Contraception: sterilisation implants (Essure)
Essure sterilisation implants are a type of permanent contraception for women. Sterilisation implants are tiny, flexible metal coils that can be inserted into the fallopian tubes to permanently block them.
Note: On 30 August 2017, the Therapeutic Goods Administration has issued a 'Hazard alert' for Essure. The manufacturer is withdrawing the device in Australia. Some women may not have been fully informed of the risks of the device before choosing to have one implanted. If you have any concerns about Essure or have experienced any side effects, please see your doctor, who will be able to advise you. Your doctor will also be able to give you a copy of the patient information brochure, which outlines possible side effects.
How does Essure work?
Normally, after an egg has been released by one of the ovaries (ovulation), it travels down the fallopian tube towards the uterus. Essure sterilisation implants cause scar tissue to form in the fallopian tubes, which blocks the tubes. This means that sperm are not able to reach and fertilise a woman’s eggs.
It takes about 3 months for the scar tissue to completely block the fallopian tubes, so an alternative form of contraception must be used for at least the first 3 months following insertion of Essure sterilisation implants.
Effectiveness at preventing pregnancy
Essure sterilisation implants are reported to be more than 99.5 per cent effective at preventing pregnancy.
Reversal of the Essure method of sterilisation is not possible, so only women who are certain that they do not wish to have any future pregnancies should consider this method of contraception.
How is it done?
The Essure sterilisation implants can be inserted using a hysteroscope (a thin, flexible instrument with a camera at the end). The hysteroscope is passed through the vagina, cervix and uterus to reach the fallopian tubes, where a coil is placed in each fallopian tube.
The procedure does not involve any incisions and does not require a general anaesthetic. It is usually performed under local anaesthetic. A sedative may also be used.
The procedure usually takes about 30 minutes and most women are able to go home after a few hours. Women can usually return to their usual activities the following day.
An alternative form of contraception must be used for at least 3 months after insertion of Essure sterilisation implants. At 3 months, you will have a special X-ray (a hysterosalpingogram) or ultrasound to determine whether the fallopian tubes have blocked off. If the test shows that the fallopian tubes are completely blocked, you are protected against pregnancy.
Most women have some cramping and abdominal pain after the insertion procedure. Some women report vaginal bleeding or spotting for a few days afterwards.
Some of the advantages of Essure sterilisation implants include the following.
- They are highly effective at preventing pregnancy.
- Sex drive and sexual spontaneity are not affected.
- Female hormones and the menstrual cycle are not affected.
- There are fewer risks associated with the insertion of sterilisation implants compared with surgical sterilisation (tubal ligation, or ‘having your tubes tied’).
- If a pregnancy should occur (which is rare), there is an increased risk that it will be in the fallopian tubes (ectopic pregnancy), which can cause serious internal bleeding.
- It is not possible to reverse the process, and so it should be undertaken only by women who are absolutely certain that they do not want any (more) children.
- It does not protect you from sexually transmitted infections (STIs).
- In a small number of cases, it may not be possible to correctly position the sterilisation implants.
2. Family Planning Victoria. Female sterilisation (updated Jan 2010). http://www.fpv.org.au/assets/Uploads/PDF-Downloads/SH-Info/Full-brochures/FSTERILE.pdf (accessed Aug 2013).
3. NHS Choices. Female sterilisation (updated 10 Jan 2013). http://www.nhs.uk/Conditions/contraception-guide/Pages/female-sterilisation.aspx (accessed Aug 2013).
4. MayoClinic.com. Essure (updated 12 Jan 2012). http://www.mayoclinic.com/health/essure/MY00999 (accessed Aug 2013).