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Notes on Women's Health
Notes on Women's Health

The End of Essure as a Permanent Birth Control Option: What You Need to Know

Patient speaking with doctor about birth control and EssureA look back at Essure

It’s been almost 16 years since the Food and Drug Administration approved Essure in late 2002. Back then, Essure was created as an alternative to tubal ligation, a surgical procedure in which a woman’s “tubes are tied” — or, more accurately, clamped and sealed, resulting in sterilization and permanent birth control.

How does Essure work?

Essure implants consist of two tiny, implantable metal coils that are inserted into the fallopian tubes — a pair of tubes along which eggs travel from the ovaries to the uterus. Once inside the fallopian tubes, Essure implants cause scar tissue to gradually form, eventually blocking the tubes and preventing fertilization of a woman’s eggs. While tubal ligation is considered major surgery that requires local, general or spinal anesthesia, Essure involves a simpler procedure that can be done in a doctor’s office, with less anesthesia required.

Essure’s controversy and discontinuation

For the past few years, Essure has become controversial, with many women complaining of side effects, including pain, internal bleeding, perforation of the uterus, and unintended pregnancies.  Nevertheless, more than 99% of women who have undergone this procedure have had no side effects or failures of sterilization. A few weeks ago, the company that owns the product — Germany-based Bayer — announced that it would end the sale of Essure in the United States by the end of 2018. According to the company, the decision to discontinue Essure was due to declining use and not because of safety issues or lawsuits.

How Essure’s discontinuation affects our practice

Like many other ob/gyn practices, we’ve provided Essure implants for many years. While no procedure of this type is risk-free, we found Essure to be an effective and generally complication-free approach to birth control. However, as a result of Bayer’s decision, we will no longer offer Essure implant procedures.

For women who are considering contraception options, there are other birth control methods that we recommend, including hormonal methods, IUDs and bilateral salpingectomy (surgical removal of fallopian tubes), which is more considered to be more effective than tubal ligation in preventing pregnancy and is also effective in preventing 75% of ovarian cancers.

What to do if you have Essure implants

If you have Essure implants already, there’s no need to be concerned unless you’re experiencing side effects or complications. These can include:

If you have any of these symptoms, you should contact your gynecologist. Although it’s possible that your symptoms may be related to Essure implants, there may be another cause, such as endometriosis or adenomyosis.

If you need to have your Essure implants removed, be sure find a gynecologist who has experience with this kind of procedure. You may also wish to consider a bilateral salpingectomy after the implants are removed. If you have any questions, feel free to contact us.

Additional information

Additional information from the American College of Obstetricians and Gynecologists can be found on the following webpages:

About the practice

Dr. John Garofalo, M.D., is a gynecologist located in Fairfield County, Connecticut. He has more than 20 years of practice and surgical experience covering many facets of obstetrics and gynecology.

Laury Berkwitt, APRN, is a nurse practitioner specializing in women’s health in Fairfield County, Connecticut. Laury has a passion for providing quality women’s healthcare in a safe and comfortable manner by creating a trusting patient-practitioner relationship. She has been in practice for more than 10 years, caring for women of all ages.