EPWORTH HAWTHORN HOSPITAL
Level 2, 50 Burwood Rd, Hawthorn, 3122
Phone 03 9347 7100 - Fax 03 9818 1341
ROYAL WOMEN’S HOSPITAL
Level 2, 20 Flemington Rd, Parkville, 3052
www.advancedgynaecologymelbourne.com.au
What is a Mirena?
Mirena is the brand name for an
intrauterine device. As the name states, the
contraceptive device is inserted inside the
uterine cavity.
How does it work?
The Mirena IUD releases a small daily dose
of a progesterone-like hormone called
Levonorgestrel.
Its contraceptive effect is achieved by a
combination of factors:
The frequency of ovulation is reduced.
The presence of the IUD inside the uterus
triggers the release of substances
(leukocytes and prostaglandins) that are
hostile to both sperm and eggs
It changes the lining of the uterine cavity
making it unsuitable for a pregnancy
It makes the mucus produced by the cervix
thicker thus making it difficult for sperms
to enter the uterine cavity.
What are the advantages of the Mirena IUD
as a contraceptive method?
It is very effective in preventing
pregnancies
It acts for an extended period of time (5
years)
Once inserted, it does not require further
action such as taking a pill every day or an
injection every three months
It is readily reversible and usual fertility
returns soon after it is removed
It often reduces the amount of menstrual
bleeding and can reduce period pain
It is quite inexpensive for 5 years of
contraception
What are the disadvantages of the Mirena
IUD?
Insertion and removal can only be done by
a doctor
Some women can experience irregular
bleeding
It does not protect against sexually
transmitted diseases
The insertion procedure can be
uncomfortable and some women may
require local anaesthetic
How is the Mirena IUD inserted?
The Mirena IUD is inserted by a doctor. It is
pushed inside the uterine cavity through the
natural opening of the cervical canal.
When should the Mirena IUD be inserted?
To insert a Mirena IUD the doctor must be
certain that the woman is not pregnant.
Once that is confirmed the IUD can be
inserted at any time.
If possible, the ideal time is the first week
after the period ends.
Is it painful to have the IUD inserted?
In most cases the insertion is tolerated very
well with just minimal discomfort. Some
women may require local anaesthetic and,
in some rare cases, women are taken to
theatre and given a light general
anaesthetic.
How soon after the Mirena is inserted can I
rely on it for contraception?
If it is inserted during the first week after
the start of your period, it is effective
immediately. If it is inserted at any other
time in your cycle, it is effective after one
week.
How soon after the insertion of a Mirena can
I have sex?
You can have sex any time after you have a
Mirena inserted. If the insertion was outside
the first week of your menstrual cycle, you
should use alternative contraception such as
condoms for one week before relying solely
on the Mirena for contraception.
EPWORTH HAWTHORN HOSPITAL
Level 2, 50 Burwood Rd, Hawthorn, 3122
Phone 03 9347 7100 - Fax 03 9818 1341
ROYAL WOMEN’S HOSPITAL
Level 2, 20 Flemington Rd, Parkville, 3052
www.advancedgynaecologymelbourne.com.au
What happens to my periods once I have a
Mirena IUD inserted?
The Mirena IUD reduces the amount of
menstrual flow. Only about 5% of women
will continue to have regular periods after
they have a Mirena IUD inserted. About
60% of women will have no periods at all
and about 30-35% of women will have a
very light period for one or two days every
month
How long does the Mirena IUD
contraceptive effect last for?
The Mirena IUD is effective for 5 years, but
it can be removed any time before that.
After 5 years the Mirena IUD needs to be
removed. If the woman still requires
contraception, the old Mirena IUD is
removed and a new one is inserted.
How effective is the Mirena IUD?
The Mirena IUD is one of the most effective
contraceptive methods. The effectiveness
of a Mirena IUD is around 99%. That means
that out of 100 women using a Mirena for 1
year, 1 may fall pregnant.
Will I feel the Mirena once it has been
inserted?
No, you will not. The presence of the Mirena
IUD should not be felt at all.
Will my partner feel the IUD while we are
having sex?
The IUD cannot be felt, as it is inside the
uterine cavity and not in the vagina. There
have been some cases where partners were
able to feel the Mirena IUD strings in the
vagina. This is not a problem and is quite
normal. If it persists, you should see your
doctor and ask him/her to trim the strings
shorter.
How is the Mirena IUD removed?
There are two little strings attached to the
IUD and these are cut about 1cm outside
the cervix. To remove the Mirena all the
doctor has to do is pull on those strings. It is
a very straight forward procedure that only
lasts a few seconds and can be done in any
doctor’s
rooms
without
requiring
anaesthesia.
Are there any side effects with the use of a
Mirena IUD?
The amount of hormone released daily by
the Mirena IUD is much less than one
contraceptive Pill, so the side effects are
usually very minimal. In some women,
similar side effects to those felt with the
contraceptive pill may be experienced.
These include fluid retention, breast
tenderness, headache and mood swings.
Are there any long term complications?
Once the Mirena IUD is removed any side
effects should cease.
What if I want the Mirena IUD removed
before the end of the 5 years?
The Mirena IUD can be removed at any
time.
Once the Mirena IUD is removed how long
does it take for me to be fertile again?
As soon as the Mirena IUD is removed its
effect ceases and the return to fertility is
very quick. Some women have fallen
pregnant one week or two after the removal
of the Mirena, so if you do not intend to fall
pregnant, alternative contraception needs
to be used as soon as the Mirena IUD is
removed.
Can women who have not had children have
a Mirena IUD inserted?
Yes they can.
The concern in these women is a rare
complication caused by sexually transmitted
diseases such as chlamydia and gonorrhoea.
The infection starts in the vagina, but can go
up to the uterus, fallopian tubes and
ovaries. This is called Pelvic Inflammatory
Disease (PID). Any woman who acquires
these infections can develop PID, but the
risk is higher in women with an IUD.
The infection is usually not severe and can
be treated with antibiotics; it may though
have implications for future fertility as it can
compromise the fallopian tubes.
EPWORTH HAWTHORN HOSPITAL
Level 2, 50 Burwood Rd, Hawthorn, 3122
Phone 03 9347 7100 - Fax 03 9818 1341
ROYAL WOMEN’S HOSPITAL
Level 2, 20 Flemington Rd, Parkville, 3052
www.advancedgynaecologymelbourne.com.au
Every woman with an IUD should be
concerned about sexually transmitted
disease. If they have not had children that
concern is even more important.
Does the IUD cause abortions?
No it doesn't. There is a misconception that
the mechanism of action of the IUD is
actually preventing implantation of an
already fertilised egg. If that were the case,
some people say that the embryo that is lost
could potentially become a baby. Some
religious groups think this is an abortion and
therefore do not use IUDs. There have been
studies showing with certainty that this is
not the case and that the mechanism of
action of the IUD is actually preventing the
fertilisation of the egg in the first place.
Is Mirena particularly recommended for
certain women?
Mirena can be the preferred option for
women who:
Want an effective long term, but
reversible contraceptive method
Experience heavy bleeding or period pain
Have a contraindication for the use of
oestrogens
Don’t want to remember to take a pill
every day
Have had a baby and want to wait a few
years before falling pregnant again
Is Mirena not recommended for certain
women?
Mirena may not be a suitable option for
women who:
Are at high risk of sexually transmitted
diseases, i.e., who have or are likely to
have several partners
Who have an abnormal uterus or cervix
Have irregular bleeding and the cause is
unknown
And, of course, a Mirena IUD should not be
inserted in woman who are or who suspect
being pregnant.
What are other options for contraception if I
don't want to have an IUD?
All the other contraceptive options can be
considered. These include:
Combined Contraceptive pills
Progesterone only pill
Three monthly progesterone injections
Subcutaneous Implant (Implanon)
Vaginal ring (NuvaRing)
Condoms
Diaphragm
And for women who have completed their
families and no longer desire to be able to
fall pregnant:
Tubal ligation
Essure procedure