Essure was a non-hormonal, permanent birth control device approved by the FDA in 2002. It consisted of two small coils made of a body-safe plastic that doctors would insert through the vagina and into the fallopian tubes without surgery. The device worked by prompting the body to produce scar tissue around the coils, blocking the fallopian tubes and preventing an egg from reaching the uterus. Marketed as a convenient and non-surgical solution for permanent contraception, it quickly gained popularity. However, the initial promise of Essure was soon overshadowed by a growing number of reports detailing serious side effects. Due to declining sales, Essure’s manufacturer, Bayer, voluntarily removed the product from the market. If you were looking into sterilization procedure options between 2002 and 2018, you may have heard about Essure.
This article explores the potential link between Essure removal and weight loss, delving into the reasons why women may experience weight changes after the procedure, and providing a comprehensive overview of Essure, its complications, and the removal process.
The Rise and Fall of Essure
Essure hit the United States market after its approval by the FDA in 2004, but, by 2018, the female sterilization device was pulled from the market due to complications. Despite its FDA approval in 2002, Essure doesn’t seem to be the answer to women’s demand for permanent contraception after all.
Complications Associated with Essure
Thousands of patients started suffering from severe abdominal pain, while others found that their periods were much heavier than they used to be. More alarmingly, many patients found that the device broke and there were fragments lodged in various places in their bodies. There were reports of perforations, devices migrating to other parts of the body, or the device getting lodged in the wrong position or coming loose. Women reported painful health complications after having Essure coils implanted. Some women have reported issues with the product itself, including breakage and malfunction.
More alarming, there are many reported long-term complications associated with Essure. Some women have experienced long-term abdominal, pelvic and back pain. Also, some women, particularly those with a common nickel allergy, have dealt with allergic reactions to the coil implants, resulting in pain and inflammation. Rarely, the Essure device has sliced through the fallopian tubes and perforated the uterus, or has migrated into the wrong place within the pelvis or abdomen. Other reactions, according to reports that were sent to the FDA, include unexplained fatigue, mood disorders like depression, hair loss, headaches, and weight changes.
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Essure migration is a long-term side effect of the procedure in which the device migrates from the fallopian tube. This can cause perforation of the uterus and possible damage to other internal organs. It can be life-changing if not treated immediately, so it is important to be aware of the signs:
- Pelvic Pain: If not fitted correctly, the coil can be released into the pelvis, causing pain and discomfort if the device has migrated. Pelvic pain could be a sign that the Essure has perforated your fallopian tube and possibly damaged other organs as well.
- Severe Bloating: If you feel severely bloated after only eating small amounts or even nothing at all, you should monitor it the first time you notice it and seek medical help if it does not diminish after a few days.
- Memory Lapses, Dizziness, Fainting: If you begin to feel frequently dizzier and continue to have memory lapses, contact a medical provider.
- Abnormal Periods: If you have sudden, heavier, or no periods at all, it may be a sign that your device has migrated. If there is constant heavy bleeding or a change in your cycle, contact a doctor immediately.
- Aching Joints or Twinges in Implant Location: You may feel twinges at any time, during any simple activity. This should be monitored and if it continues to persist, contact your doctor.
- Changed Toilet Habits: If you are having to visit the toilet more often or are experiencing blood in your excrement and urine as well as pain while passing, your Essure may have migrated and you should seek medical attention.
- Weight Gain: Weight gain is a common side effect of Essure migration.
- Fatigue: A migrated Essure device can cause you to feel drained and exhausted, even without a change in your normal routine. Seek medical advice if this happens to you.
Essure Removal: Options and Considerations
If you got an Essure device and you’re now experiencing any of the symptoms we discussed, the first thing you need to do is to go speak to your doctor. There’s a reasonable chance that you may be one of the thousands of people experiencing problems with this device. If you’re concerned about whether your Essure may be harmful, especially if you’re experiencing symptoms that worry you, don’t delay in making an appointment with Dr. It’s best to work with a doctor who has experience working with Essure problems if possible. Many doctors may not be familiar with this device and the wide-ranging symptoms it can cause.
Before you schedule your Essure removal, you’ll need to set up an exam with your doctor. After your doctor runs any tests they need to in order to rule out other causes, they’ll have to do an ultrasound. You and your doctor will also need to discuss the best option for how to remove your Essure device. The options will vary depending on your age, the status of your Essure device, and several other factors.
Surgical Techniques for Essure Removal
- Bilateral Salpingectomy: During this procedure, your surgeon will remove your fallopian tubes entirely, with the tubes intact inside. A salpingectomy is the safest way to ensure that no pieces of your Essure coil get left behind. It is a permanent birth control procedure, so people hoping to get pregnant naturally after their Essure removal will need to look for another option. Dr. Jukes can perform a laparoscopic Essure coil removal, but only with the removal of the fallopian tubes as well.
- Hysterectomy: In some cases, it may be a better option to perform a full hysterectomy, along with the salpingectomy. During this procedure, your surgeon will remove your entire reproductive system, including your uterus, ovaries, fallopian tubes, and cervix. A hysterectomy may be a good option for Essure removal in a couple of cases. First of all, for people who are older and have already gone through menopause, this operation won’t have as much of an impact on your hormonal balance. Also, some patients prefer removal of the uterus (keeping the ovaries to avoid menopause), especially if they are having abnormal bleeding and pelvic pain.
- Hysteroscopic Removal: In some very rare cases, your doctor may be able to remove your Essure devices via a hysteroscopic procedure. This procedure essentially works the same way your Essure device went in. This is not the preferred way to remove Essure devices, as it can be incredibly risky. It only works if your body has not yet begun to grow tissue around the coil and if everything is perfectly aligned.
Essure Reversal vs. Removal
If you do want to become pregnant after your Essure device is gone, it’s a good idea to talk to your doctor about reversal instead of removal. A removal procedure focuses on getting the device out of your body in one piece as safely as possible. One of the most common reversal procedures is a tubal anastomosis. During this procedure, your doctor will carefully dissect your fallopian tube, disconnecting it from your uterus and removing the Essure device and any tissue built up there.
The Link Between Essure Removal and Weight Loss
While weight gain is listed as a potential side effect of Essure migration, weight loss is not typically cited as a direct consequence of Essure or its removal. However, several indirect factors could contribute to weight changes after the removal procedure.
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Relief from Inflammation and Hormonal Imbalance
Symptoms are thought to arise directly from the presence of the foreign bodies within the uterus, whether optimally or suboptimally sited, or indirectly from components of the devices; metals (nickel, titanium and stainless steel) and polyethylene terephthalate (PET) fibers.
Some women, particularly those with a common nickel allergy, have dealt with allergic reactions to the coil implants, resulting in pain and inflammation.
The main presentation relates to pelvic pain but other gynaecological symptoms reported include abnormal uterine bleeding (AUB) and menopausal symptoms. Whether all such symptoms are caused by correctly placed Essure® devices is contentious but individual or combinations of symptoms can impact adversely on health-related quality of life.
The chronic inflammation and pain caused by Essure can disrupt hormonal balance, leading to water retention and weight gain. Once the device is removed, and the inflammatory response subsides, the body may release excess fluids, resulting in a perceived weight loss.
Improved Overall Health and Well-being
For many women, Essure removal brings relief from debilitating symptoms such as pelvic pain, fatigue, and abnormal bleeding. This improvement in overall health and well-being can lead to increased physical activity and a healthier lifestyle, contributing to weight loss.
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Addressing Weight Gain Associated with Essure
It's important to note that some women may have experienced weight gain because of Essure. In these cases, removal may help to reverse this effect. The mechanisms behind Essure-related weight gain are not fully understood, but possible explanations include:
- Hormonal Changes: Essure-related complications can disrupt hormonal balance, potentially leading to weight gain.
- Reduced Physical Activity: Pain, fatigue, and other symptoms can make it difficult to exercise, contributing to weight gain.
- Emotional Eating: Experiencing chronic pain and discomfort can lead to emotional eating as a coping mechanism.
Study on Quality of Life After Essure Removal
In this prospective observational study in an academic research hospital, 80 women with new or worsening symptoms since placement of Essure® sterilization devices undergoing subsequent surgical removal were included. There was a significant improvement in quality of life in both mental and physical health aspects of the SF-12 (34.02 (+/−1.19) vs. 49.61 (+/−1.42, P < .0001) and 36.55 (+/−0.99) vs. 43.32 (+/−1.18, P < .0001 respectively) as well as global VAS assessment (+2.91 (SD +/−0.27)) at the end of the first post-operative month. These improvements were maintained at three and six months. Mean pain decreased at one month following surgery compared to baseline (VAS 3.6 (+/−0.36) to 1.4 (+/−0.25), P < .0001 and McGill pain score 18.70 (+/−1.88) to 4.73 (+/−0.90), P < .0001). Improvements of a similar magnitude were observed when analysis was restricted to the 47 women without concomitant uterine surgery. No significant changes in bleeding were seen following of Essure® device removal.
Laparoscopic surgical removal of Essure® sterilization devices appears to be a safe, successful and ambulatory procedure associated with rapid improvement in HRQL and pelvic pain, which is sustained up to six months. No reduction in the amount of menstrual bleeding attributable to removal of the Essure® devices was observed.
Important Considerations
It's essential to consult with a healthcare professional to determine the underlying cause of any weight changes and to develop an appropriate management plan. If you are gaining weight and have not made any changes to your diet and exercise, contact a doctor.
The Recovery Process After Essure Removal
Even though your Essure inserts were probably fitted in a doctor’s office without anesthesia, you need a general anesthetic for its removal, and you have a small bikini line incision so Dr. Swainston uses robot-assisted techniques to remove the device and any scar tissue that has formed in your fallopian tubes.
Depending on what procedure you have, you may be looking at a recovery time anywhere from a few days to a few weeks. If you have a laparoscopic procedure, you’ll likely be able to go home the same day and be back on your feet within the week. If you had to have a hysterectomy or similar open procedure, your recovery timeline will be longer. You may need to stay in the hospital at least overnight, and you likely won’t be walking for a few days while your muscle tissue starts to recover.
Even though we use advanced laparoscopic techniques to remove your Essure coils, it’s still surgery and you should go easy for two weeks, or more. If you like to exercise, we suggest a nice walk around the neighborhood instead of a long run and gentle stretching instead of lifting weights at the gym. By taking a few steps to prepare and understanding your limitations, you should sail through your recovery with ease. We’re also available for any questions you may have about your recovery from Essure removal surgery.
Potential Side Effects of Essure Removal
While Essure removal may be the best option for you, it does come with some potential side effects. In almost every case, you’ll have to have an operation in order to remove the device, although most of these can be performed laparoscopically. In some cases, Essure removal surgery can cause damage to your surrounding organs. And small fragments of the device may be left behind, depending on what removal option you go with.
We mentioned that one of the primary benefits of getting your Essure device removed is easing the symptoms you’re experiencing as a result of the device. And in many cases, this procedure does help to alleviate symptoms. Unfortunately, about a third of patients who have Essure devices removed continue to experience symptoms long-term. There’s not a lot of data yet about how long these symptoms last or how they change after removal.
Post-operative Care
Cramps commonly follow an Essure coil removal procedure. This lasts for a few days and feels much like period cramps.
Naturally, the No. Once you’ve undergone the Essure removal procedure, you need to recover. After your surgery, you might experience relief from your complications within just a few days.