Mirena IUD

Posted on November 25, 2017 by - Gynaecology

The Mirena IUD is now the IUD of choice for most women. It gives good menstrual control as well as contraception with minimal side effects.

In my Practice, the Mirena IUD is the most frequently inserted IUD in comparison to the Copper IUD. It contains a hormone called Progesterone and is released slowly after insertion into the cavity of the womb. Progesterone then leads to thinning of the lining of the womb. In the majority of uses, it reduces the period loss substantially, in many cases, leading to an absence of periods whilst the IUD is in.

The IUD is easily inserted in the office and will last 5 years. Some of its uses include:

  1. Menstrual control. Used mainly for management of heavy periods.
  2. Contraception
  3. Management of endometriosis
  4. As part of combined Hormone Replacement Therapy

Like all IUDs it does have risks and side effects including:

  • Hormonal side effects. Some women experience breast soreness, headaches, mood swings and bloating. These are usually temporary.
  • Infection. There is a small risk of infection with insertion of the IUD. If significant, it may lead to issues of infertility with tubal damage.
  • Bleeding. Persistent irregular bleeding can vary from spotting to a moderate loss and may last up to 6 months. For many it is short lived.
  • Expulsion of the IUD from the womb. The womb can try to expel the IUD. It may fall out completely or partially. It may not be noticed that it has happened. This is checked for, 6 weeks after insertion. The chance of expulsion is low in my experience.
  • Perforation of the IUD through the womb. Usually this happens at the time of the insertion although over time the IUD can become embedded into the muscle of the womb. The IUD is thus not effective if complete perforation occurs and may need to be surgically removed. I have not had this experience myself.
  • Exposure of the IUD strings in the vagina. For good reason, there is a set of strings attached to the IUD that extends into the upper part of the vagina. Normally these are hard to feel for. They are there so that the IUD can be removed by simply pulling on them. However sometimes it can cause pain for the partner at sex. Whilst it can be trimmed short, it may make it impossible to find the strings when it comes to removal. In that instance an operation like a D and C will be required to remove it. Even strings that are left long, can sometimes curl up into the womb and disappear from view leading to a similar situation. This is not a common event.

For most women, the biggest issue is that of persistent bleeding. However, it tends to be light and will settle over time. In general it works well and with Government support, can be bought from Pharmacies for only about $40.00. The benefit of its use will depend on one’s individual condition.

These notes reflect my personal opinion and are intended for general advice only. It should not be used for any one individual case. You should consult your own doctor to determine the appropriate management of your own individual situation.