In my last blog I wrote about Essure, a relatively new procedure that offers a highly effective option for permanent birth control. One of the best ways to evaluate whether or not a medical procedure is right for you is to look at it in terms of its risks and benefits. Here are some more questions and answers that I hope will help you with your decision.

Is the Essure procedure effective?

While no form of birth control is 100% effective, fewer than one in 100,000 pregnancies occur when tubal blockage has been confirmed by the three-month test. The Essure procedure is the only birth control method with zero pregnancies in clinical trials.

Is the Essure procedure safe?

Studies have shown that the Essure procedure is safe. However, as with most birth control methods, there are risks. In some cases one or both Essure coils may not place properly in the Fallopian tubes and may have to be re-applied.

Is the Essure procedure painful?

In most cases the pain of an Essure procedure is far less and shorter-lasting than the pain often associated with a surgical procedure such as tubal ligation. Symptoms during or immediately after an Essure procedure may include mild to moderate cramping, nausea, vomiting, dizziness and bleeding. However, pain from the procedure is usually relatively mild. In a medical study published in 2005, 72 women who were surveyed immediately after undergoing the Essure procedure said the pain they felt was slightly less on average than the pain they experienced during their menstrual cycle.

How long does the Essure procedure take?

Essure patients are asked to arrive an hour before the procedure time. Once inside the examination room, the cervix is numbed and the uterus is filled with a liquid saline solution. The next step, insertion of the coils into the Fallopian tubes, takes about 10 minutes. The three-month test usually takes about an hour.

How long does Essure procedure recovery last?

Most women return to their normal activities in less than a day.

How quickly does the Essure procedure work?

It usually takes about three months for the Essure treatment to completely block both Fallopian tubes. During this time, women should continue to use a backup form of birth control. After three months, the Essure procedure’s effectiveness is tested using an HSG (hysterosalpingogram) test, which uses dye to test the seal. In some cases it may take six months or longer for the Fallopian tubes to become completely obstructed.

Will the Essure procedure affect my monthly cycle?

Unlike many temporary methods of birth control such as birth control pills, the patch and some IUDs, the Essure coils do not contain hormones. They will not interfere with your monthly cycle.

Is the Essure procedure covered by my insurance?

Essure procedures are covered by most insurance providers. If the procedure is performed in a doctor’s office, a co-pay may be all you need to pay. My office can work with you and your insurance company to determine what your insurance company will cover.

How does the Essure procedure compare to getting your tubes tied?

Tubal ligation, or “getting your tubes tied” is a procedure that involves severing Fallopian tubes or pinching them shut. It can be done via cutting or burning the Fallopian tubes, or by using rings or clips that restrict part of the Fallopian tubes. The procedure usually takes one to two hours, with general anesthesia. It’s usually done in a hospital or a clinic.

The Essure procedure is different from tubal ligation in that it does not involve cutting, it does not require general anesthesia, and it usually takes about 10 minutes. More than half of all Essure procedures are performed in a doctor’s office.

More information

If you’d like additional information, you can click on any of the links below, or you can contact my office directly.

Links to Essure resources

Essure’s home page
Essure patient and physician testimonials
Essure patient information booklet pdf
Essure confirmation test booklet pdf
Dr. Garofalo’s webpage on permanent birth control and Essure
Dr. Garofalo’s Essure consent form pdf

Dr. John Garofalo, M.D., is a gynecologist located in Fairfield County, Connecticut. For more information on Dr. Garofalo and his medical practice, go to www.garofaloobyn.com. Dr. Garofalo can be reached for a personal consultation at 203.803.1098.

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Lately I’ve been getting a lot of questions from my patients about the Essure birth control procedure. Maybe it’s because of the recent publicity from Olympic gold medalist Picabo Street, who announced earlier this year that she’d undergone the procedure. In any case, I thought I’d answer some of the most common questions I’ve heard. I’ve also included some useful links at the bottom of this blog.

What is Essure?

The Essure procedure is a permanent birth control method developed by an American company called Conceptus. Essure is their main product.

During the procedure, tiny flexible coils made out of polyester fibers, nickel-titanium and stainless steel are passed by a small tube called a catheter from the vagina through the cervix and uterus and into the Fallopian tubes. (Fallopian tubes are two very thin tubes that lead from the ovaries into the uterus.) Once in place, the Essure coils cause tissue growth (scarring), which seals a portion of the Fallopian tubes. This tissue barrier prevents sperm from reaching the ovaries.

How long has the Essure procedure been used?

Hundreds of thousands of women have had the Essure procedure, which was approved for use in the United States in 2002. I’ve been conducting Essure procedures for several years.

While the Essure procedure is relatively new, Essure coils are made from materials that have been used successfully for many years in cardiac stents and other medical devices that are placed in the body.

Is the Essure procedure permanent?

According to the manufacturer, the Essure procedure is intended to be permanent and non-reversible. However, as of last month, less than two dozen successful Essure reversals have been performed – all in the past three years – and the first “Essure reversal baby” was born just a few months ago.

Before having the Essure procedure, you should be sure that you do not want to have any more children.

Is the Essure procedure right for me?

Most women are candidates for the Essure method, but sometimes the coils cannot be placed due to issues such as prior tubal blockage, fibroids distorting the uterine cavity, or uterine septum (when a wall of tissue divides part or all of the uterus). In addition, the Essure procedure is not recommended for women who:

• are pregnant or have been pregnant in the past six weeks
• are not certain they are finished having children
• have had a recent infection in the pelvis
• have serious, chronic health problems
• are allergic to contrast dye or nickel
• are taking corticosteroids (a type of anti-inflammatory drug)

If you’ve had any of these conditions, we can discuss whether Essure is appropriate for you.

Tune in next week …

In my next blog I’ll write about the Essure procedure’s risks and benefits, and how it compares to another procedure, called tubal ligation – or “getting your tubes tied”.

More information

If you’d like additional information, you can click on any of the links below, or you can contact my office directly.

Links to Essure resources

Essure’s home page
Essure patient and physician testimonials
Essure patient information booklet pdf
Essure confirmation test booklet pdf
Dr. Garofalo’s webpage on permanent birth control and Essure
Dr. Garofalo’s Essure consent form pdf

Dr. John Garofalo, M.D., is gynecologist located in Fairfield County, Connecticut including Bridgeport, Norwalk, Stamford, Westport and Danbury. For more information on Dr. Garofalo and his medical practice, go to www.garofaloobyn.com. Dr. Garofalo can be reached for a personal consultation at 203.803.1098.

Although many of my patients were initially resistant to the concept of wearing a vaginal ring, well over 90% of my patients who have tried the ring have been very satisfied with their contraceptive choice. The Nuvaring is easy to place and remove and it does not interfere with spontaneity or intercourse. You will not even know it is there and your partner will probably not know either- and if he does notice something, it won’t bother him. The Nuvaring cannot get lost inside of you and it rarely slips out. When properly used, the Nuvaring is 99% effective.

For more information, go to the Nuvaring website at http://www.nuvaring.com/Consumer/index.asp or schedule an appointment with me for personalized contraceptive counseling.