Mary, a patient of mine, came to me with questions about the Mirena hormonal IUD that her gynecologist had recommended due to her heavy menstrual bleeding (menorrhagia) over the past 4 months. As her family physician, I wanted to provide Mary with objective, thorough information to help her make an informed choice. Here’s what I shared with her.
What is Mirena and how does it work?
Mirena is a small, T-shaped plastic device that is inserted into the uterus by a gynecologist. It releases a low dose of the hormone levonorgestrel, which thins the uterine lining and thickens cervical mucus to prevent pregnancy. Mirena is over 99% effective at preventing pregnancy for up to 5 years. It can also significantly reduce heavy menstrual bleeding.
Is Mirena compulsory for women with heavy periods?
No, Mirena is not mandatory, but it is one effective treatment option that your gynecologist may recommend if other treatments haven’t worked or if you also need contraception. There are other medications and procedures to treat heavy bleeding as well. Ultimately, the choice is yours.
How is Mirena inserted and is it painful?
A gynecologist inserts Mirena during a hospital visit. They will do a pelvic exam, then insert the IUD through the cervix into the uterus. You may feel some cramping and discomfort, and your doctor may recommend taking pain medication beforehand. The procedure only takes a few minutes.
What are the benefits of Mirena?
Mirena is a highly effective, long-acting, reversible form of birth control. For many women, it significantly reduces menstrual blood loss and cramping. After a few months, periods often become very light and some women stop having periods altogether. Mirena can be a good option for women who can’t take estrogen-containing birth control.
What are the potential side effects and risks?
In the first 3-6 months after insertion, Mirena can cause irregular bleeding or spotting. Other potential side effects include abdominal/pelvic pain, ovarian cysts, headaches, acne, and mood changes. More rarely, Mirena can slip out of place, perforate the uterus, or cause pelvic inflammatory disease. It does not protect against STDs. Discuss any side effects with your doctor.
Who should not use Mirena?
Mirena is not recommended for women with breast cancer, uterine or cervical cancer, liver disease, or uterine abnormalities. It’s also not recommended if you have a pelvic infection or if you are allergic to levonorgestrel. Talk to your doctor about your medical history.
How long does Mirena last and what happens when it expires?
Mirena is effective for up to 5 years, after which it must be removed and replaced if you want to continue using it. Your doctor can easily remove the IUD at any time. If it’s left in the past 5 years, there’s a higher chance of complications.
How much does Mirena cost in India?
The price of Mirena in India is around Rs. 12,000-15,000. Some health insurance plans may cover all or part of the cost. Check with your insurance provider.
Mary, I hope this information helps you weigh the potential benefits and risks of the Mirena IUD. It’s a personal decision that you should make in consultation with your gynecologist based on your medical history, symptoms, and family planning goals. Let me know if you have any other questions!
