* Make sure you thoroughly consider all other possible methods of contraception before resorting to TL
* Ensure as far as possible that you won’t regret your decision. Do not make your decision during a time of stress – such as after an abortion or at the time of a relationship crisis
* Do the usual things to minimise the risk of surgery: stop smoking and lose weight if you are obese
* Choose a surgeon you trust, one who is familiar with the operation and knows the risks. Discuss with him the safest way to perform the procedure
* If possible, choose local anaesthesia as this has a lower risk
* Opt for clips, which cause the least amount of damage of all TL methods. The clip method uses a hinged spring clip, which is locked perpendicularly across the fallopian tube to cause an obstruction. The most common types are the Filshie clip, made of titanium, and the Wolf (or Hulka) clip, made of plastic. The failure rate after 10 years with, for example, the Filshie clip is less than one in 333-500, or 0.3-0.2 per cent.
* Homoeopathic remedy Arnica 30C to help with the bruising, swelling and shock of TL surgery (Br Hom J, 1978; 65: 8)
* Milk thistle (Silybum marianum) to detoxify the liver after anaesthesia. Take 3 mL (tincture) or 500 mg/day (capsules)
* Immunonutrients such as arginine, glutamine, omega-3 fatty acids and nucleotides to boost your immune system (BMJ, 2003; 327: 117-8)
* Valerian to help you relax and to ease postoperative pain
* A 100-mL tincture of equal amounts of Echinacea, gotu kola, Salvia miltiorrhiza and comfrey to help regenerate the body (from Kingham Herbs & Tinctures, tel: 01608 659 600). Take 5 mL three times a day for no more than three weeks
* The advice of a medical herbalist for more potent pain-relieving tinctures or remedies
* Light therapy, including colour, to reduce stress and, thus, boost immune function. Consider switching to full-spectrum or daylight bulbs in your home (available from http://www.verilux.co.uk and http://www.thenaturalapproach.co.uk)
* Herbal remedies that include hormonal helpers such as chasteberry (Vitex agnus castus) or black cohosh, which may be helpful for restoring hormonal balance and other associated symptoms. However, it may be best to consult a medical herbalist before self-prescribing these powerful herbs.