Be careful selecting the type of long term and permanent contraception you choose.  Long term reversible methods such as Copper IUD, Mirena, and Nexplanon are safe and highly reliable.  Long term, proven safe and effective methods of permanent contraception are vasectomy and laparoscopic tubal interruption - Not so SURE with the EsSURE...  The most recent New England Journal of Medicine presented the following article.

"On September 24, 2015, nearly 13 years after Essure's approval, the FDA is reconvening its Obstetrics and Gynecology Devices Panel to evaluate its safety and effectiveness and to assess the need for additional postmarketing studies. Safety concerns were raised by women with Essure implants who have reported large numbers of adverse events to the FDA through its Manufacturer and User Facility Device Experience (MAUDE) database, including incomplete procedures, tubal perforations, intractable pain and bleeding leading to hysterectomies, possible device-related deaths, and hundreds of unintended pregnancies. We believe that these safety concerns, along with problems with the device's effectiveness, might have been detected sooner or avoided altogether if there had been higher-quality premarketing and postmarketing evaluations and more timely and transparent dissemination of study results."

This is not surprising with a U.S. medical industry focused on quick large profit monitored by a regulatory agency (FDA) that is under pressure to quickly approve just about any medical device or medication. 

 

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