Hysteroscopic Tubal Occlusion (Essure procedure)

In this procedure, the tube is blocked from the inside rather than from the outside as with Tubal Ligation. Completed in a day-case procedure under local anaesthetic, it can be done with or without sedation. General anaesthetic is also an option.

A small telescope is passed into the uterus via the vagina and cervix to locate the entrance of each fallopian tube. A small spring/coil-like device is then placed inside each tube, and the telescope removed.

Because no stomach cuts are made and general anaesthetic is not always required, the recovery time is quicker. Operative complications tend to be fewer but as with all contraception options, failure is a possibility. The success rates are quoted at around 99.8%. Again, if pregnancy results, ectopic pregnancy is a concern.

When is it effective?

The contraceptive effect is not immediate; it takes three months for tubal blockage to occur and after this time, an x-ray is taken to ensure the spring/coil-like device is in the correct place. Occasionally, an x-ray with dye (hysterosalpingogram) is required to confirm adequate tubal blockage. During these three months, alternative contraception should be used.

The menstrual cycle continues as usual and periods will remain as normal.

Long-term options

If you are not absolutely certain your family is complete, an excellent alternative is the Mirena intrauterine contraceptive device. A long-term contraception option, the Mirena looks like a coil and sits inside the uterus releasing a tiny amount of a progesterone type hormone that thins out the womb lining. The amount of hormone absorbed into the body is the equivalent of taking two mini-pills a week.

The failure rate is similar to that of tubal ligation, but its contraceptive effects are reversible. If you decide to get pregnant again, it is easily removed, and fertility returns immediately.

This device also makes periods shorter and lighter, and one in five women using it for a year, will have no periods at all. Ovaries and hormone levels remain as normal, but because the device thins the womb lining, periods are generally lighter.

Mirena can be put in by your family planning clinic, and some GP's. It does not require an anaesthetic and takes less than 10 minutes. The best time to do it is just after your period has finished, and the earliest it can be put in after giving birth, is six weeks.

Side effects are minimal for most people. Irregular bleeding for up to four to six months is common and tends to be spotting only. Mirena does need to be replaced after five years when the hormone reservoir runs out.

Another permanent contraceptive option is vasectomy...sending your man for the snip!

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