There are two types of spontaneous mechanical contraception available today that do not contain any type of hormone. The first is the Paragard IUD which is embedded with copper and is approved by the FDA for up to 10 years of use. The second—the Essure® device—is a permanent plug that can be placed into the openings of the fallopian tube. The technique for inserting it is called hysteroscopic tubal occlusions (HTO).
The Paragard Intrauterine Device (IUD) is the most effect reversible non-hormonal contraceptive device and is ideal in women who are seeking a long-acting method of contraception and who do not have a history of heavy or painful periods. Although the failure rate of IUDs is low it is still greater than with hormone-releasing intrauterine devices.
The advantage of the Paragard IUD is that it is reversible and unlike a hormone-containing IUD can be left in for up to 10 years. It is ideal for women who are seeking long-acting contraception and who do not have a history of heavy or painful menses. Unfortunately, this IUD often causes periods to become somewhat heavier and associated with increasing cramps. For those reasons it has fallen into disfavor especially in younger women. It is often better suited for women who’ve had one or more children and have light and tolerable menstrual periods.
The Essure device is in our opinion the “gold standard” for permanent sterilization and was first introduced in the United States in 2002. The Essure® device is a permanent “tubal plug” and provides permanent and irreversible contraception and is only recommended for women who are absolutely certain that they have completed their families. The Essure device and the method by which they are inserted can be reviewed on our website by clicking here.
The advantage of the Essure device is that it can be placed in the office using intravenous sedation and requires only a short period of time for recovery—several hours. Compared to more traditional forms of sterilization—which involve a small abdominal incision—it is safer and more reliable. There are only several situations in which this method should not be used.