Toxic Metal Elements Potentially Linked to Essure Side Effects

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A French study found nickel and chromium in the fallopian tube tissue and peritoneal fluid of women with Essure implants, suggesting that corrosion of the device releases potentially toxic metals.

The study, published in the September 2020 issue of the European Journal of Obstetrics & Gynecology and Reproductive Biology, raises the question of whether or not adverse side effects — such as heavy menstrual bleeding, fatigue, joint pain and psychological disorders — are due to the diffusion of nickel and chromium when an Essure implant breaks down.

The research team, however, found no significant link between the occurrence of adverse events and metal toxicity, and no connection between the length of implantation and the frequency and severity of symptoms.

A controversial sterilization device sold for 17 years, Essure contains polyester fibers, nickel-titanium alloy, chromium and other metals. The device is inserted vaginally through the cervix into the fallopian tube. More than 750,000 women worldwide have the implants, and tens of thousands live with moderate to severe side effects related to Essure.

The small study, conducted at the University Hospital of Lyon, analyzed concentrations of nickel and chromium in the peritoneal fluids and fallopian tubes during laparoscopic surgery to remove the Essure devices. The study group included 37 women aged 24–58 who had Essure implanted between one and 12 years.

The authors noted that the results are “in agreement with a recent study of 10 cases showing a possible degradation of the Essure weld with dissemination of metal particles” in the fallopian tubes and a part of the uterus. They called for more research to probe the potential link between the presence of toxic metal elements in the fallopian tubes and peritoneal fluid with adverse events.

By T.J. La

Ton La, Jr. (T.J.) is a sixth-year MD/JD/LLM candidate at Baylor College of Medicine and the University of Houston Law Center applying to internal medicine residency programs in Fall 2021. He was a 2019–2020 Doximity Op-Med Fellow, a former guest writer for KevinMD.com, and a past Student Editor of The New Physician Magazine from 2017–2019.

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