Doubts and questions about the Mirena IUD


The Mirena IUD is a long-acting, reversible contraceptive method that requires a single application. The MIRENA IUD works by releasing hormones that act as a contraceptive method. The contraceptive action of the Mirena IUD begins when it is inserted into the female intrauterine system by releasing a hormone similar to progesterone and found in some birth control pills.

Doubts about the Mirena IUD

  • What kind of hormones does the Mirena IUD contain?
    Mirena IUD releases only one progestin, levonorgestrel, at very low doses and only where it should act, in the uterine cavity. It does not contain estrogen so it can be used by women who suffer from intolerance to it
  • Can the Mirena IUD be used by any woman? The Mirena IUD can be used in any woman in need of contraception. MIRENA is mostly recommended for women who have been pregnant since insertion is easier on them. If you are breastfeeding, this endoceptive may also be helpful. The Mirena IUD is not the contraceptive method of choice for young women who have not been pregnant. There are also specific contraindications to the use of the Mirena IUD.
  • How long does the Mirena IUD work?
    The Mirena IUD is effective for up to 5 years.
  • How is the Mirena IUD inserted?
    Only a doctor can insert the Mirena IUD. It will be placed into the uterine cavity through the vagina using a guide that looks like a long, thin tube that is then withdrawn. The system threads pass through the cervix into the vagina. These are cut to a length of 2-3 cm.
  • Is it painful to insert the Mirena IUD?
    Most women report some mild discomfort. After its insertion, you may have cramps, such as those associated with a menstrual period. They usually go away after a few hours.
  • Can the Mirena IUD move or come out of the uterus?
    It is unlikely, but if it comes out in whole or in part, you will not be protected from pregnancy. An unusual increase in the amount of bleeding during your period may be a sign that this has occurred. If you think it has come out, use other reliable forms of birth control until you see your doctor again. Tell your doctor if there are any unexpected changes in your bleeding pattern.
  • Does the Mirena IUD decrease during menstruation?
    The decrease in menstrual bleeding is well documented by physicians. Studies from Sweden, the Netherlands and Finland have shown a marked decrease in MS to 1/10 of the pre-treatment values ​​due to use for one year.
  • How do I know I’m not pregnant if I don’t get my period?
    It is very unlikely that there is a pregnancy in women who use MIRENA®, even in those who have stopped menstruating during the use of this endoceptive. However, you can take a pregnancy test to make sure. If you have not had menstrual periods and notice sudden bleeding, you should see your doctor. This may be a sign that it has moved or come out.
  • How do I know if you have started menopause?
    In addition to changes in bleeding patterns, most women have noticeable changes when menopause begins, eg unusual hot flashes or sweating. If you think you have entered menopause, talk to your doctor about further testing.
  • Does the Mirena IUD affect menstrual periods?
    Yeah. The menstrual bleeding pattern changes in virtually all women. During the first months after its insertion, a large number of women have irregular spotting.
    The most noticeable change is the significant decrease in the volume of menstrual bleeding; 20% of women will not have menstrual bleeding of any kind (amenorrhea) after one year of use. Cycle irregularity is not a contraindication.
  • Why does the Mirena IUD cause a decrease in menstruation?
    The Mirena IUD, located high on the uterine fundus, will completely dominate the endometrium. Levonorgestrel will inhibit the synthesis of estradiol receptors making the endometrium insensitive to estradiol. Consequently, despite normal blood estradiol concentrations, there is no endometrial proliferation (growth) and the endometrium will be inactive (at rest).
    For seven years, extensive studies on this effect have been carried out. Amenorrhea has been shown not to be associated with any health risk.
    The endometrium is in full rest and, therefore, cell turnover is not required. The appearance of the mucosa is very similar to that of women nursing their children.
  • How many women stop having periods with the Mirena IUD?
    Up to 35% of women have “skipped” periods and approximately 20% of those women who use it had a bleeding-free period of at least three months during the first year.
  • How soon does menstrual bleeding start again in a woman who had no bleeding?
    In a clinical study, ovulation occurred after 2 weeks and menstrual bleeding occurred within the first 23 days after the stent was removed.
  • Spotting is the most common initial problem for women using the Mirena IUD
    . What is the number of days per month that spotting can occur? During the first month of use, women using the Mirena IUD have had an average of 9 days of spotting. However, the spotting gradually decreased and the number of days of spotting after 6 months was less than 4, which was comparable to what was observed with copper IUDs. The percentage of women with prolonged bleeding (more than 8 days) is reduced from 20% to 3% during the first 3 months of use. The individual response is highly variable.
    Why does staining occur? The effect of progestogens on the endometrium. It has been studied in great detail, but the cause of the staining has not been clarified. One explanation, but not the only one, could be the greater fragility and dilation of the small blood vessels in the endometrium.
  • Does the woman ovulate with the Mirena IUD?
    During the first year of use, some women experience suppressed ovarian function. After that, most cycles are ovulatory and the incidence of ovulatory cycles with MIRENA and with the copper IUD is the same: 85%. In general, an ovulatory cycles (5 to 15% of treatment cycles) correlate with higher serum levels of levonorgestrel. To obtain complete suppression of ovulation, a daily intrauterine release of 50 μg of LNG is required. With MIRENA, only 20 μg/day of LNG is initially released. Determination of plasma estradiol (E2) and progesterone (P) levels indicates that women using MIRENA® generally have normal ovulatory cycles.
  • Can the Mirena IUD be inserted after an abortion or childbirth?
    Clinical studies conducted with the Mirena IUD have included subgroups of people with insertions performed after abortion. It is possible to insert the Mirena IUD immediately after a first trimester miscarriage.

    Postpartum insertions should be performed after the uterus has fully involuted; In any case, they should not be performed before 6 weeks after delivery. If uterine involution is significantly delayed, consideration should be given to deferring insertion until 12 weeks postpartum.

  • Can the Mirena IUD be inserted after removing a normal copper IUD?
    The Mirena IUD can be inserted immediately after removal of a copper IUD without the need for any additional contraceptive measures. The same happens if after the age of 5 you want to replace a Mirena IUD with another.
  • Does levonorgestrel cause dryness of the vaginal mucosa?
    Estrogen levels are not affected in women using the Mirena IUD. In rare cases, patients have complained of mucosal dryness.
  • Mirena IUD and ovarian cysts Enlarged
    follicles resembling ovarian cysts may occur in approximately 12% of women taking MIRENA. These follicles are generally asymptomatic, although some may be accompanied by pelvic pain or dyspareunia (pain during sexual intercourse). In most cases these follicles disappear spontaneously within 2 to 3 months of observation. If this is not the case, it is recommended to continue with ultrasonic monitoring and consider other diagnostic or therapeutic measures. Surgical intervention is very rarely required.
  • Can prolonged use of the Mirena IUD cause infections?
    The insertion tube prevents the Mirena IUD from being contaminated with microorganisms during insertion and the Mirena IUD inserter (endoceptor) has been designed to minimize the risk of infection. In copper IUD users, the highest percentage of pelvic infections occurs during the first month after insertion and decreases thereafter. Some studies suggest that the rate of pelvic infection among IUD users is lower than among users of copper intrauterine devices.


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