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When it comes to the birth control, most women opt for oral contraceptive pills (mostly containing estrogen or progesterone) or the use intrauterine contraceptive device or IUD to deal with unwanted pregnancies. Most of these, however, provide only temporary freedom from pregnancy. When we talk about the permanent birth control measures, not many people (especially in India and the neighbouring countries) are aware of Essure. Essure is a female sterilization procedure which, when performed, makes a woman infertile for the lifetime. In this article, we will discuss Essure in detail, including its merits and demerits.

What is Essure?
Approved by FDA in 2002, Essure is a relatively new procedure that sterilizes a woman permanently by placing an insert in each of the fallopian tubes. The event serves as a trigger for the formation of a barrier (mainly comprising of scar tissues) around each of the flexible inserts. It is this barrier that prevents the fertilization of the eggs to take place (the sperm fails to cross the barrier to reach the egg) thereby preventing pregnancy.It takes between 2.5-3 months (approx) for the barrier to form. During this period, a woman should continue with the birth control pills and oral contraceptives to negate the chances of her getting pregnant. There is an Essure Confirmation Test performed at the end of 3 months, after which a woman can discontinue the use of the oral contraceptives and pills.

1. A woman who has plans of conceiving in the future.
2. There is unusual and unexplained vaginal bleeding.
3. A woman who is already pregnant.
4. A woman being allergic to metals (silver-tin, titanium, platinum, stainless steel, nickel) or fibres (especially polyester).
5. Cancer affecting the ovary, cervix, and other female reproductive organs.
6. Women with gynaecological infections (active) or tubal damage should refrain from undergoing Essure.

Merits and demerits of Essure
Essure comes with a myriad of benefits, some of which include:

1. Essure is a minimally invasive sterilization procedure that comes with a success rate of almost 99.3% (once there is an Essure Confirmation Test).
2. In most cases, the entire procedure of Essure takes a maximum of 40 minutes with the patient getting back to normal life within a day or two.
3. Unlike the various birth control pills, Essure does not involve the use of any hormones (especially the sex hormones estrogen and progesterone, which can trigger many complications and side effects including a hormonal imbalance).

Unfortunately, with merits come the demerits. Many medical practitioners are skeptical about the effectiveness and safety of Essure.

1. Many women having undergone Essure have complained of moderate to excruciating pain (short-term or chronic).
2. Following Essure, there have been uterine and fallopian tube perforations in some women, though the percentage of such women is really low.

There’s a two-way connection between stress and sex. While it has been proven that sex can be a good stress buster, the reverse is true too. Someone who is stressed may not be able to enjoy a happy sex life. Delving deeper into the subject you can find that sex has a lot of ramifications and many physiological aspects that are often overlooked. It is a well-known fact that people who are stressed have a poor sex life and some of the reasons for the same are listed hereunder:

1. Overall lifestyle: A person who is stressed obviously has a poor lifestyle. There could be harmful effects of binge eating, smoking, excessive drinking all of which can affect a person’s wellbeing. So, when a person is stressed and has such a poor lifestyle, there cannot be a healthy sex life. Also, these lifestyle changes leave a person with a poor image – both physically and emotionally. While physically the person could be obese and have low physical appeal, the emotional aspects can also take a toll on their sex life. The person may have a low self-image, poor esteem, and be anxious or depressed. There could be frequent outbursts, temper tantrums, and fits of rage all of which do not create a happy and peaceful environment which is so essential for a happy sex life. All this leads to a poor personality, which on the other hand affects sex life.
2. Hormonal changes: These chemicals, which are present in small amounts, determine almost all actions of the body, including sex life. A happy person secretes more of serotonin which contributes to a happy feeling. When a person is stressed, the secretion of this hormone gets reduced. Also, the secretion of pituitary hormone is reduced to smaller amounts. The pituitary hormone, known as a master hormone, is essential for proper functioning of all the other hormones. Thus, Sex hormones, testosterone, and estrogen are not produced adequately, leading to sexual problems like erectile dysfunction and premature ejaculation, leading to poor sex life. Other key hormones like thyroid and adrenals are also affected, which have a great effect on ovulation, fertility, and sperm production.
3. Circulation: Sex requires a good blood supply. Stress causes vasoconstriction, which sort of reduces blood supply to any part. Therefore, those who are stressed have a poor sex life.
4. Social effects: When we look around, it is common to see people who are stressed to have poor social relationships in terms of friends and family relationships. There could be issues relating to trust and love and there could be unhealthy relationships like infidelity and lack of freedom. These again, due to stress, can lead to poor sex life.

So, if you intend to have a better sex life, work on stress management. A good relationship can further help reduce stress levels.