Essure Education Video - Gynecologic Surgery & Menopause Solutions
Birth Control in Midlife and the Essure Debate: It's Complicated
Non-Estrogen Birth Control Options
Intrauterine devices (like Mirena, Skyla, and Paraguard) and implants (like Nexplanon) are excellent long-acting, reversible non-estrogen options. But if you've given your maternity clothes to Goodwill and used the crib for firewood, you may be considering permanent sterilization.
Since the 1970s, outpatient tubal interruption has been performed laparoscopically using a small incision in the belly button, and one or two other tiny incisions in the lower abdomen. The surgeon uses clips, rings, or cautery (the use of a heated instrument) to seal the fallopian tubes. No matter the method, the result is the same: An egg can no longer rendezvous with a sperm.
Essure: A Method Under Fire for Unexpected Risks
In an effort to avoid an incision and general anesthesia, Essure was developed and then FDA-approved, entering the market in 2002. But what exactly is Essure, you might ask? It's a technique in which a slender scope is inserted through a woman's cervix, enabling the gynecologist to place tiny coils inside her fallopian tubes where they enter the uterus. The coil doesn’t block the sperm; instead, it stimulates formation of scar tissue around the coils, which eventually blocks the tubes. A woman who has the procedure has an X-ray three months later to ensure that her tubes are completely closed.
Essure has recently come under fire because the complication rate is higher than originally thought. From 2002 through May 2015, the FDA received 5,093 complaints related to Essure, including chronic pain, abnormal bleeding, headache, chronic fatigue, and weight fluctuations.
In response, the FDA held a hearing this month to address the concerns of women who feel that their medical problems are a direct result of Essure. No doubt, many of these complaints are unrelated to Essure. Keep in mind that, worldwide, roughly one million Essure coil sets have been placed, most without complications.
But some risks may not have been recognized early on. The FDA's review of the data is appropriate so that women who opt for Essure can be fully informed not only about the benefits, but about potential problems as well.
What's the Best, Safest Contraception?
Problems with Essure and other forms of birth control leave many women struggling to find the best and safest contraception. The obvious perfect solution for the midlife woman is not female contraception, but vasectomy. The obvious barrier, however, is a willing spouse or partner. If you are single and looking — and not interested in having kids — consider adding “has vasectomy” to your perfect-guy wish list, along with “great sense of humor” and “likes pets.”
Stay tuned to see what the FDA decides about Essure, consider an IUD, and encourage Match.com to list “vasectomy” as a profile choice.
PHOTO CREDIT: AP Photo
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