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Essure - In Office Sterilization is an Option


Nearly 50% of all pregnancies annually are unintended, and many occur while a patient is using a current method of contraception. While there are many options for women desiring contraception, permanent birth control/sterilization is the most common choice for women age 35 and over. Reasons include easiness/good compliance on the patient’s part; a desire for a hormone-free method; a future pregnancy would be a health risk for the patient; and for many, the ability to take control over one’s fertility/desire for permanent protection is empowering.

The ESSURE permanent birth control system was approved by the U.S. Food and Drug Administration in 2002 and has been utilized worldwide successfully prior to that. It is incisionless. It is 99.8% effective based upon four years of data. The same data shows that 98% of women who underwent the procedure rated their comfort as “good to excellent” during four years of follow-up. The ESSURE method is the only method of female birth control that uses a confirmation test to provide women with the peace of mind associated with knowing they are permanently protected.

For this procedure, a hysteroscope (long, narrow camera) is passed through the vaginal canal and cervix into the uterus (womb). The bilateral ostia (fallopian tube openings) are identified and the small, flexible microinserts are placed. The procedure can be done in an office setting, which provides patients with the ultimate in convenience, efficiency and privacy. This differs from traditional in-hospital tubal ligation. Typically, local anesthetic with or without minimal sedation is used for comfort and feasibility of the procedure.

As with any in-office procedure, not all women are candidates. Occasionally, patients cannot tolerate an in-office procedure or the cervix, uterine cavity or tubal openings will not permit appropriate passage of the hysteroscope or microinserts. When successful, the process takes approximately twenty minutes. Return to work, daily activity and sexual activity is typically within a day or so.

This procedure is not reversible. Post-op pain is minimal and downtime essentially nil. Subsequent to the procedure day and one post-op follow up, the patient must use a back-up method of birth control for three months until the confirmational test is done confirming bilateral tubal blockage. This Hysterosalpingogram study is an out-patient radiology test simply arranged by the office three months post-op. A radio-opaque dye is passed through the cervix/uterus to confirm blockage of the tubes. This test is a unique requirement of ESSURE and provides patients with the security of being “sure” they have achieved permanent birth control.

In comparison, similar time frames are utilized post-op from vasectomies as well to assure sterility. Most feel it’s worth the wait. We see in the majority of patients that permanent birth control allows them to be more spontaneous with their partners and at the same time focus on their other wellness issues/daily life. A mechanical method such as this is also ideal for those patients in whom hormonal methods become risky due to side effects of hormonal contraceptives. Following any method of tubal sterilization, it is always imperative to meet with a Gynecologist if a patient feels she may be pregnant to rule out a tubal or ectopic pregnancy. To obtain more information regarding this in-office sterilization procedure, visit

For patients whom also have a concomitant gynecological complaint of irregular menses, a “bonus” secondary procedure can be done following the three month confirmational test. In-office endometrial ablations are minimally invasive procedures, done via the same type of hysteroscope, designed to burn the lining of the uterus to stop menses. An updated/normal pap and pathology is assured prior as with ALL cases of irregular menses. This is a great alternative to having a hysterectomy for many patients. We call it a “double whamey” in the office – permanent birth control and no more periods – how bad can that be?

Individuals having further related questions can contact us at

Anne Lord-Tomas, D.O., FACOG
U First Health, Ft. Myers, FL


 Sterilization for women
 female gynecologist
 family planning

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