Mirena (Hormonal Iud)

1 What is a Mirena (Hormonal IUD)?

A hormonal intrauterine device (IUD) which is inserted into the uterus for a long-term birth control or contraception is called Mirena.

This is a T-shaped plastic frame that releases a type of progestin and this thins the lining of the uterus and partially suppresses ovulation. To prevent sperm from reaching or fertilizing an egg the Mirena thickens the cervical mucus.

The Food and Drug Administration approved the use of Mirena which prevents pregnancy for up to five years, along with the other hormonal IUD known as Skyla which prevents pregnancy for up to three years.

2 Reasons for Procedure

Here are the most common reasons to receive a Mirena (hormonal IUD).

Mirena can be used in premenopausal women of all ages including teenagers and it offers effective as well as long-term contraception.

In Mirena, it:

  • Does not require partner participation.
  • Eliminates the need for interrupt sex for contraception.
  • Can be removed at any time followed by a quick return to baseline fertility.
  • Can remain in place for up to five years.
  • Decreases severe menstrual pain and pain related to endometriosis.
  • Decreases menstrual bleeding after at least several months of use.
  • Decreases the risk of endometrial cancer and possibly cervical cancer.
  • Decreases the risk of pelvic inflammatory disease caused by sexually transmitted infections (STIs) by causing the cervical mucus to thickens leading to the creation of barrier against bacteria.
  • Does not carry the risk of side effects related to birth control methods containing estrogen.
  • Can be used while breastfeeding though recommendations will make you wait up to six weeks after childbirth.

Your doctor may discourage the use of this if:

  • Have cervical or uterine cancer.
  • Have uterine abnormalities such as fibroids that interfere with the retention or placement of Mirena.
  • Have breast cancer.
  • Have liver disease.
  • Have unexplained vaginal bleeding.
  • Have a history of the pelvic inflammatory disease or currently have a pelvic infection.
  • Have or at high risk of a sexually transmitted infection.
  • Are allergic to any component of Mirena.
  • Have inflammation of the cervix or vagina or lower genital tract infection.

Consult your doctor if you:

  • Have high blood pressures or diabetes.
  • Take any medications including nonprescription and herbal products.
  • Have migraines.
  • Have a heart condition or have had a heart attack.
  • Breastfeeding or recently gave birth.
  • Have had a stroke or have blood clotting problems.

3 Potential Risks

Along with undergoing Mirena (hormonal IUD) procedure comes potential risks. Mirena does not offer protection from sexually transmitted infections (STIs).

The percentage of the women who will get pregnant in a year of typical use is less than 1 percent. You will be at higher risk of ectopic pregnancy if you do conceive while using Mirena.

Ectopic pregnancy is when the fertilized egg implants outside the uterus mostly in the fallopian tube, but you are at lower risk of having this other than sexually active women who are not using contraception because of Mirena.

The side effects are:

You are most likely to expel Mirena from your uterus if you:

  • Have prolonged or heavy bleeding
  • Have never been pregnant
  • Previously expelled an IUD
  • Have severe menstrual pain
  • Had Mirena inserted after childbirth or abortion
  • Are younger than 20 years old

Your doctor will suggest waiting for at least 8 weeks before having Mirena inserted to avoid possible expulsion after childbirth.

Your doctor will also suggest the removal of Mirena if you develop:

  • Cervical or Endometrial cancer
  • Pelvic infection
  • A significant increase in blood pressure
  • Inflammation of the endometrium or endometritis

4 Preparing for your Procedure

To prepare for the Mirena (hormonal IUD), your doctor will first do a pelvic exam and evaluate your overall health. He may also suggest screening for STIs.

During your menstrual cycle and if you haven’t had sex since your last period or if you have been using another birth control method consistently, you can have Mirena inserted.

Your doctor will also recommend taking a pregnancy test before the Mirena will be inserted if you are breastfeeding, have been constantly using birth control or have irregular periods.

You must be prepared to use backup contraception for one week if you have Mirena inserted more than seven days after the start of your period.

One to two hours before the procedure you can take a nonsteroidal anti-inflammatory drug such as ibuprofen (Advil, Motrin IB) to reduce the cramping.

5 What to Expect

Read on to learn more about what to expect before, during, and after your Mirena (hormonal IUD) procedure.

During the procedure, your doctor will clean your cervix and vagina with an antiseptic solution and will insert a speculum into your vagina.

He will use an instrument to align your uterine cavity and your cervical canal and also use another tool to measure the depth of your uterine cavity.

Your doctor will then folds Mirena's horizontal arms and place the device inside an applicator tube. He will insert the tube into your cervical canal and carefully place Mirena in your uterus.

Mirena will remain in place when the applicator tube is removed. You may experience dizziness, cramping, nausea, fainting, bradycardia and low blood pressure during the insertion of Mirena.

You should check to feel that Mirena’s strings are protruding from your cervix once a month. Your doctor will re-examine your Mirena to make sure it has not moved and check for symptoms of infection.

Consult your doctor if you:

  • Has abdominal pain or pain during sex.
  • Think you may be pregnant.
  • Have an unexplained fever.
  • Have unusually heavy and persistent vaginal bleeding.
  • Were exposed to a sexually transmitted infection.
  • Develop very severe headaches or migraines.
  • Have to yellow of the eyes or skin (jaundice).
  • Have unusual or foul-smelling vaginal discharge, sore or lesions.

If you suspect that the Mirena is no longer in place, consult your doctor if:

  • The IUD strings are missing or suddenly seem longer.
  • Sex is painful for you and your partner.
  • Your normal period returns.
  • You felt that a part of the device’s hard plastic is at your cervix or vagina.

This can remain for up to five years. Your doctor will use forceps to get the device’s strings and gently pull to remove the Mirena.

The device's arms will fold upward as it's withdrawn from the uterus. In some cases, removal might be complicated and you may feel light bleeding and cramping.

6 Procedure Results

As a result of Mirena (hormonal IUD), you may notice some changes in your period. Your period may be irregular and you may have frequent spotting or light bleeding after three to six months of the insertion.

After your body has adjusted your period may remain irregular, may be shorter and lighter than before or may even stop altogether. Your period may return if Mirena is removed.