Your doctor and pharmacist have more information on medicines to be careful with or avoid while taking this medicine. Follow all directions given to you by your doctor or pharmacist carefully.
They may differ from the information contained in this leaflet. If you do not understand the instructions given, ask your doctor or pharmacist for help.
The system should be inserted within seven days from the beginning of your period. If you already have the system and it is time to replace it with a new one, you do not need to wait for your period.
Mirena can be inserted immediately after a first trimester abortion. It should not be used until the womb has returned to normal size after giving birth and no earlier than six weeks after delivery.
When Mirena is used to protect the lining of the womb during estrogen replacement therapy, it can be inserted at any time if you do not have monthly bleeding or else during the last days of menstruation or withdrawal bleeding.
You may feel faint after the system is inserted. This is normal and your doctor will tell you to rest for a while. The current recommendation is to wait about 24 hours after having Mirena inserted before having sexual intercourse. You may feel faint after Mirena is placed.
In rare cases, part or all of the system could penetrate the wall of the womb. If this happens, Mirena needs to be removed. You should have Mirena checked usually weeks after it is placed and then once a year until it is removed. It can stay in place for five years. Your doctor can remove the system at any time and removal is usually easy. Mirena should be removed before the seventh day of the menstrual cycle unless another form of contraception is used in the week leading up to the removal.
Intercourse during this week could lead to pregnancy after Mirena is removed. Additional methods should be used i. If the system comes out either partially or completely you may not be protected against pregnancy. It is rare but possible for this to happen without you noticing during your menstrual period. The muscular contractions of the womb during menstruation may sometimes push the IUS out of place or expel it. Possible symptoms are pain and increased amount of bleeding.
If you have signs indicative of an expulsion or you cannot feel the threads you should either avoid intercourse or use another contraceptive e. After each menstrual period, you can feel for the two thin threads attached to the lower end of the system. Your doctor will show you how to do this. Do not pull on the threads because you may accidentally pull it out. If you cannot feel the threads, consult your doctor. You should see your doctor if you can feel the lower end of the system itself or you or your partner feel pain or discomfort during sexual intercourse.
Many women have frequent spotting or light bleeding in addition to their periods for the first months after they have had Mirena inserted. Overall, you are likely to have a gradual reduction in the number of bleeding days and in the amount of blood loss. Some women eventually find that their periods stop altogether.
If you are using Mirena with estrogen replacement therapy, a non-bleeding pattern is likely to develop during the first year of use. Mirena can perforate the wall of the womb most often during placement.
The risk of perforation increases in breastfeeding women and in postpartum after giving birth insertions. The risk may also be increased in women with a fixed retroverted uterus tilted womb. If this happens, the IUS must be removed as soon as possible.
If you experience excessive pain or bleeding after insertion, tell your doctor immediately. It is very rare to become pregnant while using Mirena. However, if you become pregnant while using Mirena, the risk of an ectopic pregnancy where the foetus is carried outside of your womb is increased. Although the rate of pregnancy is low, if you suspect you are pregnant, you should see your doctor straight away.
Ectopic pregnancy can cause internal bleeding, infertility, and death. It is a serious condition that requires immediate medical attention. The following symptoms could mean that you may have an ectopic pregnancy and you should see your doctor immediately:. There are also risks if you get pregnant while using Mirena and the pregnancy is in the womb. Because of this, your doctor may try to remove Mirena, even though removing it may cause a miscarriage. If Mirena cannot be removed, talk with your healthcare provider about the benefits and risks of continuing the pregnancy.
If you continue your pregnancy, see your doctor regularly. Call your doctor right away if you get flu-like symptoms, fever, chills, cramping, pain, bleeding, vaginal discharge, or fluid leaking from your vagina.
These may be signs of infection. It is not known if Mirena can cause long-term effects on the foetus if it stays in place during a pregnancy. The Mirena system and insertion technique have been designed to minimise the risk of infections. Despite this, there is an increased risk of pelvic infection immediately and during the first month after insertion.
Pelvic infections can occur with contamination of the IUS. When having sex with anybody who is not a long-term partner, a condom should be used to minimise the risk of infection with HIV, hepatitis B and other STIs. Pelvic infections must be treated promptly. Pelvic infection may impair fertility and increase the risk of ectopic pregnancy. Mirena must be removed if there are recurrent pelvic infections or if an infection does not respond to treatment within a few days. Tell your doctor immediately if you have persistent lower abdominal pain, fever, pain during sexual intercourse or abnormal bleeding.
As with other gynaecological or surgical procedures, severe infections or sepsis can occur following IUD insertions. Ovarian cysts or enlarged group of cells follicles have been reported with the use of Mirena and may cause pelvic pain or pain during intercourse. You may not experience any symptoms with ovarian cysts or follicles. In most cases, the follicles resolved spontaneously.
Your doctor will monitor you while you are using Mirena. Breast cancer has been detected slightly more often in women who use combined oral contraceptives the Pill compared to women of the same age who do not use the Pill. It is not known whether the difference is caused by the Pill or whether cancers were detected earlier in Pill users. Miniscule systemic absorption of LNG crowns Mirena with negligible side effects, unlike other progestin pills and injectables.
We also have in stock Depo Provera Shot which provides contraception for a long term of 12 weeks with just one injection. Mirena IUD a T — shaped device to be inserted into the uterine cavity. The T -shaped frame is made of plastic or polyethylene. It has a pair of nylon type threads attached to the end of the stem forming a tail of sorts.
These threads facilitate self-identification of the device as being located correctly in place and help in device removal when needed. This is nothing but a reservoir for Levonorgestrel and consists of a special mixture of silicone rubber and LNG. LNG is exuded in microscopic amounts on a daily basis from this core and acts on the uterine cavity and its lining the endometrium, in particular.
The silicone-Levonorgestrel based elastomer core on the stem of the Mirena IUD contains a total amount of 52 mg of Levonorgestrel. From this storehouse, LNG is released at the rate of 20 micrograms per day.
However, it is the local actions of LNG on the uterine environment that decide its effectiveness as a contraceptive. Mirena birth control device lasts and provides efficiency as a contraceptive for up to 5 years from the date of insertion.
Most women experience light periods, but in some cases periods totally disappear. Prior to Mirena IUD insertion, every woman must be adequately counseled in the language she understands about the advantages, drawbacks, reversibility, precautions and safety with use of the device. A Pap smear and evaluation for pelvic infection is advisable. It is to be inserted by a doctor or a specified medical caregiver who is adequately trained in IUD insertion and has had experience in handling Mirena.
For contraceptive purposes the ideal time for insertion is during menses or within 7 days of the onset of menses. Such timing affords a softer cervix, easy access to the uterine cavity and masking of insertion bleeds by menses. Mirena is ideal for lactating women as the circulating progestin does not interfere in the quality or quantity of breast milk produced and the levels of LNG are too low to pose any reasonable problems to the ingesting infant.
Moreover, progesterone only pills are a recommended mode of contraception in lactation. However, pregnancy must be ruled out and a withdrawal bleed must be ensured prior to insertion during lactation. The Mirena is used for control of heavy menstrual bleeding. It is the first line treatment recommended by the Royal Australian and New Zealand College of Obstetricians and Gynaecologists for heavy menstrual bleeding with no known or reversible causes.
It can be used as an adjunct for Hormone Replacement Therapy. Who can have the Mirena? Most women can have it. There are certain conditions where the Mirena is not recommended. Please discuss this with your doctor in further detail. It does not matter if the woman has had children before. What are the benefits of Mirena compared with the contraceptive pill? It is more effective than the oral contraceptive pill.
It is It is a long acting reversible contraception which lasts for 5 years. You can set and forget, without the need to remember to take a pill every day. It is more cost effective in the long term. There is minimal absorption of the progesterone hormone into the rest of the body. What are the disadvantages of the Mirena? There is some discomfort associated with the insertion process.
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