Well Being

Essure, IUDs, And More: Long-Term Birth Control That Doesn’t Involve Hormones

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essure and other non hormonal birth control methods

Whether you're finished having children, you're not ready to have any yet, or you don't want to have any at all, you most likely need some form of birth control. There's a dizzying array of options out there, from hormonal pills, patches and rings to Essure and other permanent or long-term birth control options. Since we recently wrote about what happens to your body when you go off of hormonal birth control, we thought we'd research a few of the other long-term options for non-hormonal contraceptive protection.

Many women are hesitant or resistant to using hormonal birth control. While the actual health risks of hormonal birth control are relatively low (users are at an increased risks for conditions like blood clot and stroke, especially if they have high blood pressure or if they smoke), lots of women dislike the other side effects associated with birth control. These can range widely from woman to woman and pill to pill, from weight gain to headaches to mood changes and depression.

There are a myriad of factors to consider when choosing a birth control method including type of hormonal method, lifestyle, reproductive history, health conditions…the list goes on. You should always talk to your doctor or care provider if you're thinking about switching contraceptive methods.

Here are four of the most common long-term (and in some cases, permanent) non-hormonal birth control options for women. (Note: This information is meant to provide a basic overview of these specific methods only and should not be considered a comprehensive guide to all permanent or long-term birth control options) .

Copper IUD

An IUD (intrauterine device) is a tiny, T-shaped device that is wrapped in either copper or hormones and inserted into the uterus.  IUDs must be inserted by doctors. Today, there are two main kinds of IUDs available to women in the United States: the Mirena, which is considered a form of hormonal birth control, and the ParaGard, a copper (non-hormonal) IUD.

Copper IUDS can prevent pregnancy for up to ten years. They prevent pregnancy because copper is toxic to sperm; The IUD causes the uterus and fallopian tubes to make fluid that kills sperm. Copper IUDs cannot be felt in the uterus (although they do contain plastic strings that hang down into the vagina, which can irritate some women and/or their partners).

According to Dr. Steven Rabin, a practicing OB/GYN,  IUDs are the  “unsung and forgotten heroes of birth control.” He recommends them especially to patients who are under age 35. IUDs used to be recommended only for women that had had a pregnancy (insertion is thought to be easier in this case, especially if a woman has had a vaginal birth), but in the past few years, doctors have been approving IUDs for women of different ages and reproductive situations.

Hanna, one of our writers who got a copper IUD placed a few months ago, has written pretty extensively about her experience. Read about her feelings about getting one, how the procedure was, and how she felt afterwards.


Essure is a permanent, non-hormonal, non-surgical form of pregnancy prevention for women. In use since 2002, it works in a way similar to tubal ligation (having your tubes tied), and is recommended for women who do not want to have any (or any more) children. Dr. Carrie Panoff, an OB/GYN, explains what Essure is and how it works:

 A trained physician places soft/flexible inserts into your fallopian tubes via your cervix. Over the course of three months, scar tissue develops within these inserts and your tubes are blocked permanently. The entire procedure takes just a few minutes and you can immediately return to your usual activities. Over the next three months, the body works with the inserts to form a natural barrier in the fallopian tubes to prevent sperm from reaching the egg. Three months after the Essure procedure, an Essure Confirmation Test is given to confirm that the inserts are in place and that the fallopian tubes are blocked, verifying that the patient can rely on Essure for permanent birth control.

Essure has been shown to be 99.8% effective in clinical studies. Women like Essure because it's non-invasive, fast and low-risk. The most common side affects are cramping and discomfort. Since it takes a few months to confirm that Essure is working, women should use a backup method of birth control for those three months. It's also covered by most major medical insurance companies, including Medicaid.

Although Essure is used by over half a million women in the US as a permanent form of birth control, it's still not as common as surgical procedures like tubal ligation or vasectomy. Dr. Panoff, who hopes awareness of Essure as a permanent method of birth control will increase, said, “I like to compare tubal ligation and Essure to the typewriter and the computer. You would never use a typewriter nowadays.”

Tubal Ligation

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