Essure - Does It Really Work? How Safe Is It?

When it comes to the birth control, most women opt for oral contraceptive pills (mostly containing estrogen or progesterone) or the use intrauterine contraceptive device or IUD to deal with unwanted pregnancies. Most of these, however, provide only temporary freedom from pregnancy. When we talk about the permanent birth control measures, not many people (especially in India and the neighbouring countries) are aware of Essure. Essure is a female sterilization procedure which, when performed, makes a woman infertile for the lifetime. In this article, we will discuss Essure in detail, including its merits and demerits.

What is Essure?
Approved by FDA in 2002, Essure is a relatively new procedure that sterilizes a woman permanently by placing an insert in each of the fallopian tubes. The event serves as a trigger for the formation of a barrier (mainly comprising of scar tissues) around each of the flexible inserts. It is this barrier that prevents the fertilization of the eggs to take place (the sperm fails to cross the barrier to reach the egg) thereby preventing pregnancy.It takes between 2.5-3 months (approx) for the barrier to form. During this period, a woman should continue with the birth control pills and oral contraceptives to negate the chances of her getting pregnant. There is an Essure Confirmation Test performed at the end of 3 months, after which a woman can discontinue the use of the oral contraceptives and pills.

Who should avoid Essure?
In spite of its effectiveness and being minimally invasive, Essure may not be a wise option under the following circumstances.

1. A woman who has plans of conceiving in the future.
2. There is unusual and unexplained vaginal bleeding.
3. A woman who is already pregnant.
4. A woman being allergic to metals (silver-tin, titanium, platinum, stainless steel, nickel) or fibres (especially polyester).
5. Cancer affecting the ovary, cervix, and other female reproductive organs.
6. Women with gynaecological infections (active) or tubal damage should refrain from undergoing Essure.

Merits and demerits of Essure
Essure comes with a myriad of benefits, some of which include:

1. Essure is a minimally invasive sterilization procedure that comes with a success rate of almost 99.3% (once there is an Essure Confirmation Test).
2. In most cases, the entire procedure of Essure takes a maximum of 40 minutes with the patient getting back to normal life within a day or two.
3. Unlike the various birth control pills, Essure does not involve the use of any hormones (especially the sex hormones estrogen and progesterone, which can trigger many complications and side effects including a hormonal imbalance).

Unfortunately, with merits come the demerits. Many medical practitioners are skeptical about the effectiveness and safety of Essure.

1. Many women having undergone Essure have complained of moderate to excruciating pain (short-term or chronic).
2. Following Essure, there have been uterine and fallopian tube perforations in some women, though the percentage of such women is really low.