The Essure system is a type of permanent birth control for women. It cannot be reversed.
During insertion of the Essure system, your health care provider uses a flexible tube with a small camera (hysteroscope) inserted through the vagina, into the cervix and up to the uterus. Once the openings to the fallopian tubes are visualized, small metal and fiber coils are passed through the hysteroscope and into your fallopian tubes. The Essure system causes scar tissue to form around the coils, blocking your fallopian tubes and preventing sperm from reaching the egg.
The Essure system takes three months to become effective in preventing pregnancy, and in some women, it may take up to six months. During this time, you must use other contraceptive methods to prevent pregnancy. Essure doesn't offer protection from sexually transmitted infections (STIs).
The Essure system is a type of female sterilization. It offers a permanent way to prevent pregnancy. Benefits of the Essure system include:
- Lack of significant long-term side effects
- No need to buy contraception, interrupt sex for contraception or seek partner compliance
- No incision or scarring of the skin
- Convenience — the Essure system can be inserted at your health care provider's office
The Essure system isn't appropriate for everyone, however. Your health care provider may discourage implantation of the Essure system if:
- You might want to become pregnant
- You gave birth or had an abortion within the past six weeks
- You recently had a pelvic infection
- You're allergic to the contrast agent used to confirm tubal blockage
- You have a uterine or tubal condition that prevents access to one or both tubal openings
- You previously had a tubal ligation
The Food and Drug Administration (FDA) issued updated guidelines in 2016 for women who choose the Essure system and their doctors to help them better understand the risks and know when to be evaluated for side effects. According to the FDA, the Essure system remains an appropriate treatment for the majority of women seeking permanent birth control, but some women may be at risk of serious complications.
Risks associated with the Essure system include:
- Tubal blockage occurring on only one side
- Perforation of the uterus or fallopian tubes from movement of the device
- Pelvic pain
You may not be able to have further pelvic electrosurgical procedures, such as some types of endometrial ablation, after having the Essure system implanted.
The Essure system doesn't offer protection from sexually transmitted infections (STIs).
In the first year after implantation of the Essure system, fewer than 1 out of 100 women will get pregnant. The risk of unintended pregnancy is likely highest during the first three months after the placement of the Essure system.
Testing to confirm the Essure system has blocked the fallopian tubes can reduce the risk of unintended pregnancy.
If you do conceive after having the Essure system inserted, there's a higher chance that the pregnancy will be ectopic — when fertilization happens outside the uterus, usually in a fallopian tube.
Before you have the Essure system inserted your health care provider will likely:
- Review the risks and benefits of reversible and permanent methods of contraception
- Ask about your reasons for choosing sterilization and discuss factors that could lead to regret, such as a young age or marital discord
- Explain the details of the procedure
- Discuss the causes and probability of sterilization failure
- Reinforce that the Essure system can't be reversed
- Discuss the need for you to use another method of contraception for three months after the procedure, or until tubal blockage is confirmed
- Help you choose the best time to do the procedure
- Discuss the risks of sexually transmitted infection (STI) and explain the need for condom use if you are at high risk of STI
Your health care provider will need a clear view of your tubal openings to insert the Essure system. He or she may recommend having the procedure done shortly after your period. If your periods are irregular, he or she may recommend using a hormonal contraceptive that contains progestin — such as the combination birth control pill, minipill or contraceptive injection (Depo-Provera) — to thin the lining of your uterus (endometrium).
The Essure system is usually inserted by visualizing the fallopian tubes using a hysteroscope — a thin tube equipped with a camera lens — as an outpatient procedure. The procedure typically takes 30 minutes or less. You may be given medication before the procedure to minimize spasm of your fallopian tubes and reduce pain from the procedure.
During the procedure
Your health care provider will insert a hysteroscope through your vagina and cervix into your uterus and check to make sure both fallopian tube openings are accessible. Using a small catheter attached to the hysteroscope, your health care provider will place tiny coils inside your fallopian tubes.
After the procedure
You may be allowed to go home immediately after the procedure and return to your normal activities the same day. Side effects may include:
- Abdominal pain
- Nausea or vomiting
- Dizziness or lightheadedness
- Bleeding or spotting
Contact your health care provider immediately if:
- You have severe or persistent pelvic pain
- You pass a coil
During the three months following the procedure, you must use another method of contraception. After three months, you will have an X-ray (hysterosalpingography) or an ultrasound to confirm the correct placement of the Essure system and verify that your fallopian tubes are blocked. If the procedure is successful, you can stop using other forms of birth control at this point.
If you think you're pregnant at any time after the procedure, contact your health care provider immediately. The Essure system doesn't affect your menstrual cycle.
The Essure system isn't reversible. Couples who want to try in vitro fertilization need to be aware that a portion of the coil protrudes into the uterine cavity. Because of this, the Essure system may interfere with the success of in vitro fertilization (IVF).
March 15, 2016
- Hatcher RA, et al. Contraceptive Technology. 20th ed. New York, N.Y.: Ardent Media; 2011:249.
- Greenberg J. Hysteroscopic sterilization. http://www.uptodate.com/home. Accessed Oct. 26, 2014.
- Essure (prescribing information). Milipitus, Calif.: Bayer Healthcare LLC; 2012. http://www.essuremd.com. Accessed Oct. 28, 2014.
- Adelman MR, et al. Management of complications encountered with Essure hysteroscopic sterilization: A systematic review. Journal of Minimally Invasive Gynecology. 2014;21:733.
- Jost S, et al. Essure permanent birth control effectiveness: A seven-year survey. European Journal of Obstetrics & Gynecology and Reproductive Biology. 2013;168:134.
- FDA takes additional action to better understand safety of Essure, inform patients of potential risks. U.S. Food and Drug Administration. http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm488313.htm. Accessed March 3, 2016.
- Laughlin-Tommaso SK (expert opinion). Mayo Clinic, Rochester, Minn. March 4, 2016.