Essure was once considered a breakthrough in permanent birth control for women who were seeking a non-surgical, hormone-free option. Unlike traditional tubal ligation, which involves surgically cutting or sealing the fallopian tubes, Essure was inserted through the cervix and uterus without incisions. This outpatient procedure involved placing small metal and fiber coils into each fallopian tube, which caused scar tissue to form and block the tubes, preventing sperm from reaching an egg.
For many years, Essure was praised for its convenience, lack of downtime, and elimination of the risks associated with general anesthesia. However, as more women used the device, concerns about potential complications began to emerge. While Essure has since been discontinued in the United States, it remains important to understand its benefits, risks, and what women with the device should consider moving forward. At May-Grant OB/GYN, we support patients in Lancaster, PA and beyond with the guidance and care they need regarding Essure and other permanent contraception methods.
Why Women Chose Essure
The appeal of Essure was largely based on its minimally invasive nature. It was performed in-office, often without the need for general anesthesia, and typically took less than an hour. Recovery time was minimal, and most women returned to daily activities within a day or two. The procedure was marketed as a low-risk alternative to tubal ligation with long-lasting results.
Essure also offered women a hormone-free option, which was particularly appealing to those who had experienced negative side effects from birth control pills or hormonal intrauterine devices. With no implants under the skin and no daily maintenance required, Essure seemed to offer simplicity and peace of mind. For many, the permanent nature of the procedure aligned with their family planning goals, especially for those who were confident they did not want to have more children.
How the Procedure Worked
Essure was unique in that it did not require incisions or laparoscopic surgery. Instead, a healthcare provider inserted the micro-inserts into each fallopian tube through the cervix and uterus using a thin, flexible catheter. Once in place, the body’s natural healing response caused scar tissue to develop around the coils, gradually blocking the fallopian tubes.
Patients were instructed to use a backup form of contraception for at least three months following the procedure. After that time, a special imaging test called a hysterosalpingogram (HSG) was conducted to confirm that the tubes were fully blocked. Only after successful confirmation was Essure considered effective. The device boasted a high success rate in preventing pregnancy, with over 99% effectiveness reported in clinical trials once proper placement and blockage were confirmed.
The Emerging Concerns and Reported Complications
Despite its initial popularity, reports of complications began to surface as more women underwent the Essure procedure. Some patients experienced chronic pain, allergic reactions, device migration, and autoimmune symptoms. Others reported heavy bleeding, fatigue, and painful intercourse following insertion. In some cases, the device was found to have perforated the uterus or fallopian tubes, requiring surgical removal.
These complications led to increased scrutiny from the U.S. Food and Drug Administration (FDA), which issued multiple warnings and eventually required a black box warning—the most serious advisory—on the product. In 2018, Bayer, the manufacturer of Essure, voluntarily discontinued sales in the U.S. due to declining usage and growing legal concerns. While the device is no longer available, it remains implanted in many women who may now be seeking answers, follow-up care, or removal options.
Evaluating the Benefits in Retrospect
While Essure has faced significant criticism, it’s important to acknowledge that many women used the device successfully and without complications. For those who had a positive experience, the procedure delivered on its promise: a permanent, hormone-free birth control method without the need for surgery or downtime.
Additionally, Essure represented an innovative step in the evolution of contraceptive choices. Its popularity prompted further conversations about alternatives to surgical sterilization and underscored the importance of informed consent in reproductive healthcare. Though its use is now part of medical history, the lessons learned from Essure continue to shape the development of future contraceptive technologies.
Considerations for Women with Essure
For women who currently have Essure in place, regular monitoring and communication with a healthcare provider are essential. Not every patient will experience complications, and many do not require device removal. However, those who experience persistent pelvic pain, abnormal bleeding, or other symptoms should seek medical evaluation.
In some cases, imaging tests may be recommended to confirm the location of the device and assess any potential issues. For women experiencing complications, removal may involve a hysteroscopic approach or, in more complex cases, surgical removal of the fallopian tubes or uterus. At May-Grant OB/GYN, our providers offer individualized care plans for patients with Essure, including symptom management and surgical consultations if necessary.
Alternatives to Essure and Other Permanent Options
Since Essure is no longer available, patients seeking permanent birth control have several alternatives. Traditional tubal ligation, often called “having your tubes tied,” remains a widely used and reliable method. It involves cutting, tying, or sealing the fallopian tubes through a laparoscopic procedure under anesthesia.
Other long-term options include the levonorgestrel IUD (such as Mirena), which can last up to eight years, and the copper IUD, which provides hormone-free contraception for up to ten years. While not permanent, these options offer highly effective protection with flexibility for future fertility, should a woman change her mind. May-Grant OB/GYN provides counseling on all available methods to help patients choose the option best aligned with their reproductive goals.
Navigating Your Options at May-Grant OB/GYN
At May-Grant OB/GYN, we understand that decisions about contraception are deeply personal and often complex. Whether you’re living with an Essure implant, considering permanent sterilization, or exploring non-surgical alternatives, our team is here to provide comprehensive, compassionate care across all our locations in Lancaster, PA and beyond.
We believe in empowering patients with clear, accurate information and individualized treatment plans. If you have concerns about Essure or are seeking guidance on other methods of contraception, we invite you to schedule a consultation. Our providers are committed to supporting your reproductive choices with honesty, respect, and medical expertise.
Frequently Asked Questions About Essure
Is Essure still available?
No. Essure was discontinued in the U.S. in 2018 due to safety concerns and declining use. It is no longer available for implantation.
Can Essure be removed?
Yes, but removal may require surgery depending on the position of the device and severity of symptoms. Consult your provider for evaluation.
Is it safe to leave Essure in place?
In many cases, yes. If you are not experiencing symptoms, regular monitoring may be sufficient. Any unusual symptoms should be reported.
What are alternatives to Essure now?
Tubal ligation, hormonal IUDs, and copper IUDs are effective options. Your provider can help you explore what’s best for you.
Does Essure affect fertility if removed?
Essure is intended to be permanent. Removal typically does not restore fertility, and additional procedures like IVF may be required to conceive.
Supporting Safe and Informed Contraceptive Care
The story of Essure highlights both the importance of innovation in women’s healthcare and the responsibility to ensure long-term safety. While the device provided effective contraception for many, it also raised critical questions about oversight, follow-up, and patient communication.
At May-Grant OB/GYN, we take these lessons seriously. Our mission is to provide safe, evidence-based care that empowers each patient to make choices that reflect their health, values, and life goals. Whether you’re managing life with an Essure implant or exploring your next steps, we’re here to guide and support you with the highest standard of care.
Resources:
Mahajan, S. T., & Magrina, J. F. (2015). Essure: A review. Journal of Minimally Invasive Gynecology.
U.S. Food and Drug Administration. (2018). FDA actions on Essure. FDA.gov.
Arjona, J. E., et al. (2008). Complications following hysteroscopic sterilization with the Essure device. Journal of Minimally Invasive Gynecology.
