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Essure

By

Megan Freedman

What is Essure?

Essure provides permanent birth control for women. Essure involves inserting a small coil, called a micro-insert, into both fallopian tubes. The body forms scar tissue over the micro-inserts. This permanently blocks the fallopian tubes so a man’s sperm cannot reach a woman’s egg and fertilize it to begin a pregnancy.

The fallopian tubes are located in the lower abdominal (pelvic) area. They connect the ovaries to the uterus and provide a passage for sperm to move to a woman’s egg and for a fertilized egg to move into the uterus. 

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The Essure procedure is generally considered safe, but it does have risks and potential complications. They are many other birth control methods, each with its own risks and level of effectiveness. Discuss all of your birth control options with your doctor or healthcare provider to understand which option is right for you.  

Why is Essure used?

Your doctor may recommend Essure if you want area woman who wants permanent sterilization and life-long birth control. You should only consider Essure if you are sure you are finished having children or know you don’t want to have children. 

The Essure procedure is an alternative to more invasive permanent birth control procedures, such as a vasectomy for men or a tubal ligation for women. It is also an alternative for temporary types of birth control, such as condoms and the birth control pill and patch.  

Who performs the Essure procedure?

An obstetrician-gynecologist (Ob/Gyn) performs the Essure procedure. An obstetrician-gynecologist is a doctor who specializes in the medical and surgical treatment of conditions of the female reproductive system.

How is the Essure procedure performed?

Your Essure procedure will be performed in an office or clinic. It does not involve incisions or cutting. 

Essure is a type of hysteroscopic or transcervical sterilization that involves inserting a hysteroscope through the vagina and cervix into the uterus. A hysteroscope is a thin, lighted instrument that contains a small camera and special instruments. The camera transmits pictures of the inside of your body to a video screen viewed by your doctor while performing the procedure. 

The Essure procedure generally includes these steps:

  1. You remove your clothing and dress in a gown. Your care tem will provide blankets for modesty and warmth.

  2. You are positioned on a procedure table.

  3. Your doctor inserts a speculum in your vagina to widen its opening.

  4. Your doctor injects anesthetic medication around certain nerves in your cervix (opening to the uterus). This will numb the area. You may also have a sedative medication to relax you and help you stay comfortable. You will be awake, but kept as comfortable as possible during the Essure procedure.

  5. Your doctor inserts the hysteroscope into your vagina, through your cervix, and into your uterus.

  6. Your doctor uses the hysteroscope to insert surgical fluid (a salt-water solution) into your uterus to gain a clear view of your fallopian tubes.

  7. A thin tube attached to the end of the hysteroscope is passed into your fallopian tubes. The surgical tube holds and places the Essure micro-insert.

  8. The hysteroscope is withdrawn from your first fallopian tube and inserted into your other fallopian tube.

  9. Your doctor places the second micro-insert.

  10. The hysteroscope is withdrawn out of your body through your cervix and vagina.

Will I feel pain?

Your comfort and relaxation is important to you and your care team. You may have menstrual-like cramps or discomfort in your lower back or pelvis during the Essure procedure. Take a few long, deep breaths to help yourself relax. Tell your doctor if any discomfort does not pass quickly.

What are the risks and potential complications of Essure?

Complications after an Essure procedure are uncommon, but any procedure involves risks and the possibility of complications that may become serious in some cases. Complications can occur during the procedure or recovery. 

Risks and potential complications of Essure include:

  • Electrolyte imbalance (too much or too little salts in your body) caused by the salt solution that is inserted into your uterus during the Essure procedure

  • Incomplete blockage of the fallopian tubes even after the Essure micro-inserts have been in place for three months

  • Increased risk of a future ectopic pregnancy (a pregnancy occurring outside your uterus)

  • Movement of one or both of micro-inserts out of your fallopian tubes

  • Perforation or puncture of your uterus

  • Vaginal bleeding during or for a few days after Essure placement

Some women should not have Essure due to increased risks. This includes women with the following conditions:

  • Allergy to nickel or the type of dye used in an Essure confirmation test

  • Current or recent infection of the uterus

  • Desire to bear a child in the future

  • Having only one fallopian tube available for the micro-insert

  • A previous tubal ligation

  • Pregnancy or recent pregnancy

Reducing your risk of complications

You can reduce the risk of some complications by following your treatment plan and:

  • Following activity, dietary and lifestyle restrictions and recommendations before your Essure procedure and during recovery

  • Using another method of birth control or abstaining from sex until your doctor tells you that your fallopian tubes are completely blocked

  • Informing your doctor or radiologist if you are nursing or if there is any possibility of pregnancy

  • Notifying your doctor right away of vaginal bleeding or discharge, fever, and increase in abdominal pain or cramping

  • Taking your medications exactly as directed

  • Telling all members of your care team if you have any allergies, especially a nickel allergy. The Essure micro-insert contains nickel.

How do I prepare for my Essure procedure?

You are an important member of your own healthcare team. The steps you take before your procedure can improve your comfort and outcome. You can prepare for Essure by:

  • Answering all questions about your medical history and medications. This includes prescriptions, over-the-counter drugs, herbal treatments, and vitamins. It is a good idea to carry a current list of your medical conditions, medications, and allergies at all times.

  • Taking or stopping medications exactly as directed

  • Telling your doctor about all your pregnancies, how recently you were pregnant, and if there is any possibility of current pregnancy

Questions to ask your doctor

Preparing for an Essure procedure can be stressful. It is common for patients to forget some of their questions during a doctor’s office visit. You may also think of other questions after your appointment. Contact your doctor with concerns and questions before Essure placement and between appointments. 

It is also a good idea to bring a list of questions to your appointment. Questions can include:

  • What are my other options for birth control?

  • How long will the procedure take? When can I go home?

  • What restrictions will I have after the procedure? When can I return to work and other activities?

  • What kind of assistance will I need at home?

  • When can I stop using another method of birth control?

  • When should I return for my confirmation test?

  • How should I take my medications?

  • How will you treat my pain?

  • When should I follow up with you?

  • How should I contact you? Ask for numbers to call during and after regular hours.

What can I expect after my Essure procedure?

Knowing what to expect can help you get back to your everyday life as soon as possible.

How will I feel after the Essure procedure?

You may experience menstrual-like cramps, nausea, vomiting, dizziness, or discomfort in your lower back or pelvis for a few days after the Essure procedure. Call your doctor if these symptoms worsen or continue past a few days because it may be a sign of a complication.

When can I go home?

The procedure generally takes about an hour. Patients generally go home and resume normal activities immediately afterwards. You may need to take medication for a few hours or days to treat cramping or discomfort.

When should I call my doctor?

It is important to keep your follow-up appointments after an Essure procedure. Contact your doctor for questions and concerns between appointments. Call your doctor right away or seek immediate medical care if you have:

  • Bloating, swelling or pain in your abdomen or belly

  • Fever

  • Inability to urinate, pas gas, or have a bowel movement

  • New or unusual vaginal discharge

  • Respiratory or breathing problems such as shortness of breath, difficulty breathing, labored breathing, or wheezing

  • Vaginal bleeding

  • Vomiting

When will I know that my Essure procedure was successful?

You must schedule an Essure confirmation procedure, called a hysterosalpingography, to confirm that the procedure was successful. This will occur three months after your Essure procedure. 

The confirmation procedure involves inserting a type of dye into your uterus through your vagina and cervix. X-ray pictures are taken of your pelvic area to ensure that the dye does not pass through your fallopian tubes. This confirms that the Essure micro-inserts completely block both fallopian tubes and that sperm cannot pass into them and cause a pregnancy.

When can I stop using birth control after my Essure procedure?

You can stop using birth control after you have received results from an Essure confirmation procedure. This occurs at least three months after your Essure procedure. Your obstetrician-gynecologist will confirm test results with you.

How might an Essure procedure affect my everyday life?

Essure provides permanent birth control (sterilization) after three months and a positive confirmation test. This means that you will never again need to use contraception to prevent pregnancy. Women who still want to have children should not have an Essure procedure. 

You will also have:

  • Continued need for routine gynecological screenings, including PAP smears and pelvic exams, because you still have a uterus and cervix

  • Your monthly period. You may have changes to your menstrual cycle and menstrual bleeding after the Essure procedure. This is not due to the procedure or the micro-insert, but to hormonal changes due to discontinuing hormonal birth control.

  • Continued need to use condoms to protect against sexually transmitted diseases when you have intercourse

  • An increased risk of miscarriage or ectopic pregnancy if pregnancy occurs before your fallopian tubes are fully sealed

Medical Reviewers: Daphne E. Hemmings, MD, MPH

© 2017 Healthgrades Operating Company, Inc. All rights reserved. May not be reproduced or reprinted without permission from Healthgrades Operating Company, Inc. Use of this information is governed by the Healthgrades User Agreement.

View Sources

Medical References

  1. Birth control methods fact sheet. U.S. Department of Health and Human Services, Office on Women’s Health. http://womenshealth.gov/publications/our-publications/fact-sheet/birth-control-methods.cfm.
  2. Common Questions about Essure. Conceptus Inc. http://www.essure.com/what-is-essure/common-questions
  3. Hysteroscopic Sterilization: History and Current Methods. Greenberg, James A. Rev Obstet Gynecol. 2008 Summer; 1(3): 113–121. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2582641/.
  4. Sterilization for Women and Men. The American College of Obstetricians and Gynecologists. http://www.acog.org/~/media/For%20Patients/faq011.pdf?dmc=1&ts=20120806T1648034907.
  5. Use of Hysterosalpingography After Tubal Sterilization. The American College of Obstetricians and Gynecologists. http://www.acog.org/Resources_And_Publications/Committee_Opinions/Committee_on_Gynecologic_Practice/...
  6. What Can I Expect? Conceptus Inc. http://www.essure.com/what-can-i-expect/essure-confirmation-test.
  7. What is Essure? Conceptus Inc. http://www.essure.com/what-is-essure/what-is-essure.

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