Mirena IUD (inter-uterine device)

Copper IUDs are not recommended for women with heavy menstrual periods, because they often make the bleeding heavier. However Mirena will reduce a woman's periods, and may be a useful treatment for women with small to moderate fibroids or heavy menstrual bleeding.

Using Mirena

Mirena must be inserted in a doctor's office or clinic. It is often inserted during your period or shortly after having an abortion or giving birth when your caregiver can be sure that you are not pregnant. The insertion takes about five minutes. It is inserted into the uterus so that thin strings attached to the base of the T hang down through the cervical opening. These strings are trimmed so they are just long enough for you to check that the IUD is in place and so that a health care provider can use them to remove the IUD at a later date. Most women have some cramps when the IUD is being inserted.

You may want to use another method of birth control as back-up for a month in case the IUD moves or comes out. After six weeks, return to your doctor or clinic for a check-up then continue to have your regular check-ups. The Mirena can remain in place for 5 years and can be easily and quickly removed by a health care provider.

Changes to your Menstrual Cycle and other Side Effects

Mirena will change your menstrual cycle and eventually make your periods much lighter. However, in the first three months of use, many women experience unpredictable bleeding, and about 20 percent have prolonged periods that last more than 8 days. After three months bleeding becomes more regular and may stop altogether. In studies of Mirena, women's periods were reduced by 85 percent after three months and 97 percent after a year. Although bleeding is much lighter, some women who use Mirena have difficulty predicting when their period will occur.

Beyond these menstrual irregularities, Mirena has few side effects because it contains such a small amount of hormone. Some women do experience mild side effects related to the hormones such as headaches, water retention, breast tenderness or acne. Often these resolve after the first two months of use.

Advantages

• very effective
• neither partner can feel an IUD during sex
• the woman controls this method of birth control
• can remain in place for many years
  

Disadvantages

• cost
• does not protect against sexually transmitted infections
• unpredictable bleeding and other side effects particularly in the first few months
• increased risk of pelvic infection mainly associated with insertion
• increased risk of benign ovarian cysts
• may be difficult to insert in some women
• rarely an IUD may puncture the wall of the uterus
  

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