Mirena is an intrauterine implant approved by the Food and Drug Administration (FDA) in 1990 to prevent pregnancy. Mirena is also prescribed to treat symptoms of endometriosis. Mirena is most commonly recommended for women who have given birth to at least one child. Mirena contains the drug levonorgestrel.
Mirena should not be inserted if a woman is pregnant. Mirena is not appropriate for women who have a lower genital tract infection of any kind. Do not use Mirena if you have ever had, or suspect you may have, cancer of the breast, cervix, or uterus. Mirena is not recommended for women who have liver disease or undiagnosed uterine bleeding. Mirena may not be appropriate for women with a history of pelvic inflammatory disease. If you have fibroids or other benign uterine growths that distort the shape of the uterus, Mirena may not be a good option for you. Mirena should be used with caution in women with high blood pressure, migraine or severe headaches, or a history of heart attack or stroke. You must not have given birth or experienced a genital infection in the weeks before Mirena is placed.
Mirena is a contraceptive. Mirena is a flexible plastic device approximately 1.3 inches long and shaped like a T. Two threads extend from the end of Mirena and will emerge from your cervix once the device is placed. Mirena supplies the synthetic steroid hormone levonorgestrel, a progestin. In cases of endometriosis, Mirena is thought to work by suppressing the growth of endometrial tissue and reducing pelvic inflammation.
How do I take it?
Your doctor will perform a pelvic exam and may administer a pregnancy test before placing the Mirena device.
Mirena is inserted by a trained health professional at a clinic or doctor’s office during the first week after you begin menstruating. You may feel some pain or discomfort during the brief procedure to place Mirena, and you may experience cramping for a few hours after the device is placed. You may temporarily feel dizzy or faint, but these sensations should pass quickly. Avoid intercourse for 24 hours after Mirena is placed.
Schedule a follow-up visit with your doctor approximately six weeks after Mirena is inserted to check that the device is still placed properly. While you are using Mirena, be sure to attend annual gynecological check-ups.
Once a month after your period, you should check that Mirena is still in place by gently feeling for the threads with your fingers. Do not tug on the threads. Although Mirena’s threads can be felt with the fingers, neither you nor your sexual partners should be able to feel Mirena during intercourse.
The contraceptive effects of Mirena last for five years. Mirena can be removed at any time, and fertility returns within four to six weeks. When you are ready for Mirena to be removed, a medical professional will remove it by pulling on the threads. Withdrawal of the device may cause a brief moment of pain or discomfort.
Note that although Mirena provides effective birth control, it does not protect you against sexually transmitted diseases including AIDS, herpes, syphilis, gonorrhea, and chlamydia.
Always follow your doctor’s instructions exactly while using Mirena.
Mirena has been evaluated for the treatment of endometriosis in a series of small trials, the longest of which lasted for three years. Clinical results show that Mirena is effective at reducing endometriosis pain for at least three years. The most pronounced improvements in pain occur during the first 12 to 18 months. Also, three to six months after beginning treatment with Mirena, most women have lighter menstrual periods, and some no longer experience periods at all.
Rare but serious side effects of Mirena include an increased risk for developing pelvic inflammatory disease and ectopic pregnancy.
Common side effects of Mirena include acne, nausea, vomiting, thinning of hair on the head, unwanted hair growth elsewhere, weight gain, headache, fatigue, dizziness, nervousness, a decrease interest in sex, and swollen or painful breasts. Most of these side effects will gradually resolve as your body adjusts to the medication. It is normal to experience prolonged bleeding or spotting for the first few weeks after Mirena is inserted. Mirena may increase your risk of developing a painful but temporary ovarian cyst. Such a cyst usually resolves on its own, but in the worst cases, it may require surgery.
Notify your doctor if side effects worsen. Call your doctor if you experience heavy or prolonged bleeding, sudden weakness, swelling, or pain in one or both legs, trouble speaking, yellowing eyes or skin, unusual vaginal discharge, weakness or numbness on one side of the face or body, abdominal pain, swollen limbs or extremities, severe chest or shoulder pain, pain during sex, chills, fever, or genital sores while using Mirena.
Unusually, Mirena may become dislodged. Contact your doctor if you cannot feel Mirena’s threads during a monthly check, if you can feel the device itself protruding from your cervix, if you or your partner experience discomfort during sex, or if you experience a significant change in your bleeding pattern from the pattern you had established with Mirena.
Many drugs can cause allergic reactions that, in the most serious cases, can result in death. Seek immediate medical help if you experience signs of a severe allergic reaction such as difficulty breathing or swelling of the face, throat, eyes, lips, or tongue.