Essure is a permanent form of birth control that was introduced to the market in 2002 by the pharmaceutical company Bayer. Essure consists of two small, flexible coils that are inserted into the fallopian tubes. Over time, scar tissue forms around the coils, which blocks the tubes and prevents fertilization. While Essure was initially touted as a safe and effective form of birth control, it has since become the subject of controversy due to reports of adverse events and the perceived lack of transparency on the part of the manufacturer. In this essay, we will explore the Essure contraceptive controversy and its impact on women's health.

Background Essure was approved by the U.S. Food and Drug Administration (FDA) in 2002 and marketed as a safe and effective form of permanent birth control. Essure was promoted as a minimally invasive alternative to surgical sterilization, with a shorter recovery time and fewer complications. However, over time, reports of adverse events associated with Essure began to surface, including perforation of the uterus and fallopian tubes, migration of the coils to other parts of the body, and chronic pain. In 2015, the FDA held a hearing to discuss the safety and efficacy of Essure, and in 2018, Bayer announced that it would discontinue the sale of Essure in the United States.

Controversy and Criticism The Essure contraceptive controversy has been fueled by several factors, including reports of adverse events, concerns about the regulatory process, and allegations of unethical behavior on the part of the manufacturer.

Adverse Events: Women who have undergone Essure implantation have reported a range of adverse events, including chronic pain, perforation of the uterus and fallopian tubes, and migration of the coils to other parts of the body. Some women have required surgical removal of the coils, and there have been reports of fatalities associated with Essure. While the overall incidence of adverse events is relatively low, the severity of the events has led to significant concerns about the safety of Essure.

Regulatory Process: The FDA's approval process for Essure has also been a source of controversy. In 2002, Essure was approved through the FDA's 510(k) clearance process, which allows medical devices to be approved based on their similarity to existing devices, without requiring clinical trials. Critics have argued that the 510(k) process is not sufficient to ensure the safety and efficacy of medical devices, particularly those that are permanent and involve an irreversible procedure.

Allegations of Unethical Behavior: Bayer has been accused of unethical behavior related to the marketing and promotion of Essure. In 2018, a report by the independent news organization The Implant Files alleged that Bayer had downplayed the risks associated with Essure, misrepresented the effectiveness of the device, and engaged in aggressive marketing tactics that targeted vulnerable populations. The report also alleged that Bayer had paid kickbacks to doctors to promote Essure and had used patient data for marketing purposes without obtaining informed consent.

Impact on Women's Health The Essure contraceptive controversy has had a significant impact on women's health, particularly for those who have experienced adverse events associated with the device.

Adverse Events: Women who have experienced adverse events associated with Essure may require additional medical treatment, including surgical removal of the coils. The removal of the coils can be complicated and may require multiple surgeries, which can lead to additional complications and costs. Additionally, women who have experienced adverse events may experience chronic pain and other long-term health consequences.

Decreased Access to Permanent Birth Control: The discontinuation of Essure has decreased women's access to a permanent form of birth control. While there are other options available, such as surgical sterilization, these procedures are more invasive and carryadditional risks and complications.

Loss of Trust in Medical Devices: The Essure controversy has eroded trust in the medical device industry and the regulatory process. Many women who have experienced adverse events associated with Essure feel that they were not adequately informed of the risks and that their concerns were not taken seriously by healthcare providers or the manufacturer.

Advocacy and Awareness: The Essure controversy has also led to increased advocacy and awareness around women's health issues. Women who have experienced adverse events associated with Essure have organized and advocated for increased transparency and accountability in the medical device industry. Additionally, the Essure controversy has highlighted the importance of informed consent and the need for patients to be fully informed of the risks and benefits of medical procedures.

Moving forward, there are several steps that can be taken to address the issues raised by the Essure contraceptive controversy.

Improved Regulatory Oversight: The regulatory process for medical devices should be improved to ensure that devices are thoroughly evaluated for safety and efficacy before they are approved for use. The FDA has already made changes to the approval process for medical devices, including the requirement for post-market surveillance studies and increased transparency. However, continued efforts are needed to ensure that medical devices are safe and effective for patients.

Informed Consent: Patients should be fully informed of the risks and benefits of medical procedures, including medical devices. Informed consent is essential to ensure that patients can make informed decisions about their healthcare and are aware of any potential risks associated with a particular device or procedure.

Increased Patient Advocacy: Patients who have experienced adverse events associated with medical devices should be empowered to advocate for themselves and others. Patient advocacy groups can play a critical role in raising awareness about the risks and consequences of medical devices and advocating for greater transparency and accountability in the medical device industry.

Improved Communication: Healthcare providers should improve communication with patients to ensure that they are fully informed of the risks and benefits of medical devices. Providers should also be receptive to patient concerns and work to address any issues that arise.

Continued Research and Innovation: Continued research and innovation are essential to improve the safety and efficacy of medical devices. The medical device industry should prioritize research and development of safe and effective devices that meet the needs of patients.

Conclusion
The Essure contraceptive controversy has brought attention to the safety and efficacy of medical devices and the regulatory process. Women who have experienced adverse events associated with Essure have suffered significant physical and emotional consequences, and the controversy has eroded trust in the medical device industry and the regulatory process. While the discontinuation of Essure may decrease the number of women who experience adverse events associated with the device, it also decreases women's access to a permanent form of birth control. Moving forward, it is essential that the medical device industry and regulatory bodies prioritize patient safety and transparency and work to rebuild trust in the healthcare system. Additionally, increased advocacy and awareness around women's health issues can lead to improved patient outcomes and greater accountability in the medical device industry.