Rather a long winded response but I wanted to explain my experience/reasoning.
I'm 45 and I have one child (3). I definitely don't want any more. I didn't plan my DD (although I wouldn't change anything) and I am far too old to be considering nay more!
I think, from your OP, that we've probably had similar problems with contraception. I can't take the combined pill - it makes me have migraines that have stroke-like symptoms and with both the mini-pill and Mirena coil I bleed almost constantly so they're out too (not to mention getting quite plump on Mirena). I've refused to try the implant or injection as I wouldn't be able to get the drugs out of my system quickly if they give me the same symptoms as combined pill(which seems likely).
I went to see my GP and was immediately referred to a consultant. Obviously, didn't actually see him/her but saw one the minions. He did attempt to suggest that Mirena was the way to go but I explained otherwise (my GP had warned me this would be necessary). He pretty much immediately agreed that I could have the op. I did do the charmingly reasonable but clearly not taking "no" for an answer routine though.
I then had received a date for the op which was only a few weeks away and an pre-operation appointment. I went to that appointment and rearranged the date for the op as it was a bit too quick for me - I wanted a little longer to be certain. Had a chat with the nurse etc and am now booked in for November.
I saw some stories/anecdotes online where people had had unexplained severe pain afterwards and there is no way that the NHS will reverse the operation. This worried me. When I spoke to the nurse about it, she said she'd never seen anyone with these symptoms following sterilization but she had heard of this following other operations. It seems to be a potential effect of surgery in general rather than just this particular operation.
I have decided to go ahead although part of that decision is based on the fact that, apart from contraception, I am medically very dull. I don't generally have complications or difficulties with anything and so am assuming this will be the same (not really a scientific basis).
I am nervous about it and I have some concerns about whether it will affect me psychologically ie feel less feminine or something.
Also, my GP told me that some patients report more period pain/mood swings etc after having the op but, in her experience, those women were previously on combined pill or Mirena and so had hormonal influence. She thinks that the changes may be due to them no longer having the hormonal influence from the contraception rather than the operation. Again, this is anecdotal and not scientific, etc.
Finally, should say that I am in West Yorkshire so not sure if that helps re Health Authority and likely decision, etc.