Contraception occupies an important place in the life of every woman who wants to protect herself from possible pregnancy. There are several types of contraception, but gynecological doctors believe that intrauterine devices are considered the safest method of contraception, which can protect a woman from an unplanned pregnancy with a 99.9% probability. Among the large assortment of intrauterine devices, the Mirena device is especially popular, the reviews of specialist doctors are positive, since its use not only protects a woman from conceiving a child, but can also be prescribed for medical reasons, for a number of gynecological diseases.

Mirena spiral - what is it?

The Mirena intrauterine device (IUD) is a contraceptive method that contains a hormone that increases the viscosity of mucus in the cervical canal, which allows for a lasting contraceptive effect. The Mirena hormonal IUD allows the hormone levonorgestrel to be released daily from the cylinder of the IUD, thereby preventing sperm from entering the uterine cavity. This type of contraception allows women to protect themselves from pregnancy for 5 years. After a period of time has passed, the spiral is removed, and the reproductive system is completely restored, which allows the woman to plan a pregnancy.

In gynecology, the Mirena coil is often placed on those women who have a history of benign hormone-dependent tumors, as well as pathological growths of the endometrium. Specialists in the field of gynecology confirm the high contraceptive and therapeutic effect of Mirena. It is important to note that if the spiral is indicated for fibroids or endometriosis, then the effect of its use will be noticeable only in the initial stages of the disease. Mirena spiral - reviews from specialists and women themselves - are ambiguous, since the effect of its use depends on many factors. That is why, before installing the IUD, a woman needs a thorough diagnosis, as well as consultation with a highly qualified specialist.

Mirena IUD, the instructions indicate that only an experienced doctor should install an intrauterine contraceptive device. Before installation, it is important to undergo a series of gynecological examinations; this will help eliminate possible complications from further use of the contraceptive. Like any other medical drug, the Mirena spiral has its advantages and disadvantages, but in any case, if a woman wants to install this type of contraception, an individual approach is required.

Advantages of the Mirena IUD

Among the advantages of the Mirena intrauterine device, doctors in the field of gynecology note the following advantages:

• Protects against pregnancy for 5 years.
• Reduces the amount of discharge during menstruation.
• Reduces pain during menstruation.
• Well suited for those women for whom oral hormonal contraceptives are contraindicated.
• Protects against the development of benign tumors in the endometrium.

The intrauterine hormonal device Mirena is considered one of the most popular, since it has been used for more than 20 years in different countries of the world.

Disadvantages of the Mirena IUD

Side effects from Mirena are quite rare, and in almost all cases they go away on their own, without medical help, within a few weeks or months after the installation of the device. After a woman has been installed the Mirena hormonal device, she may experience the following symptoms:

• Bloody vaginal discharge between periods.
• Periodic pain and discomfort in the lower abdomen and lower back.
• The appearance of acne on the face.
• Frequent mood swings.
• Decreased sexual desire.
• Formation of a cyst in the ovaries (occurs in 10% of women who use Mirena) In the first months after the installation of the IUD, a woman may experience spotting. But such discharge usually goes away on its own within 2 to 3 months.

Approximately 5% of women using this type of contraception experience uterine bleeding, but their occurrence is most often associated with improper installation of the IUD. The Mirena hormonal device can often provoke the development of an inflammatory process in the uterine mucosa. The reason for the occurrence of such diseases is non-compliance with antiseptic rules during the installation of the system or the low professionalism of the doctor who installed the spiral.

What do doctors think about the Mirena IUD?

The Mirena intrauterine device has been widely used in gynecology for more than 20 years and is considered the safest method of contraception. During this time, the Mirena spiral has collected quite a few reviews from both practicing doctors and women themselves. Reviews about the spiral are mixed, since some women are quite satisfied with the result of its action, while others have had side effects in the form of bleeding. Therefore, there is no clear answer regarding the Mirena spiral, and everything depends on the woman’s body, the quality of the installation of the spiral and the qualifications of the specialist who performed this procedure.

Specialists in the field of gynecology have come to the same conclusion that this type of contraception should be installed only after a thorough diagnosis of the female body. If there are no contraindications to the Mirena spiral, then the doctor should familiarize the patient with possible complications or sensations after installing the spiral. In cases where, after installing the Mirena coil, a woman experiences severe pain in the lower abdomen and heavy bleeding, she should consult a doctor as soon as possible. Installation of the IUD should only be carried out by an experienced, qualified specialist, since in 60% of cases side effects after using this type of contraception develop due to the fault of the doctor. Therefore, it is very important to choose the right clinic and doctor who will perform this procedure.

The intrauterine device is one of the most reliable and convenient methods of birth control. There is no hassle with it, similar to taking pills, no inconvenience, like with a condom.

The IUD has only a local effect, without affecting the entire body. But since it remains in the uterine cavity for a long time, it is natural that menstruation after the IUD, as well as during it, can change their characteristics.

There are different types of IUDs, they are not suitable for every woman, so it is important to pay attention to menstruation and everything that accompanies it.

Read in this article

Read more about the IUD and its effect on the reproductive system

Modern spirals have the shape of the letters T, S or rings and are made of plastic with the addition of metal. The contraceptive effect is ensured by:

The impact of the device is aimed at the organs directly involved in the process of menstruation. Therefore, menstruation with a spiral may have different parameters than without it.

Only a doctor should insert an IUD after a thorough examination of the woman for infectious diseases and inflammatory processes in the uterus. Since it must be located in the cavity of the organ, the natural question is: when is the IUD placed before or after menstruation?

Access to the uterine space is through the cervical canal. This is a rather narrow “corridor,” especially for nulliparous women. Traumatizing it is extremely undesirable, as it carries the risk of infection and appearance. Damage to the cervix may be a negative circumstance for subsequent births.

It is more advisable to insert the IUD during menstruation:

• The cervix is ​​slightly open more widely than usual and has a soft consistency;
• The insertion of the IUD will be precise and painless;
• The reproductive system is undergoing an update, which will help it quickly adapt to the presence of a foreign object.

But what about the discharge? Can't it interfere with the doctor? This consideration leads to the question of what day of menstruation the IUD is placed on. With a 3-day menstruation, it is better to do this on the last day. If it lasts 4-7 days, also closer to the end, for example, 2-3 days before it. In this case, by the time the IUD is inserted, menstruation is no longer so intense as to prevent the gynecologist from seeing the working field. But the cervix has not yet narrowed enough to make inserting the IUD difficult.

What about other days?

Installation of an intrauterine device

For some women, the doctor prescribes the installation in addition to their critical days. But they doubt whether the IUD is inserted without menstruation. In principle, doing this on other days of the cycle is not prohibited. It’s just that many specialists prefer to do the installation in the last days of menstruation. This way you can be sure that the patient is not pregnant.

But if there is urgency in protection, you should not be afraid and doubt whether it is possible to insert the IUD without menstruation. This is often done to women who have recently had a successful birth. In order for the hormonal IUD to work immediately, it is administered a week after the start of the cycle.

For many, their critical days have already ended by this time, and the IUD is thus installed “dry”. The process may be a little more painful. But local anesthetics will help relieve the sensations, and the manipulation itself lasts no longer than 5 minutes.

Dates of menstruation with an IUD

Menstruation during the spiral should normally come on schedule. But since the body has suffered stress associated with its introduction, and also needs to adapt to the presence of a foreign object in the uterus, a small amount is acceptable. It is also made possible by a shock to the nervous system, which provides hormonal accompaniment of the cycle.

In this case, if there is a spiral, a delay in menstruation is likely due to a deficiency of certain substances, which causes a prolonged wait. Its increase is facilitated by installation outside critical days. But the wait for menstruation should not be longer than 3 weeks. And when it exceeds this period, the woman urgently needs to see a doctor.

A short delay in menstruation with the IUD is not an alarming signal if it is observed only for 3-4 cycles. The period of adaptation may well be that long. When this happens for longer, it makes sense to consult a specialist.

If a woman has had an IUD and has not had her period for a long time, then it is possible that conception has occurred. This probability is very small, but it should not be denied at all.

This also requires immediate consultation with a specialist. To avoid this, you should use other methods of protection for a couple of weeks after installing the IUD.

First menstruation and IUD: nature of discharge

The nature of menstruation in most women changes towards increased discharge and duration. The spiral makes it possible due to its irritating effect on the endometrium and changes in the composition of the cervical mucus.

We must also not forget about unstable hormonal levels due to installation-related stress. The spiral makes the first menstruation be especially intense. A woman may need more than 1 pad for 3-4 hours. If she also feels severe pain and severe weakness, she may need medical help immediately.

But normally, menstruation, although it goes beyond what is usual for a particular woman, does not pose any danger. And if they are stronger than before, they are removed with antispasmodics.

If there is no effect from the medications, or severe bleeding occurs, you should consult a doctor immediately. This could mean severe inflammation, the body’s rejection of the IUD, or injury to the uterus. The spiral must be removed immediately.

During the remaining days of your period immediately after inserting the IUD, you should not use tampons. They increase the risk of infection in the internal genital organs and can interfere with adaptation to the spiral.

Installed intrauterine device

One cycle after installation

Gradually, the body restores hormonal balance, which brings menstruation after the introduction of the IUD to the usual norm for a particular woman. If their intensity remains at the level of the first, this may indicate that the body does not accept this method of contraception or type of contraceptive.

In some women, due to existing diseases and past surgical interventions, the IUD increases the risk of its occurrence. Therefore, the test will not be superfluous.

Heavy menstruation

The first period after the IUD normally comes within 30-40 days. They may be delayed for the reasons mentioned above, or when the IUD was removed urgently. Menstruation can be heavy, which is associated with hormonal imbalances.

The spiral for a long time interfered with the normal development of the endometrium and prevented the maturation of the egg. This could not but have an impact on the functioning of the ovaries. Discharge becomes intense due to:

• Inflammation arising in the reproductive system. In most cases, it is the culprit, so it is important to monitor the cycle in collaboration with a doctor;
• Damage to the uterus. The process of removing an IUD is much simpler and shorter than insertion, but injury is still likely. It happens that parts of the contraceptive remain inside the organ. In this case, discharge will be observed from the very beginning after removal. And the pain, which normally should go away soon, will remain for a long time and may intensify.

How menstruation goes after the IUD depends on the diseases the woman has. In some of them, the IUD is prescribed not only as a means of preventing pregnancy, but also as a treatment for existing or preconditions for the occurrence of endometrial hyperplasia.

When the IUD is removed, menstruation may return to its previous form due to the fact that the factors that provoke the abundance of discharge are again in force.

Removing the IUD and scanty periods

The active components of the Mirena spiral are the hormones gestagen and levonorgestrel. The spiral is inserted directly into the uterine cavity. For contraceptive purposes, IUDs are installed in women of childbearing age for 7 days. from start . After an abortion in the 1st trimester of pregnancy, Mirena should be installed immediately. After childbirth, the IUD is used when the uterus is restored, but not earlier than after 6 weeks.

In order to protect the endometrium during estrogen replacement therapy in women suffering from amenorrhea, Mirena can be used at any time; In women with preserved blood, the procedure is performed according to the cycle schedule, in the last days of menstruation or immediately after the end of bleeding. Before installing the IUD, it is necessary to undergo examinations of both the mammary glands and the pelvic organs, and take a smear test from the cervix. It is also necessary to exclude pregnancy and - without fail - the presence of sexually transmitted diseases. Existing genital infections should be treated.

How to install the Mirena intrauterine device

Mirena is sold in sterile packaging, which must be opened immediately before inserting the spiral. When handling an opened system, you must follow the rules of asepsis. If the sterility of the packaging is compromised, the IUD is destroyed as medical waste. Mirena should be installed by a doctor who already has sufficient experience with this IUD. Before the procedure, the doctor determines the position of the uterus and the size of its cavity. It is important that the IUD is positioned correctly in the fundus of the uterus, which creates the necessary conditions for maximum effectiveness. Mirena is installed using sterile instruments - mirrors and forceps.

After 4-12 weeks, it is necessary to undergo an examination, then it is carried out once a year or more often if indicated. If there are difficulties when installing the Mirena, if there is severe pain or if bleeding occurs during the procedure or occurs after it, an ultrasound is performed immediately to exclude perforation (perforation) of the uterus. The spiral is removed after 5 years, it can be replaced with a new one any day.

Side effects of Mirena

Mirena may have the following side effects: nausea, discomfort and bloating, headache, nervousness, decreased mood, decreased libido, breast engorgement, urticaria, menstrual dysfunction, acne, itching, eczema, back pain and pain in the small area. pelvis, dysmenorrhea, vaginal discharge and bleeding, spotting, endometritis, cervicitis, inflammatory diseases, benign ovarian cysts.

Content

Pharmaceutical companies offer many ways to protect against unwanted pregnancy. Each of them is characterized by certain features. One of the most common contraceptives is the Mirena intrauterine device. Its advantages include a long-lasting effect and reliable protection.

Manufacturer Mirena

The Mirena intrauterine device was invented in the 80s in Finland. Today its manufacturer is the German brand “Bayer”. The package contains an intrauterine therapeutic system with the required concentration of the active substance.

Composition of the Mirena spiral and principle of action

Mirena is made in the form of a T-shaped structure placed in the conductor tube. The white core contains hormones necessary to prevent unwanted pregnancy. At both ends of the T-shaped body there are loops for fixing and removing the spiral from the uterine cavity. The body is covered with a membrane that meters the release of the active substance.

The active substance of the contraceptive system is levonorgestrel. It is presented in a volume of 52 mg. The auxiliary function is performed by polydimethylsiloxane elastomer. The contraceptive effect is achieved by reducing the susceptibility of receptors that respond to an increase in estrogen and progesterone. Thanks to this, the endometrium ceases to be influenced by estradiol. Levonorgestrel thickens the consistency of cervical mucus, preventing sperm from moving towards the uterus. In some cases, there is a temporary disappearance of ovulation. All this together makes the process of conception and embryo attachment impossible.

What hormone does Mirena contain?

The action of the Mirena intrauterine system is due to the content of a synthetic progestogen - levonorgestrel. The IUD releases 20 mcg of substance into the uterine cavity every day. After 5 years, this amount drops to 10 mcg, so the contraceptive effect decreases. The process of hormone release begins 40-60 minutes after the contraceptive is introduced into the uterine cavity.

Indications for the Mirena coil

It is recommended to study the indications and contraindications for the Mirena spiral in advance. A woman’s desire alone is not enough to install a spiral. You must first visit a gynecologist and undergo an extensive examination. Indications for using the spiral are as follows:

• endometriosis;
• lack of desire to have a child;
• myoma;
• prevention of endometrial hyperplasia;
• idiopathic menorrhagia.

Is it possible to install the Mirena spiral for uterine fibroids?

Myoma is a benign neoplasm that arises in the muscular layer of the uterus. It is considered a common disease in women of reproductive age. The presence of an intrauterine device does not have any effect on fibroids. But the hormone it secretes can suppress the growth of tumors. Therefore, protection with Mirena is often practiced for medicinal purposes.

Mirena spiral for menopause

Menopause is a process of slowing down the production of sex hormones. It develops in mature women. The decline of ovarian function is accompanied by hot flashes, nervous disorder and exacerbation of chronic diseases. These symptoms arise due to a systematic decrease in sex hormones. To stop the symptoms of menopause, the doctor may prescribe the hormonal Mirena spiral. It stabilizes hormonal levels, helping a woman get through a crisis period without complications.

Contraindications to Mirena

The Mirena gynecological device is placed for a long period of time. Therefore, before installing it, you need to make sure there are no contraindications. This will avoid side effects and health complications. Contraindications include:

• infectious diseases;
• cervicitis;
• uterine bleeding of unknown origin;
• endometritis;
• septic abortion occurring within the last 3 months;
• inflammatory process in the pelvis;
• atypical degeneration of cervical cells;
• hormone-dependent tumors;
• age over 70 years.

Comment! Women who have not given birth are not recommended to use an intrauterine device.

Instructions for use of Mirena

The Mirena IUD is installed in the uterine cavity for a period of 5 years. Installation is carried out in a medical facility. Within an hour after its implementation, the hormone penetrates the blood. After 2 weeks, the maximum concentration of the substance in the body is observed. It is excreted from the body through the intestines. The half-life is 1 day.

Before installing a contraceptive, a woman must undergo a comprehensive examination. It includes the following manipulations:

• gynecological examination and visit to a mammologist;
• taking a vaginal smear;
• colposcopy;
• ultrasound examination of the pelvis;
• donating blood for infections.

Diagnostic measures are necessary to exclude pregnancy, infectious diseases and inflammation. The volume of the uterus is also revealed. This is necessary for the most accurate installation of the spiral.

On what day of the cycle should the Mirena IUD be placed?

Doctors recommend putting Mirena in the first half of the cycle. It is advisable to wait until your period ends. Installation after ovulation is strictly prohibited. In this case, the contraceptive effect of the IUD is reduced. After an abortion, the IUD can be inserted regardless of the day of the menstrual cycle.

Installation of Mirena

The Mirena contraceptive is installed by a specialist who has experience working with the intrauterine system. The installation process is carried out on a gynecological chair. There is no need to place a woman in a hospital. A dilating instrument and a speculum are inserted into the vagina. The mucous surface of the cervix is ​​disinfected with an antiseptic.

The spiral is inserted into the uterine cavity using a special plastic tube. A woman may feel discomfort at this moment. But there should not be severe pain. If necessary, local anesthesia is used. You should lie on the couch for 1-2 hours after installation. After half an hour, any discomfort should go away. If this does not happen, the intrauterine system is removed.

Is it painful to insert the Mirena IUD?

A woman’s reaction to the installation of a contraceptive depends on the magnitude of her pain threshold. If unpleasant sensations appear, they do not last long. A day after installing the contraceptive system, the discomfort should subside. Pain experienced while wearing the IUD indicates the need to remove it.

What not to do after installing the Mirena coil

An intrauterine device with hormones does not interfere with a full life. It is not felt at all during operation. The body of the contraceptive is located in the uterus. Thin antennae extend into the vagina, which do not cause any discomfort. They are not felt during sexual intercourse. After installing the IUD, a woman can do her usual activities as usual. There is no ban on physical activity.

In the first 10 days after visiting a gynecologist, it is recommended to limit physical activity. It is also advisable to give up intimate relationships. During this period, the uterus is in a vulnerable position. Any intervention can provoke an inflammatory process. It is especially important to listen to your body during this period.

It is recommended to pay special attention to the health of the reproductive organs after installation of the Mirena system. The hormone-secreting intrauterine system is considered a factor that increases the likelihood of inflammatory processes. To avoid unwanted complications, you must:

• stop changing partners frequently;
• improve the quality of intimate hygiene;
• Visit your gynecologist regularly.

For how many years is Mirena IUD installed?

The main advantage of the intrauterine system is its long service life. The dosage of levonorgestrel is enough for 5 years. After this period, the contraceptive effect begins to decline. 30 days after installation of the IUD, the woman should visit a gynecologist. Further preventive examinations are carried out every six months.

Removing Mirena

The instructions involve removing the Mirena IUD during menstruation. The procedure is performed on a gynecological chair. Using medical forceps, the contraceptive is pulled out by the antennae. If difficulties arise, the cervical canal is widened, after which the device is removed using a special hook. At the woman’s request, the next spiral is installed immediately after the previous one is removed.

Warning! Mirena can be removed from the uterine cavity prematurely.

Is it possible to get pregnant with Mirena?

In terms of effectiveness, Mirena is on par with the mini-pill. The probability of successful embryo implantation is only 1%. Mirena has an abortifacient effect. Even if the egg can be fertilized, it will not be able to attach to the uterine cavity. This is due to insufficient thickness of the endometrium. The contraceptive effect may be reduced by the following factors:

• incorrect installation of the spiral;
• untimely removal of the IUD;
• installation of the spiral in the second half of the cycle;
• loss of contraceptive.

Side effects of the Mirena coil

Side effects after installing Mirena often develop. In most cases, changes affect the nature of menstrual flow. In the first 90 days, the body adapts to the created conditions. Therefore, menstruation may become irregular. Gradually the menstrual cycle returns to normal. Subsequently, the discharge becomes less abundant due to insufficient growth of the endometrium.

Side effects most often occur in the genital organs or nervous system. But other options are also possible. The most common side symptoms include:

• increased blood pressure;
• pain syndrome in the pelvic area;
• increased breast sensitivity;
• acne;
• alopecia;
• nausea;
• vulvovaginitis.

Since the installation of a contraceptive interferes with a woman’s hormonal background, the degree of sexual desire and emotional state may change. In some cases, depression develops, and the attitude towards familiar things changes. There may be a decrease in libido.

Insufficiently professional installation of Mirena leads to a serious complication in the form of cervical rupture. This happens extremely rarely. The situation is corrected surgically and with the help of conservative therapy. Typical signs of a cervical rupture include:

• paleness of the skin;
• acute abdominal pain;
• low pressure;
• increased heart rate.

Discharge after installation of the Mirena coil

On the first day after installation of the IUD, spotting may be present. In the following days, brown spots will appear. They indicate healing of the cervix. The discharge should not be accompanied by the following symptoms:

• unpleasant odor;
• increased body temperature;
• throbbing abdominal pain;
• bleeding;
• general malaise;
• presence of purulent inclusions.

Spotting that appears in the first days after installation of the coil should have a uniform structure. The presence of clots indicates the development of an inflammatory process. Amenorrhea while wearing a contraceptive is not considered a pathology.

Comment! If spotting continues to bother a woman for more than a week, she needs to see a doctor.

Bleeding with Mirena

Thanks to its hormonal composition, Mirena affects the nature of bleeding. Most often, the volume of blood released decreases. This is due to the inhibition of the growth of the uterine layers by the active substance of Mirena. Intense blood loss indicates the development of a pathological process in the body. In this case, it is necessary to remove the contraceptive from the uterus as quickly as possible.

Intermenstrual bleeding of a bloody nature is not normal. Especially if they appear six months after installation. To determine the cause of bleeding, it is enough to undergo an ultrasound examination. Taking measures on your own is strictly prohibited.

Attention! If menstruation does not come on time while using Mirena, it is necessary to take a pregnancy test or undergo appropriate research.

How much does the Mirena spiral cost?

The price of the Mirena intrauterine device depends on the place of purchase. It varies from 9,000 to 14,000 rubles. Considering the duration of use, it is much more profitable than birth control pills and condoms. Doctors recommend buying contraceptives only at official points of sale.

Analogue of the Mirena spiral

If Mirena for some reason is not suitable for a woman, the doctor offers several alternative options to choose from. These include oral contraceptives and latex products intended for barrier contraception. The most common drugs with contraceptive effects include:

• "Yarina";
• "Jess";
• "Novinet";
• "Regulon";
• "Janine."

Other intrauterine devices are an equivalent replacement for Mirena. They vary in shape, material and price. Spirals are in greatest demand:

• Nova T;
• Juno;
• Multiload.

Conclusion

The Mirena spiral is a reliable remedy for pregnancy, requiring a responsible approach. The main advantages of the contraceptive are monetary benefits and ease of use. To prevent possible complications, you should make regular preventive visits to your doctor.

The most popular intrauterine hormonal contraceptive is the Mirena device (IUD). Intrauterine contraceptives (IUDs) have been used since the middle of the last century. They quickly fell in love with women due to many positive qualities: the absence of a systemic effect on the female body, high performance, ease of use.
The spiral does not affect the quality of sexual contact, is installed for a long period, and requires virtually no control. But the IUD has a very significant disadvantage: many patients develop a tendency to metrorrhagia, as a result of which they have to abandon this type of contraception.

In the 60s, intrauterine systems containing copper were created. Their contraceptive effect was even higher, but the problem of bleeding from the uterus was not solved. And as a result, in the 70s, the 3rd generation of VMK was developed. These medical systems combine the best qualities of oral contraceptives and IUDs.

Description of the Mirena intrauterine device

Mirena has a T-shape, which helps to securely fit into the uterus. One of the edges is equipped with a loop of threads designed to remove the system. In the center of the spiral is a whitish hormone. It slowly enters the uterus through a special membrane.

The hormonal component of the IUD is levonorgestrel (gestagen). One system contains 52 mg of this substance. An additional component is polydimethylsiloxane elastomer. The Mirena IUD is located inside a tube. The spiral has individual vacuum plastic and paper packaging. It should be stored in a dark place, at a temperature of 15-30 C. Shelf life from the date of manufacture is 3 years.

Effect of Mirena on the body

The Mirena contraceptive system begins to “release” levonorgestrel into the uterus immediately after installation. The hormone enters the cavity at a rate of 20 mcg/day; after 5 years, this figure drops to 10 mcg per day. The spiral has a local effect, levonorgestrel is almost all concentrated in the endometrium. And already in the muscular layer of the uterus the concentration is no more than 1%. The hormone is contained in the blood in microdoses.

After inserting the spiral, the active ingredient enters the bloodstream in about an hour. There its highest concentration is reached after 2 weeks. This indicator can vary significantly depending on the woman’s body weight. With a weight of up to 54 kg, the level of levonorgestrel in the blood is approximately 1.5 times higher. The active substance is almost completely broken down in the liver and evacuated by the intestines and kidneys.

How Mirena works

The contraceptive effect of Mirena does not depend on a weak local foreign body reaction, but is mainly associated with the effect of levonorgestrel. The introduction of a fertilized egg is not carried out due to the suppression of the activity of the uterine epithelium. At the same time, the natural growth of the endometrium stops and the functioning of its glands decreases.

Also, the Mirena coil impedes the motility of sperm in the uterus and its tubes. The contraceptive effect of the drug increases the high viscosity of the cervical mucus and thickening of the mucous layer of the cervical canal, which complicates the penetration of sperm into the uterine cavity.

After installation of the system, a restructuring of the endometrium is observed for several months, manifested by irregular spotting. But after some time, proliferation of the uterine mucosa provokes a significant decrease in the duration and volume of menstrual bleeding, up to its complete cessation.

Indications for use

An IUD is installed primarily to prevent unwanted pregnancy. In addition, the system is used for very heavy menstrual bleeding for an unknown reason. The possibility of malignant neoplasms of the female reproductive system is preliminarily excluded. As a local gestagenic agent, the intrauterine device is used to prevent endometrial hyperplasia, for example, during severe menopause or after bilateral oophorectomy.

Mirena is sometimes used in the treatment of menorrhagia, if there are no hyperplastic processes in the uterine mucosa or extragenital pathologies with severe hypocoagulation (thrombocytopenia, von Willebrand disease).

Contraindications for use

The Mirena spiral is an internal contraceptive; therefore, it cannot be used for inflammatory diseases of the genital organs:

• endometritis after childbirth;
• inflammation in the pelvis and cervix;
• septic abortion performed 3 months before installation of the system;
• an infection localized in the lower part of the genitourinary system.

The development of acute inflammatory pathology of the pelvic organs, which is practically untreatable, is an indication for removal of the coil. Therefore, internal contraceptives are not prescribed if there is a predisposition to infectious diseases (constant change of sexual partners, severely decreased immunity, AIDS, etc.). To protect against unwanted pregnancy, Mirena is not suitable for cancer, dysplasia, fibroids of the body and cervix, and changes in their anatomical structure.

Since levonorgestrel is broken down in the liver, the spiral is not installed in case of malignant neoplasm of this organ, as well as in case of cirrhosis and acute hepatitis.

Although the systemic effect of levonorgestrel on the body is insignificant, this progestin substance is still contraindicated in all gestagen-dependent cancers, for example, breast cancer and other conditions. This hormone is also contraindicated for stroke, migraine, severe forms of diabetes, thrombophlebitis, heart attack, and arterial hypertension. These diseases are a relative contraindication. In such a situation, the question of using Mirena is decided by the doctor after laboratory diagnostics. The spiral should not be installed if pregnancy is suspected and hypersensitivity to the components of the drug.

Side effects

Common side effects

There are several side effects of Mirena, which occur in almost every tenth woman who has the IUD installed. These include:

• disorders of the central nervous system: short temper, headache, nervousness, bad mood, decreased sexual desire;
• weight gain and acne;
• gastrointestinal dysfunction: nausea, abdominal pain, vomiting;
• vulvovaginitis, pelvic pain, spotting;
• chest tension and tenderness;
• back pain, as with osteochondrosis.

All of the above signs appear most clearly in the first months of using Mirena. Then their intensity decreases, and, as a rule, unpleasant symptoms disappear without a trace.

Rare side effects

Such side effects occur in one patient out of a thousand. They are also usually expressed only in the first months after the installation of the IUD. If the intensity of manifestations does not decrease over time, the necessary diagnostics are prescribed. Rare complications include bloating, frequent mood swings, itching, swelling, hirsutism, eczema, baldness and rash.

Allergic reactions are very rare side effects. If they develop, it is necessary to exclude another source of urticaria, rash, etc.

Instructions for use

Installation of the Mirena coil

The intrauterine system is packaged in a sterile vacuum bag, which is opened before inserting the IUD. If the system is opened in advance, it must be disposed of.

Only a qualified person can install the Mirena contraceptive. Before this, the doctor must conduct an examination and prescribe the necessary examination:

• gynecological and breast examinations;
• cervical smear analysis;
• mammography;
• colposcopy and pelvic examination.

You need to make sure there is no pregnancy, malignant neoplasms or STIs. If inflammatory diseases are detected, they are treated before placing Mirena. You should also determine the size, location and shape of the uterus. The correct position of the spiral ensures a contraceptive effect and protects against system expulsion.

For patients of fertile age, an IUD is inserted in the first days of menstruation. In the absence of contraindications, the system can be installed immediately after an abortion. If the uterus contracts normally after childbirth, Mirena can be used after 6 weeks. You can replace the IUD on any day, regardless of your cycle. To prevent excessive growth of the endometrium, the intrauterine system should be inserted at the end of the menstrual cycle.

Precautionary measures

After installation of the IUD, you need to see a gynecologist in 9-12 weeks. Then you can visit the doctor once a year, more often if complaints arise. So far, there are no clinical data proving a predisposition to the development of varicose veins and thrombosis of the leg veins when using the spiral. But if signs of these diseases appear, you need to consult a doctor.

The effect of levonorgestrel negatively affects glucose tolerance, as a result of which patients with diabetes need to systematically monitor blood glucose levels. If there is a threat of septic endocarditis in women with valvular heart defects, insertion and removal of the system should be performed with the use of antibacterial agents.

Possible side effects are minor

1. Ectopic pregnancy is extremely rare and requires emergency surgery. This complication can be suspected if symptoms of pregnancy occur (long delay of menstruation, dizziness, nausea, etc.) together with severe pain in the lower abdomen and signs of internal bleeding (severe weakness, pale skin, tachycardia). There is a higher likelihood of developing such a complication after severe inflammatory or infectious pathologies of the pelvis or a history of ectopic pregnancy.
2. Penetration (ingrowth into the wall) and perforation (perforation) of the uterus usually develop when the IUD is inserted. These complications may be accompanied by lactation, recent childbirth, or unnatural position of the uterus.
3. Expulsion of the system from the uterus occurs quite often. For its early detection, patients are recommended to check the presence of threads in the vagina after every menstruation. It’s just that, as a rule, it is during menstruation that the probability of the IUD falling out is high. This process goes unnoticed by the woman. Accordingly, when Mirena is expelled, the contraceptive effect ends. To avoid misunderstandings, it is recommended to inspect used tampons and pads for loss. The manifestation of the beginning of the IUD falling out in the middle of the cycle can be bleeding and pain. If incomplete expulsion of the intrauterine hormonal device occurs, the doctor must remove it and install a new one.
4. Inflammatory and infectious diseases of the pelvic organs usually develop in the first month of using the Mirena system. The risk of complications increases with frequent changes of sexual partners. The indication for removal of the coil in this case is recurrent or severe pathology and the lack of results from the treatment.
5. Amenorrhea develops in many women while using an IUD. The complication does not occur immediately, but about 6 months after Mirena installation. When you stop menstruating, you must first rule out pregnancy. After removing the IUD, the menstrual cycle is restored.
6. Approximately 12% of patients develop functional ovarian cysts. Most often, they do not manifest themselves in any way and only occasionally may pain during sex and a feeling of heaviness in the lower abdomen occur. Enlarged follicles usually return to normal within 2-3 months on their own.

Removal of the IUD

The spiral must be removed 5 years after installation. If the patient does not plan pregnancy further, then the manipulation is carried out at the beginning of menstruation. By removing the system in the middle of the cycle, there is a possibility of conception. If desired, you can immediately replace one intrauterine contraceptive with a new one. The day of the cycle does not matter. After removing the product, you need to carefully inspect the system, since if there are difficulties in removing Mirena, the substance may slip into the uterine cavity. Both insertion and removal of the system may be accompanied by bleeding and pain. Sometimes fainting or a seizure occurs in patients with epilepsy.

Pregnancy and Mirena

The IUD has a strong contraceptive effect, but not 100%. If pregnancy nevertheless develops, then first of all it is necessary to exclude its ectopic form. In a normal pregnancy, the IUD is carefully removed or a medical abortion is performed. Not in all cases, it is possible to remove the Mirena system from the uterus, then the likelihood of premature pregnancy increases. It is also necessary to take into account the likely adverse effects of the hormone on the formation of the fetus.

Use during lactation

Levonorgestrel IUD enters the bloodstream in small dosages and can be excreted in milk when breastfeeding. In this case, the hormone content is about 0.1%. Doctors say that at such a concentration it is impossible that such a dose could affect the general condition of the baby.

FAQ

The price of Mirena is quite high, and the use of a contraceptive can cause many side effects. Does the product have any positive effect on the female body?

Mirena is often used to restore the condition of the endometrium after bilateral ovarian removal or during pathological menopause. Also intrauterine device:

• increases hemoglobin levels;
• prevents endometrial cancer and hyperplasia;
• reduces the duration and volume of idiopathic bleeding;
• restores iron metabolism in the body;
• reduces pain during algomenorrhea;
• carries out the prevention of fibroids and endometriosis of the uterus;
• has a general strengthening effect.

Is Mirena used to treat fibroids?

The spiral stops the growth of the myomatous node. But additional diagnostics and consultation with a gynecologist are needed. It is necessary to take into account the volume and localization of the nodes, for example, in case of submucosal formations of fibroids that change the shape of the uterus, installation of the Mirena system is contraindicated.

Is Mirena intrauterine drug used for endometriosis?

The IUD is used to prevent endometriosis because it stops the growth of the endometrium. Recently, the results of studies proving the effectiveness of treating the disease were presented. But the system provides only a temporary effect and each case must be considered individually.

Six months after the introduction of Mirena, I developed amenorrhea. Is this how it should be? Will I be able to get pregnant in the future?

The absence of menstruation is a natural reaction to the influence of the hormone. It gradually develops in every 5 patients. Just in case, take a pregnancy test. If it is negative, then there is no need to worry; after removal of the system, menstruation resumes and you can plan a pregnancy.

After installing the Mirena contraceptive, can you experience discharge, pain or uterine bleeding?

Usually these symptoms appear in a mild form, immediately after the introduction of Mirena. Severe bleeding and pain are often indications for IUD removal. The cause may be ectopic pregnancy, improper installation of the system, or expulsion. Contact your gynecologist immediately.

Can the Mirena IUD affect your weight?

Weight gain is one of the side effects of the drug. But you need to take into account that it occurs in 1 woman out of 10 and, as a rule, this effect is short-lived; after a few months it disappears. It all depends on the individual characteristics of the body.

I protected myself from unwanted pregnancy with hormonal pills, but often forgot to take them. How can I change the drug to the Mirena spiral?

Irregular oral hormone intake cannot completely protect against pregnancy, so it is better to switch to intrauterine contraception. Before this, you need to consult a doctor and undergo the necessary tests. It is better to install the system on days 4-6 of the menstrual cycle.

When can I get pregnant after taking off Mirena?

According to statistics, 80% of women become pregnant, if that is what they want, of course, in the first year after removing the IUD. Thanks to its hormonal action, it even slightly increases the level of fertility (fertility).

Where can I buy the Mirena spiral? And what is its price?

The IUD is available only with a prescription and is sold at pharmacies. Its price is determined by the manufacturer, and varies from 9 to 13 thousand rubles.