Female sterilization has traditionally been done with
tubal ligation. This is a surgical procedure where the fallopian tubes are cut and tied to keep eggs released from the ovaries from reaching the uterus.
By comparison, Essure is a small metallic implant that is placed into a woman’s fallopian tubes. Unlike other sterilization procedures for women, no incision or
general anesthesia
is required.
How Does Essure Work?
A tool called a hysteroscope is inserted into the vagina and through the cervix. The tool allows the doctor to see inside of the uterus. A thin tube is used to thread the Essure device through the vagina, uterus, and then into the fallopian tube. This procedure is repeated to implant a second device into the other fallopian tube. The procedure causes pain in some women, but it is likely that pain is less than with other forms of permanent sterilization.
Essure implants work by causing scar tissue to form over the implant. The scar tissue permanently blocks the fallopian tube and prevents fertilization of the egg by the sperm.
How Long Does It Take to Work?
Women must use an alternate birth control method for 3 months after the procedure. This will allow the scar tissue to grow. At the 3-month point, the doctor checks to make sure that the device has been properly placed, and that the scar tissue has fully blocked the fallopian tubes. This is done with an injection of dye into the uterus followed by an x-ray. If implantation was successful, alternate contraception can be stopped. In some cases, implantation is not successful.
Is It Effective?
The Essure device is 99.8% effective in preventing pregnancy. Pregnancies that do occur after sterilization are more likely to be ectopic pregnancies, which occur outside the uterus and can be life-threatening.
Other risks associated with Essure include:
- Infection
- Pain or cramping
- Blockage of the fallopian tube on only 1 side
- Damage to the uterus or fallopian tube during the procedure
- Vaginal bleeding
- Changes in menstrual cycle
- Nausea or vomiting
- Lightheadedness
Is This the Right Procedure for You?
Essure is not the right procedure if you:
- Want to become pregnant—Essure is permanent. You will not be able to have a baby.
- Think you may be pregnant
- Are allergic to nickel (used in the insert) or contrast dye (used in imaging tests)
- Have a condition that affects your uterus or fallopian tubes
Talk to your doctor to find out if Essure is a good option for you.
RESOURCES
Planned Parenthood http://www.plannedparenthood.org
US Food and Drug Administration http://www.fda.gov
CANADIAN RESOURCES
The Canadian Women's Health Network http://www.cwhn.ca
The Society of Obstetricians and Gynaecologists of Canada http://www.sogc.org
References
Duffy S, Marsh F, Rogerson L, Hudson H, Cooper K, Jack S, et al. Female sterilisation: a cohort controlled comparative study of ESSURE versus laparoscopic sterilisation. BJOG. 2005;112:1522-1528.
Essure System—P020014. US Food and Drug Administration website. Available at: http://www.fda.gov/MedicalDevices/ProductsandMedicalProcedures/DeviceApprovalsandClearances/Recently-ApprovedDevices/ucm083087.htm. Updated September 5, 2013. Accessed July 29, 2014.
Female Sterilization (Essure). Planned Parenthood website. Available at: http://www.plannedparenthood.org/stlouis/female-sterilization-38378.htm. Accessed July 29, 2014.
Sterilization for women and men. American College of Obstetricians and Gynecologists website. Available at: http://www.acog.org/~/media/For%20Patients/faq011.pdf?dmc=1&ts=20120818T2151049198. Published September 2015. Accessed July 15, 2016.
Are you ready for permanent birth control? Essure.com website. Available at: http://www.essure.com/permanent-birth-control/is-your-family-complete. Updated May 2016. Accessed July 15, 2016.