Hi Alice,

I noticed that you have information on tubal ligation (surgical sterilization for women), but not on Essure. Can you tell me more about it? What are the risks and benefits?

Thanks.

Your #1 Fan

Dear Your #1 Fan,

Thanks for pointing to a gap in the Contraception category. As you allude to in your question, if by surgery, you mean a procedure that requires an incision, then you are correct: Essure is a birth control method that works to prevent pregnancies much like tubal ligation. Both are types sterilization, which means that they both inhibit the ability for sperm to meet an egg (and in turn, fertilization). They do this by physically and permanently blocking the fallopian tubes, but they do this in different ways (more on that in a bit). And much like other birth control methods, Essure does have its share of pros and cons, which are worth exploring prior to deciding on a birth control method.

While tubal ligation is a procedure that physically ligates (ties off, staples, or clamps) the fallopian tubes, Essure is not so much a procedure, but a product. Small coils made of metal and fiber are inserted into the fallopian tubes and over time, scar tissue builds up around the coils and blocks the tubes – thus achieving the same end result. The main difference between tubal ligation and Essure is that tubal ligation requires an incision through the wall of the pelvis. With Essure, no incision is required. A health care provider inserts the coils into the fallopian tubes by passing it through the uterus. To do this, a thin tube with a camera on the end called a hysteroscope is inserted through the vagina and cervix (which is first filled with water to ensure the fallopian tubes are open). The hysteroscope then uses a catheter to insert the coils into the fallopian tubes. Most women who’ve undergone the Essure placement procedure are sent home that same day. Although there may be some pain or discomfort, resuming normal activities are typically given the green light that day or the next.

It’s good to note that Essure is not immediately effective as birth control, as it takes time for the scar tissue to form (up to three months). To prevent pregnancy during this time, using another method of birth control for the first three months, such as the pill, the patch, or condoms is advised. After three months, an ultrasound or X-ray will help confirm whether the coils are in the right place and that the fallopian tubes are blocked. Once that’s been established by a health care provider, other methods of birth control can be stopped. Essure does not protect against sexually transmitted infections (STIs) so the use of condoms or barrier methods are recommended if a person is concerned about her/his risk.

There are additional benefits and risks involved in using Essure, like all methods of birth control. Reviewing them can really inform the decision-making process regarding this specific method.

The other benefits of Essure include:

  • Permanence and effectiveness: women who have had the Essure procedure have a less than one percent chance of becoming pregnant
  • Generally quick and painless insertion: no need for general anesthesia during insertion, the coils can be placed in less than an hour, and placement doesn’t result in scarring or wound healing due to intravaginal insertion
  • Not interruptive to sex: that is to say once scar tissue has developed (not including methods used to reduce STI risk)
  • Menstrual periods are not affected

Risks may include:

  • Considered permanent and not reversible: women who think they may want to become pregnant in the future may want to seek out another method.
  • Some side effects: immediate side effects of the placement procedure can include abdominal or pelvic pain, bleeding or spotting, cramping, dizziness, nausea, or vomiting (though usually short-lived)
  • Infection, persistent pelvic pain, perforation or tearing of the uterus or fallopian tubes
  • Only one of the fallopian tubes being blocked
  • May interfere with a previously inserted intrauterine device (IUD)
  • Eligibility for future surgeries that involve electrosurgical procedures (the metal coils could conduct electricity and damage tissues)

If extreme or persistent pelvic pain is experienced as a result of using Essure, or if a coil comes out of the vagina, it’s crucial to seek medical care immediately. Additionally, this method of birth control isn’t recommended for all women. This includes those who have a sensitivity or allergy to nickel, an existing uterine or fallopian tube blockage, a recent pelvic infection, been pregnant or given birth, or have had her fallopian tubes previously ligated may not be the best candidates for this method.

Learning more about this product is a great first step in deciding whether to use Essure. As far as next steps are concerned for those interested in the method, making an appointment to chat further with a health care provider is recommended!  

Alice!

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