Mirena - Risks and Removal
The Mirena IUS
The Mirena coil arrived on the scene with promises of preventing pregnancy through the active ingredient levonorgestrel. It is an intrauterine system; a coil that also releases the synthetic form of progesterone. It is used for contraception as well as heavy menses. Some post-menopausal women are using it to protect from overgrowth of the uterine lining caused by estrogen-only HRT.
Drugs.com explains the method by which the Mirena IUS works to prevent pregnancy is by thickening a woman's cervical mucus to make it harder for sperm to reach the egg. The use of levonorgestrel prevents endometrial growth which is necessary for implantation of a fertilized egg. It also may prevent the release of an egg from the ovary.
Risks of the Mirena IUS
As with all types of birth control, there are risks with the Mirena IUS. Although the risk is said to be very low for pregnancy with use of the Mirena, if conception does happen it is more likely to be an ectopic pregnancy. It also does not protect against STDs.
Some of the risks of the Mirena IUS include:
· pelvic infection
· endometriosis (inflammation of the uterine lining)
· endometrial or cervical cancer
· uterine or cervical perforation
· increase in blood pressure
It is also possible to expel the Mirena from your uterus. This is more likely to happen if you:
· have never been pregnant
· have heavy or long periods
· have severe menstrual pain
· have previously expelled and IUD
· you are younger than 20
· you had the Mirena inserted immediately following birth or abortion
The Mirena IUS is recommended for use for five years at the end of which time it should be removed by a medical doctor. If you want to continue using a Mirena IUS, then a new one can be inserted immediately following the removal of the older coil. If you don't want to continue using the Mirena and also don't want to get pregnant, the Mirena should be removed in the first few days of starting your period.
Removing the Mirena IUS
Removing the Mirena is done by a health care professional who will grasp and gently pull on the threads in the cervix that are attached to the Mirena. The coil itself is a T-shape, but when it is pulled, the arms fold down. This action can be uncomfortable and in some cases painful for a woman. The pain is usually not serious and there is slight abdominal cramping that can develop once the IUS is removed from the uterus. By having the IUS removed during menses, the pain and discomfort can be reasonably diminished due to the softness of the cervix during menstruation. If there is sharp, severe, or persistent pain with removal, it could indicate a pregnancy or other difficulty and a doctor should be advised.
After It Is Removed
Once the coil is removed, there can be some spotting or tissue loss - both of which are considered to be normal. Some women experience heavier periods after having had the coil removed and spotting between periods for several months following removal of the Mirena. This may be due to hormonal changes as the body readjusts after the levonorgestrel. Some women who find that the Mirena causes a cessation of their periods (dysmenorrheal) when they have one inserted, may find that it takes a couple of months for their periods to resume normally following the removal of the IUS. Just to be sure, check with the doctor to be sure you're not pregnant.
It is possible that after the removal of the Mirena, neurovascular episodes may occur that impact the blood vessels and nerves in the body manifesting with a slower heart rate or fainting. These occurrences are generally mild and happen before you leave the clinic.
Many different types of birth control are available for women. Not all women can use IUDs, nor do they want to. Learn more about birth control in this section of our site.