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Updated November 10, 2014.

What is Essure Birth Control?

Essure birth control is a FDA-approved permanent contraception option for women who may not want to undergo traditional tubal ligation. A tubal ligation is a procedure that where your fallopian tubes are closed, cut, or "tied." Once the tubes are closed off, sperm will not be able to reach an egg, so the egg cannot become fertilized, and pregnancy will not take place. Having your “tubes tied” is considered a surgical procedure.


Essure is considered hysteroscopic sterilization. This is a type of tubal sterilization procedure that uses your body’s natural openings to place small implants into the fallopian tubes. It is the only non-surgical permanent contraception option, is performed in a doctor’s office and does not require an overnight stay.

     -->The Essure Birth Control Procedure

How Does Essure Birth Control Work?

Essure works by “plugging up” the fallopian tubes. During the Essure procedure, two small metal springs (known as inserts) are placed in each fallopian tube. Over time, the coil implants will trigger scar tissue to grow around them. The scar tissue serves to permanently block the tubes. The Essure implants are inserted, without surgery, through a hysteroscope (an instrument that is inserted through the vagina and cervix and then into the uterus).

Benefits of Essure Birth Control:

• The Essure inserts do not contain or release any hormones.
• Essure is the only sterilization choice that does not require a skin incision.

• It is a non-surgical procedure.
• Essure is one of the most effective forms of birth control available.

Compared to surgical tubal ligation procedures, Essure:

• Leaves no visible scarring (since no incisions are made)?.
• Is safer? since there is no need to use general anesthesia or sedation.
• Is a good, safe option for women with certain medical conditions, such as heart disease and obesity (surgical tubal ligation is often not recommended for women with these conditions)?.
• Does not require an overnight hospital stay.?
• Offers a faster recovery -- most women go home within 45 minutes after having Essure inserted and can return to normal activities within 1-2 days (where as it often takes 4-6 days before women can return to their normal activities after a surgical tubal ligation)?.

Essure Disadvantages:

• Once you obtain Essure, this procedure cannot be reversed. This is because the tissue around the implants grows and creates a closed passage. When this happens, the fallopian tubes will become damaged by surgically removing the inserts.
• It can take three months (and possibly up to 6 months) for the tissue to build up around the inserts and completely block the fallopian tubes. During this time, you will need to use back-up contraception. You cannot depend on Essure as birth control until your doctor confirms that your tubes have been fully blocked.
• Three months after having the Essure implants inserted, you will need to schedule another doctor’s appointment. At this appointment, your doctor will perform a hysterosalpingogram (an x-ray using contrast dye) to determine if the inserts are correctly placed and if your tubes are completely blocked. Once your doctor confirms this, then you will no longer need to rely on back-up birth control.

Who Should Not Use Essure?

Essure may not be the best birth control method for you if:

• You have one or both fallopian tubes closed or obstructed.
• You have already had your “tubes tied” surgically.
• You only have one fallopian tube.
• You do not want to use an alternative birth control method for three months or are not willing to have the confirmation hysterosalpingogram.
• You are not certain that you do not want to get pregnant in the future.

You should also not seek Essure if you are allergic to contrast dye used during the hysterosalpingogram.

You may need to wait to obtain Essure if you:

• Are pregnant or have been pregnant within the past 6 weeks.
• Have had a recent pelvic infection.
• Are in the second half (weeks 3 and 4) of your menstrual cycle. During that time, there is an increased risk of being pregnant prior to undergoing the Essure procedure.

A Note About the Essure Inserts:

The inserts used for Essure birth control are soft and flexible, so they can easily bend and conform to your body’s shape. Although the inserts do not contain hormones, they are made of materials that include a nickel-titanium alloy. Once the Essure inserts are positioned inside the fallopian tubes, small amounts of nickel are released from the inserts. Because of this, Essure may not be the best option for you if you are allergic to nickel.

Essure Costs:

Medicaid should cover the cost for this birth control method. You should check with your private health insurance policy as coverage for the Essure birth control procedure as well as the confirmation hysterosalpingogram should be covered with no copays or out-of-pocket costs for all non-grandfathered insurance plans.

• Why Do I Still Need to Pay for Essure?

Safety and Effectiveness of Essure Birth Control:

Because the FDA received many health complaints (that were not indicated on Essure product labeling or described in clinical research) from women who have obtained Essure birth control, the agency conducted a review of Essure’s safety. The FDA evaluated the available clinical literature to determine what long-term complications may be associated with Essure more than five years after placement since the post-approval study of Essure only evaluated safety and effectiveness up to five years.

     -->Risks Associated with Essure Birth Control Procedure

The FDA concluded that,

“Although there is evidence of complications, as there are with all medical devices, overall results from this study did not demonstrate any new safety problems or an increased incidence of problems already known. …To date, we have found no evidence in the literature indicating any new or more widespread complications definitely associated with Essure occurring more than five years after Essure placement.”

Essure is considered to be 99.83% effective at permanently preventing pregnancy.  Out of every 1,000 women who use Essure for 5 years, 1.7 will become pregnant.

Essure effectiveness is lowered if:

• You do not use a back-up method until fallopian tube blockage is confirmed.
• The confirmation hysterosalpingogram is misinterpreted/misread.
• You have the NovaSure procedure (a procedure that removes the lining of the uterus to lighten or stop menstrual bleeding) after undergoing Essure.
• You are using medications that suppress your immune system, such as chemotherapy or corticosteroids (like prednisone).

STD Protection:

Essure birth control offers no protection against sexually transmitted infections.

Sources:

<sub>Basinski CM. "A review of clinical data for currently approved hysteroscopic sterilization procedures." Rev Obstet Gynecol 2010;3:101–10. Accessed via private subscription.

FDA. "Essure Permanent Birth Control." 06/06/2014. Accessed 10/21/14.

Shavell VI, Abdallah ME, Diamond MP, Kmak DC, Berman JM. "Post-Essure hysterosalpingography compliance in a clinic population." J Minim Invasive Gynecol 2008;15:431–4. Accessed via private subscription.</sub>