can still deliver a healthy baby if hypertension is detected early and treated with regular prenatal care. If hypertension is severe, it can leave to preeclampsia, which can have much for serious effects on mothers and babies.

Preeclampsia/toxemia – 2-6%
Preecplampsia is a condition that occurs only during pregnancy. It usually occurs after week 20 of pregnancy. Preeclampsia may also be called toxemia and is often precluded by gestational hypertension.

Symptoms: high blood pressure, water retention, headaches, blurred vision, fatigue, nausea/vomiting, reduced urine, pain in the upper abdomen, and shortness of breath.

Effects of condition: Preecplampsia can lead to serious complications for the mother such as liver/renal failure, future cadiovascular issues and two other conditions directly related to preeclampsia that could be life threatening. Eclampsia is a severe form of preeclampsia that leads to seizures in the mother. HELLP (hemolysis, elevated liver enzymes, and low platelet count) is a condition usually occurring in late pregnancy that affects the breakdown of red blood cells, the blood clots, and the liver function for the pregnant woman.

Placenta Previa (Placenta obstructing birth canal) – 0.5%
Placenta previa is the attachment (implantation) of the placenta over or near the cervix, in the lower rather than the upper part of the uterus.

Symptoms/effects of condition: Women may have painless, sometimes profuse bleeding late in pregnancy.
Abruptio Placentae (Separation of placenta from the uterus before the baby is delivered) – 0.1%

Placenta abruptio is the separation of the placenta (the organ that nourishes the fetus) from its attachment to the uterus wall before the baby is delivered.

Symptoms: Abdominal pain, back pain, frequent uterine contractions, uterine contractions with no relaxation in between, vaginal bleeding
Effects of condition: Fetal distress occurs early in the condition in about half of all cases. Infants who live have a 40-50% chance of complications, which range from mild to severe.

Ectopic (outside the uterus) Pregnancy – 2%
With an ectopic pregnancy, the fertilized egg implants somewhere outside the uterus. An ectopic pregnancy can’t proceed normally. The fertilized egg can’t survive, and the growing tissue might destroy various maternal structures. Left untreated, life-threatening blood loss is possible. Early treatment of an ectopic pregnancy can help preserve the change for future healthy pregnancies.

Symptoms: Abdominal/pelvic pain and light vaginal bleeding are often the first warning signs of an ectopic pregnancy. If the fallopian tube ruptures, heavy bleeding inside the abdomen is likely.

Effects of the condition: A fertilized egg cannot develop normally outside the uterus. To prevent life-threatening complications, the ectopic tissue must be removed. The cell growth is terminated either through an injection of the drug methotrexate or through laproscopic surgery.

Miscarriage – 10-20%
Miscarriage is the spontaneous loss of a pregnancy before the 20th week. Most miscarriages occur because the fetus isn’t developing normally.

Symptoms: Most miscarriages occur before the 12th week of pregnancy. Signs include: vaginal spotting/bleeding, pain/cramping, fluid/tissue passing from the vagina
Effects of condition/treatment: This can be a very emotionally difficult time. In this situation, women may choose let the miscarriage progress naturally, pursue medical intervention with medicine to speed along the expulsion process, or opt for surgical treatment.

Gestational Diabetes – 2-10%
Gestational diabetes develops during pregnancy (gestation). Gestational diabetes causes high blood sugar that can affect the pregnancy and baby’s health.

Incidence: Reported rates of gestional diabetes range from 2-10% of pregnancies. Immediately after pregnancy, 5-10 percent of women with gestational diabetes are found to have diabetes, typically Type 2. Women who have had gestational diabetes have a 35-60% chance of developing diabetes in the next 10-20 years.

Effects of condition: Most women who have gestational diabetes deliver healthy babies. However, gestational diabetes that’s not carefully managed can lead to uncontrolled blood sugar levels and cause problems for women and babies, including an increased likelihood of needing delivery by C-section.

Rh Incompatibility
Rh incompatibility is a condition that develops only when a pregnant woman has Rh-negative blood and the baby in her womb has Rh-positive blood. Thanks to the use of special immune globulins called RhoGHAM, this problem has become uncommon in places that provide access to good prenatal care.

Symptoms: Rh incompatibility can cause symptoms ranging from very mild to deadly. In its mildest form, Rh incompatibility causes the destruction of red blood cells without other effects.
Effects of condition: After birth, the infant may have: yellowing of skin/eyes, low muscle tone (hypotonia), brain damage due to high levels of bilirubin, fluid buildup and swelling in the baby, problems with mental functioning, movement, hearing, speech, and seizures. http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002567/

Rupture of the uterus – 1-8%
Rupture of the uterus during pregnancy or labor is a serious emergency that can be fatal to both mother and fetus. Uterine rupture results in: bleeding, rupture of the amniotic sac, partial or full delivery of the fetus into the abdominal cavity, and loss of oxygen delivery to the fetus.

Incidence: Uterine rupture is a rare event, occurring in less than 1% of women with a low transverse cesarean section scar, 2-4% with low vertical scar, and 4-8% with previous classical cesarean incision.

Effects of condition/treatment: If the baby has not been delivered, then an emergency C-section is scheduled. If damage to the uterus is not too severe and the bleeding is easily controlled, a hysterectomy can be avoided. This process generally calls for a blood transfusion for the mother, due to the amount of blood loss, plus antibiotics to prevent infection. http://healthline.com/health/pregnancy/complications-uterine-rupture

Hyperemesis Gravidarum (severe vomiting) – 20%
Hyperemesis gravidarum is extremely severe nausea and excessive vomiting during pregnancy.
Effects of condition/treatment: In some cases, hyperemesis gravidarum requires hospitalization and administration of IV fluids, tube feeding, and medications.

Hyperthyroidism during pregnancy – 2.5%
HCG is the hormone that “pregnancy tests” detect. It has mild thyroid stimulating effects and, as a result, can cause some symptoms of hyperthyroidism.
Incidence: The prevalence of hyperthyroidism in pregnancy is about 0.2%. The most common causes is Graves’ disease. It is estimated that 2.5% of all pregnant women have some degree of hyperthyroidism. The frequency varies among different populations and different countries.

Symptoms: Patients with hyperthyroidism complain of feeling restless, emotionally hyper, and hot and sweaty. They may experience tremors, trouble concentrating, and weight loss. Frequent bowel movements and diarrhea are common.

Effects of condition/treatment: Women with hyperthyroidism may experience miscarriage, preterm labor, low birth-weight babies, stillborns, complications of pregnancy, including pre-eclampsia and heart failure. The treatment of hyperthyroidism in pregnancy is limited because the safety of the baby must also be considered. While the drugs used do cross the placenta and can enter the baby’s system, treatment is still preferred because of the poor outcomes associated with not treating these women.

Risks of childbirth/post-partum

Vaginal and perineal laceration – Majority
Obstetric vaginal and perineal lacerations are classified as first to fourth degree, depending on their depth. Family physicians who deliver babies must frequently repair perineal lacerations after episiotomy or spontaneous obstetric tears.

Effects of condition/treatment: causing pain and scar.

Puerperal infection – 1-8%
The term puerperal infection refers to a bacterial infection following childbirth. The infection may also be referred to as puerperal or postpartum fever. The genital tract, particularly the uterus, is the most commonly infected site.

Given modern medical treatment and antibiotics, it very rarely advances to the point of threatening a woman’s life. An estimated 2-4% of new mothers who deliver vaginally suffer from a puerperal infection, but for cesarean sections, the figure is 5-10 times higher.

Urinary incontinence
During pregnancy, many women experience at least some degree of urinary incontinence, which is the involuntary loss of urine.

Fecal incontinence – 28%
Problems with anal incontinence following childbirth may linger long after childbirth and hurt women’s quality of life and ability to care for their child.

Incidence: In a study, researchers surveyed 1,247 women in Utah who experienced anal incontinence at least once in the two years following childbirth. The results showed that 68% reported anal incontinence symptoms six months after childbirth, and 45% had symptoms 12 months following childbirth. By two years after childbirth, 28% of women still reported bouts of anal incontinence.

Post-partum depression – 10-20%
Most women experience a case of the “baby blues” after the birth of their child. For most, this moodiness and mild depression go away within several days or weeks.

If the depression is combined with lack of interest in the baby, suicidal, or violent thoughts, hallucinations, or abnormal behavior, immediate medical attention is required. These symptoms could indicate a more serious condition called postpartum psychosis.

Uterine infections
If pieces of the placenta remain in the uterus, it can lead to infection.

Symptoms/treatment: An infection of the amniotic sac during labor may lead to postpartum infection of the uterus. Flu-like symptoms accompanied by a high fever; rapid heart rate, abnormally high white blood-cell count; swollen, tender uterus; and foul-smelling discharge usually indicate uterine infection. Uterine infections usually can be treated with a course of intravenous antibiotics.

Post-partum hemorrhage – 18%
Postpartum hemorrhage usually happens because the uterus fails to properly contract after the placenta has been delivered, or because of tears in the uterus, cervix, or vagina.

Effects of condition: “Complications of postpartum hemorrhage include orthostatic hypotension, anemia, and fatigue. Postpartum anemia increases the risk of postpartum depression. In the most severe cases, hemorrhagic shock may lead to anterior pituitary ischemia with delay or failure of lactation (i.e. postpartum pituitary necrosis). Occult myocardial ischemia, dilutional coagulopathy, and death also may occur. Delayed postpartum hemorrhage, bleeding after 24 hours as a result of sloughing of the placental or retained placental fragments, also can occur.”

Perineal (between the legs) pain
For women who delivered vaginally, pain in the perineum (the area between the rectum and vagina) is quite common. These tender tissues may have stretched or torn during delivery, causing them to feel swollen, bruised and sore. This discomfort may also be aggravated by an episiotomy, an incision sometimes made in the perineum during delivery to keep the vagina from ripping.

Kidney infections
A kidney infection, which can occur if bacteria spreads from the bladder, includes symptoms such as changes in urinary frequency, a strong urge to urinate, high fever, a generally sick feeling, pain in the lower back/side, constipation, and painful urination

Treatment: Once a kidney infection is diagnosed, a course of antibiotics – either intravenous or oral – usually is prescribed. Patients are instructed to drink plenty of fluids, and are asked to give urine samples at the beginning and end of treatment to screen for any remaining bacteria.

Clogged Ducts
Clogged milk ducts, which can cause redness, pain, swelling, or a lump in the breast, can mimic mastitis. However, unlike breast infections, caked, clogged, or plugged ducts are not accompanied by flu-like symptoms.

Treatment: Breast massaging, frequent nursing until the breast is emptied, and warm packs applied to the sore area several times a day may solve the problem. However, if a woman has a lump that does not respond quickly to home treatment, she should consult her doctor.

Mastitis, or breast infection, usually is indicated by a tender, reddened area on the breast (the entire breast may also be involved).

Treatment: If a woman has a breast infection, she may continue to nurse from both breasts. Mastitis does not affect breast milk. It’s also important to rest and drink plenty of fluids. Warm, wet towels applied to the affected area may help alleviate discomfort; and cold compresses applied after nursing can help reduce congestion in breasts. Avoiding constricting bras and clothing is also recommended.

Stretch marks – 50%
Stretch marks are the striations that appear on many women’s breasts, thighs, hips, and abdomen during pregnancy.

Treatment: These reddish marks, which are caused by hormonal changes and stretching skin, may become more noticeable after delivery. Although they may never disappear completely, they will fade considerably over time. While many women purchase special creams, lotions and oils to help prevent and erase stretch marks, there is little evidence that they work. The laser treatment can improve stretch marks. http://www.webmd.com/parenting/baby/features/postpartum-problems?page=3

Hemorrhoids/constipation – common
Hemorrhoids and constipation, which can be aggravated by the pressure of the enlarged uterus and fetus on the lower abdomen veins, are both quite common in pregnant and postpartum women.

Treatment: Over-the-counter hemorrhoid cream, accompanied by a diet rich in fiber and fluids, usually can help reduce constipation and the swelling of hemorrhoids. Warm Sitz baths followed by a cold compress also can offer some relief. If hemorrhoid symptoms persist, then medical attention is necessary. The common hemorrhoid treatments include infrared coagulation, rubber band ligation and hemorrhoidectomy.

Risks of tubal ligation
METHODS of tubal ligation include: Female Laparoscopic Sterilization, Postpartum and Interval Minilaparotomy, Cesarean Delivery Tubal, Postabortion Tubal Ligation, and Transcervical Sterilization (Essure®). Methods and risks are described on the following page:

Bleeding – 0.6-1%. Infection – 1%, Death – .002%

Anesthesia-related events
About 1-2% of women undergoing tubal ligation experience anesthesia related events. The anesthesia risk, although low, can be reduced further through increased use of local and regional over general anesthesia.

Ectopic (outside the uterus) pregnancy
In general, female sterilization is protective against ectopic pregnancy because few pregnancies occur in sterilized women. However, if pregnancy does occur, it is more likely to be an ectopic pregnancy following tubal ligation. The CREST study demonstrated that the 10-year probability of ectopic pregnancy for all tubal sterilization methods studied was 7.3 ectopic pregnancies per 1000 procedures, or one third of all post-tubal sterilization pregnancies. Risk differed by occlusion method employed and age of patient at time of procedure, with bipolar coagulation and age under 30 years associated with the higher risk.

Microinsert expulsion – 2.2%
Transcervical sterilization (Essure®) removes the risks of both invasive laparoscopic incisions and general anesthesia. Although no major complications are associated with transcervical sterilization, short-term complications have been reported. 5% of total patients experience unsuccessful bilateral placement. 2.2% of women experience microinsert expulsion.

Perforation of microinserts as a result of transcervical sterilization occurs in 1.5% of cases. Pelvic cramping on the day of the procedure. 29.6% of women experience cramping the day of transcervical sterilization. Back pain in the first year of microinsert use. About 9% of women experience back pain in the year following transcervical sterilization.

Updated on 2018-01-10 by admin