Mirena IUD - everything you need to know about it!

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What is the Mirena IUD?

Mirena is a contraceptive coil worthy of the 21st century. Its effectiveness reaches up to 100%The Mirena IUD is a modern version of the well-known intrauterine coil (IUD). The Mirena IUD is a modern version of the well-known intrauterine coil. It can be said to combine the characteristics of both the coil and the oral contraceptive pill. Its effects are fully reversible and if the patient decides to try to have offspring, she will be fertile practically as soon as the IUD is removed.

What does Mirena look like?

This is a T-shaped IUD that is placed by a gynaecologist inside the uterus and guarantees protection against pregnancy for up to 5 years. During all this time, you do not have to worry about replacing it or any other issues related to its use. All thanks to the fact that one of its components is a small reservoir of hormone. It is gradually and locally released over several tens of months - up to 5 years. This hormone is levonorgestrel - a progestogen, which is a derivative of progesterone. The same substance is used in many popular oral contraceptive pills.

The Mirena IUD is an increasingly popular contraceptive method. Thanks to the fact that the hormones are released locally and act directly on the endometrium, the IUD can also be used by people who, for health reasons, should not take oral contraceptives. The Mirena IUD is also used for patients complaining of idiopathic excessive menstrual bleeding. It also reduces complaints during menstrual bleeding.

high efficiency,
a small list of potential side effects,
as well as full reversibility.

The Mirena coil is placed inside the uterus. It has a small reservoir of hormone, which is released gradually, and there are long, undetectable threads on the lower part. These are left at the mouth of the cervix to control whether the IUD is in the right place.

What positively distinguishes the Mirena IUD from other hormonal contraceptives is that it acts topically, releasing the hormone directly onto the endometrium. This ensures greater safety even for long-term use, as it does not burden the body as much as the contraceptive pill. The concentration of the hormone in the blood is up to 20 times lower than with the combined oral pill.

The container on the liner is covered with a special membrane designed to regulating hormone dosage. The Mirena intrauterine spiral is a method for preventing pregnancy that works in several ways.

reduced sperm viability and function, both in the uterus itself and in the fallopian tubes,
thickening of the mucus in the cervix - thus the passage of sperm into the uterus is significantly impeded and thus restricted,
A reduction in the binding capacity of sperm and egg cells,
inhibition of ovulation,
change in endometrial thickness.

One other point is worth mentioning. The Mirena IUD is - after all - a foreign body introduced into the body. This causes local inflammation - inside the uterus. This in turn is associated with an increased production of leukocytes (i.e. white blood cells), which damage the sperm and at the same time contribute to a thickening of the mucus.

The use of the Mirena IUD works well especially for women after childbirth and before the menopause. The IUD can also be used in young women who have not yet given birth.

The Mirena insert is almost 100% effective!

Although it is said that the only 100% contraceptive method is sexual abstinence, it is safe to say that the Mirena IUD is close to the ideal - because reliable - contraceptive. This is because it is indicated that the risk of unplanned conception is around 0.14 pregnancies per 100 women using this method for 1 year.

The effectiveness of hormonal contraceptive IUDs is estimated to be as high as 99.8%. In practice, this means that out of 1,000 women using this method correctly to prevent pregnancy, only two are likely to conceive. This result makes IUDs the most effective reversible contraceptive method available.

It is also worth comparing the effectiveness of the Mirena hormonal IUD with other pregnancy prevention methods. The risk of pregnancy is most often determined by the so-called Pearl index (also known as the Pea coefficientrla). This is the best way to compare the effectiveness of different contraceptives, which is often the first criterion for choosing a method.

The Pearl coefficient is calculated by multiplying the number of unplanned pregnancies by 1200 to the number of monthly cycles in a year, in a group of 100 women using a particular method of contraception. The lower the ratio, the greater the effectiveness of the method. For example: a Pearl index of 5 means that 5 women in a group of 100 women who had regular intercourse for a year and used a particular contraceptive method became pregnant. If the Pearl index is (for example) 50, this means that 50 out of 100 women became pregnant. Thus, by analogy: the lower the value, the greater the effectiveness and reliability of a particular method of pregnancy prevention.

birth control pills - The Pearl coefficient may vary depending on the type of tablet.

non-hormonal coil - The effectiveness of the non-hormonal copper IUD is at a similar level.

contraceptive patch - The Pearl index for correctly applied patches is approximately 0,9;
condoms - in the case of condoms, the freshness of the condom, its condition (it must not be damaged), and the correct application and removal of the condom after intercourse have the greatest influence on the effectiveness of the protection against pregnancy.

The Pearl coefficient for condoms is 3-7.

Some couples who, for various reasons, are unwilling or unable to use contraception, choose to intermittent intercourse. However, the risk of unplanned pregnancy is considerable in this case: the Pearl coefficient is 10-35.

Similarly low effectiveness has calendar method - in this case the Pearl index is as high as 25. Due to the very high risk of pregnancy, both intermittent intercourse and the calendar method should under no circumstances be used as a method of pregnancy prevention.

Advantages of using the Mirena hormonal IUD

The data are clear: the hormonal contraceptive IUD is statistically the most effective method of preventing pregnancy.

high efficiency - Although coils and IUDs are not the most common choice (one factor may be the rather high price), they are considered the most effective method of preventing pregnancy. This is due to several factors. Firstly: the hormones are released topically (so there is no risk that, due to, for example, food poisoning and associated diarrhoea or vomiting, some of the hormones from the tablets will not be absorbed), which is why their effectiveness is so high. Secondly: there is no need to remember to take the pill regularly, change the patch or put on a condom. Thirdly: a correctly placed IUD will stay in place at all times, in no way restricting either sexual activity or range of movement - it causes no perceptible discomfort in any area;
safety of use - Unlike the popular method of birth control pills, the hormones are not absorbed into the liver, but are released locally. The IUD can therefore be an excellent solution for people who, for example, cannot take oral contraception due to gastrointestinal or digestive disorders. The IUD is also free of the side effects that all other orally taken preparations can cause. In addition, because the IUD does not contain oestrogen and because it acts topically, it is also a safer choice for the prevention of thrombosis;
reversibility - even long-term use of the IUD does not adversely affect fertility. If the patient decides to become a mother, she regains her fertility almost immediately after removal of the IUD;
availability - The Mirena IUD can be used for most women. It is a safe method for both non-pregnant women (even older teenagers and very young women) and ladies who have already given birth, as well as for middle-aged pre-menopausal women;
availability - The Mirena IUD can be used for most women. It is a safe method for both non-pregnant women (even older teenagers and very young women) and ladies who have already given birth, as well as for middle-aged pre-menopausal women;
safety in breastfeeding - Many women want to return to contraception as soon as possible after giving birth. In most cases, however, this is only possible after breastfeeding has ended. The IUD can, however, be used while breastfeeding. However, your doctor will probably recommend that you wait at least a few weeks after giving birth - but this is still much quicker than with many other contraceptive methods.

In most cases, the Mirena IUD is chosen by those women who want to have intercourse without worrying about the consequences of pregnancy.

heavy periods,
endometriosis,
and painful bleeding.

This is mainly due to a reduction in the growth of the endometrium (i.e. the endometrium). It is also indicated that in the case of endometriosis, the IUD reduces pain and can also reduce inflammation.

The IUD can also be considered as part of the prevention of cervical cancer and endometrial cancer - precisely by limiting the growth of the endometrium. The Mirena IUD is therefore also applicable to "female" complaints.

In addition, it is indicated that with the use of the Mirena IUD periods become shorterand sometimes even fade away. The absence of menstruation therefore does not mean pregnancy in this case.

If you wish to give up this method of contraception, the IUD is also removed in a single visit to the gynaecologist.

there are no contraindications to its use,
the patient is healthy,
pregnancy is excluded.

Vaginal ultrasound,
cytology,
palpation of the breast.

Course of insertion of the Mirena IUD

IUD insertion is a non-surgical procedure and takes literally a few minutes. Many women compare it to a normal examination, but others feel discomfort or even pain. However, this is a very individual issue. The procedure is completely non-invasive and therefore does not require any precautions or precautions.

The IUD is inserted into the uterus using a thin tube - analogous to how regular coils are inserted. The system is small - about 3 cm long. This is why its insertion is quick and generally painless, and any discomfort felt after the procedure subsides quite quickly.

However, if the patient experiences considerable discomfort or even pain, the IUD insertion procedure can be performed under local anaesthesia and followed by painkillers.

After insertion of Mirena, the patient may feel uterine cramps (similar to menstruation), which should subside a few hours after the procedure. The very next day, the Mirena coil should not cause the slightest discomfort.

IMPORTANT

A follow-up examination is carried out 4-12 weeks after insertion of the coil and should be repeated once a year.

Removal of the IUD is carried out at the latest 5 years after insertion on any day of the cycle, preferably during menstrual bleeding - a new IUD can be inserted during the same visit.

Functioning after insertion of Mirena IUD

How the patient will feel after the IUD insertion procedure is an individual matter. The aforementioned uterine contractions should subside within a few hours. Some women also complain of increased bleeding after the procedure. If this does not go away on its own or if it gets worse, a doctor's advice must be sought quickly.

In some women the first few menstrual cycles may be heavier than before insertion, and bleeding may be accompanied by abdominal pain. However, these are symptoms that should soon go away once your body has got used to the IUD. However, if your cycles do not normalise, you should consult your doctor.

The IUD can be inserted on a different day of the menstrual cycle, but if this is the case, its effective action may start later. You will then need to use additional protection (e.g. condoms) for at least seven days after the procedure, just to be safe.

Apart from this, no special precautions need to be taken after insertion of the Mirena IUD. It is only advisable to refraining from sexual intercourse for a few days after the procedure. This is mainly due to the possibility of causing inflammation by additional mechanical irritation of the cervix, which is already irritated after the procedure. For the same reason, it is better to use sanitary pads than tampons during this period.

After a few days, once the irritation has subsided, you can return to full activity in all areas of life.

significantly prolonged bleeding,
acute, wrenching abdominal/sub-abdominal pain,
a sense of breakdown,
weakening,
fever,
burning and/or itching in the intimate area,

it is absolute indication for medical consultation as soon as possible.

Possible side effects

Of the contraceptive methods available, the IUD appears to be the safest. However, this does not mean that it is indifferent to the body and that the appearance of side effects is out of the question. The IUD is a foreign body to which the body, depending on its sensitivity, can react differently. It all depends on individual conditions.

Particular care should be taken by those women who are prone to frequent infections and irritation of the intimate area. The cervix, mechanically irritated after the procedure, can be prone to infections more than usual, even for several weeks. Therefore, special care should be taken during this time: whether it is intercourse, using a swimming pool or using tampons.

Possible (but harmless) side effects may also include possibility of intra-cyclic bleeding. However, as with other methods of hormonal contraception, you have to wait for your body to get used to the hormonal changes. So if this is a problem for the first few months (usually three months), it is worth being patient. With time, everything should stabilise: the intra-cyclic bleeding should disappear and your periods should become considerably less heavy than before. In some women, they disappear completely - and this is completely harmless.

Some women are concerned about weight gain after IUD insertion. However, no weight fluctuations have been observed for women using the Mirena hormonal IUD compared to those using non-hormonal methods.

temporary discomfort - during the insertion procedure
a feeling of irritation and cramps - shortly after the procedure, the symptoms usually disappear within a few hours,
Intra-cyclic bleeding - may or may not occur, for the first 3-4 cycles, and then subsides,
increased susceptibility to infection - for the first few weeks after insertion.

increased susceptibility to acne,
breast tenderness,
excessive hairiness,
discharge,
ovarian cysts.

frequent recurrent inflammation of the reproductive organs,
inflammatory conditions in the pelvic region,
genital tract bleeding of unknown cause,
uterine myoma,
erosion of the cervix,
anaemia and iron deficiency in the body
a pregnancy has occurred or is suspected,
a history of ectopic pregnancy,
multiple miscarriages,
abnormalities of the structure of the uterus
reduced immunity (e.g. AIDS),
allergy to insole components,
a history of bacterial endocarditis.

How much does a hormone coil cost?

The cost of inserting an IUD is not among the lowest and unfortunately it is not reimbursed by the National Health Service. The cost of the insole alone is several hundred. The final price depends on several factors, including whether you buy in-store or order online. Different pharmacies also have different prices - from around £500 to as much as £800. This is the cost of the IUD itself, to which the service of the gynaecologist must also be added. As this is not a reimbursable procedure, you have to pay for the whole thing out of your own pocket. To buy the Mirena IUD, a prescription is required.

However, it is not always necessary to have your IUD. In some surgeries, the doctors have them, so you do not need to bring anything with you when you come for treatment. The estimated cost of an IUD and its insertion is generally around £1,000-1500.

However, it is worth taking into account that the IUD only stops working after 5 years. If you take into account the fact that it is a one-off expense once every few years and that you do not have to remember to take the pill or change the patch regularly, the relative cost is not high. Most of the time, a pack of contraceptive pills or patches costs around 40 PLN. Over the course of a year, this adds up to several hundred PLN. Comparing the costs over several years, it appears that the Mirena IUD may even be a cheaper method of contraception than the pill or the patch.

Frequently asked questions

1. Can the Mirena IUD fall out?

The Mirena IUD is shaped like a uterus. Once inserted, it should therefore not fall out, but this cannot be ruled out.

2. Can the coil be moved during intercourse?

The probability of the coil shifting during intercourse is close to 0. This is because the IUD is placed in the uterus and the vagina is penetrated during intercourse.

3. is it possible to get pregnant with an IUD in place?

Although the contraceptive effectiveness of the Mirena IUD is very high (almost 100 per cent), there is no method that offers a full 100% guarantee.

4. Can the Mirena coil be used for more than 5 years?

The amount of hormone contained in the coil is released gradually over a period of five years. After this time, the contraceptive effectiveness may decrease.

5. can the IUD cause weight gain?

The amount of hormone released into the body is minimal because it acts locally. Therefore, the risk of weight gain is minimal.

Substantive consultation:

dr n. med. Beata Makowska - Specialist gynaecologist-obstetrician

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