Dr. Kate is an OB/GYN at one of the largest teaching hospitals in New York City and she answers your medical questions here every few weeks. To ask her your own question, click here.
Dear Dr. Kate,
I know I am done having children, but I do not want to go under the knife for a tubal ligation. I have heard of a procedure called Essure. Have you heard of it? How does it work and is it safe?
— Done Kidding Around
Dear D.K.A.,
Essure is the latest form of permanent contraception that combines the best of the IUD and tubal ligation. Essure is performed through a procedure called hysteroscopy. Your gyno places a camera through your cervix, up into your uterus, so she can see the openings to your fallopian tubes. Small coils (that look like the spring of a ballpoint pen) are placed into the tubes through this camera. The coils cause scarring in the tubes, and the tubes in essence block themselves around the coil. A special X-ray three months after the procedure confirms that the tubes are indeed blocked. So, unlike tubal ligation and the IUD, Essure doesn’t work right away, and you need to stay on another form of birth control until the X-ray.
But it is a permanent procedure, and you won’t have any incisions made in your belly (so no scars). Doctors can perform this procedure in the operating room, and some can now do it in their office; either way it’s a one-day, no-admission-to-the-hospital procedure. It is a relatively new procedure, though, so you may have to call around in your area to find a gyno who can do it. While all procedures carry some risk, the risks of Essure are low.
— Dr. Kate
Gynotalk
Related: Check out Dr. Vanessa’s recent post on Tubal Sterilization vs. Vasectomy
Dr. Kate is an OB/GYN at one of the largest teaching hospitals in New York City. She also lectures nationally on women’s health issues and conducts research on reproductive health. Check out more of her advice and ask her a question at Gynotalk.com.
I had the Essure procedure done just over 2 years ago. I had no pain from it and would highly suggest it to anyone who is sure they don’t want any more children. My doctor did tell me it was completely permanent, there is no way to reverse it. I had 2 babies on two different types of the pill and 1 through marriage. I knew I was done, even if I do have second thoughts whenever I see cute babies in a store.
My question for Dr. Kate is: Is it normal to have an abnormal amount of cramping when my body would normally be ovulating? I’ve always had cramps when I ovulate, but they have definetly gotten worse since I had this done. I’m not too worried, but want to make sure it isn’t something I should talk to a doctor about.
Dr. Kate, my guess would be this procedure would probably avoid the not often talked about, but often reported “premature perimenopause” that so many women get when blood supply to the ovaries is compromised during a regular tubal lig. I’ve worked with a number of patients complain about hot flashes, night sweats, lack of libido etc after a tubal lig. (Even after the hormone changes after childbirth were long gone.) The general thought (among the docs and nurses I know who believe them, and I DO believe them) is that blood supply was compromised to the ovaries during or after the procedure, and caused the semi-perimenopause.
While my own natural perimen has proven SO awful, I wouldn’t wish a premature perimen on ANYBODY.
Thank you for the info. I’m not working in a doc’s office or directly in a hospital at the moment, so I was not fully aware of how this procedure, Essure, worked. Sounds great for women who KNOW they are done having babies.
My guess would be it is LESS “reversible” than a regular Tubal Lig? No telling how much of the tube would scar and all the scar tissue would have to be removed and the rest of the tube pulled and reconnected. But, IMO, one should be SURE one is done with having kids before any type of permanent birth control is performed.
It may not mean much, but my mom, who is in her mid-forties, had this done and absolutely loves it. While yes, it does take a few months to become fully healed and blocked, my mother said it was really simple and has experienced no trouble at all. She highly recommends it as a form of permanent sterilization for women.