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Hormonal IUD (Mirena)

Mirena is brand name for a hormonal intrauterine device (IUD). A hormonal IUD is a type of birth control that’s placed in the uterus and uses hormones to give long-term birth control. Birth control also is called contraception.

The device is a T-shaped plastic frame. It releases a type of the hormone progestin.

To prevent pregnancy, Mirena:

Mirena is one of several hormonal IUDs that the Food and Drug Administration has approved. It’s been shown to prevent pregnancy for up to eight years.

Mirena gives long-term birth control. It can be used in people assigned female at birth who haven’t been through menopause. This includes teenagers.

Among various pluses, Mirena:

After three or more months of using Mirena, you might bleed less during your period. About 20% of people who use Mirena stop having periods after one year of use.

Mirena also can lessen:

Because of these benefits, Mirena often is prescribed for people with:

Mirena isn’t right for everyone. Your healthcare professional might not want to prescribe Mirena if you have:

Tell your healthcare professional if you:

Less than 1% of people who use Mirena will get pregnant in a year of typical use.

If you do get pregnant while using Mirena, you’re at higher risk of having the egg implant outside the uterus. That is called an ectopic pregnancy. In ectopic pregnancies, the egg most often is in a fallopian tube. But because Mirena prevents most pregnancies, people who use it are at lower risk of having an ectopic pregnancy than are others who have sex without using birth control.

Mirena is mainly safe. But know that:

Side effects linked to Mirena include:

Mirena also can come out of the uterus. This may be more likely to happen if you:

Your healthcare professional may suggest removing Mirena if you get:

Your healthcare professional will check your health and do a pelvic exam before putting in Mirena. You may be screened for STIs.

Mirena can be put in:

If you have Mirena put in more than seven days after the start of your period, be sure to use other birth control for one week.

Taking a nonsteroidal anti-inflammatory medicine, such as ibuprofen (Advil, Motrin IB, others), 1 to 2 hours before the procedure might help reduce cramping.

Mirena most often is put in at a healthcare professional’s office.

During the procedure

Your healthcare professional puts a device called a speculum into your vagina to hold it open. The next step might be to clean your vagina and cervix with an antiseptic liquid that kills germs.

Special instruments might be used to hold the cervix still and line it up with the uterus. Your health professional looks at the size and shape of the uterus and measures how deep it is.

Next, your healthcare professional folds Mirena’s arms and puts the device inside a tube that applies the IUD. The tube goes into your cervical canal to place Mirena in your uterus. Then the tube is removed and Mirena stays in place.

Your healthcare professional trims Mirena’s strings so that they don’t go too far into the vagina. You might be asked to feel the cut strings. That’s so you know what to feel for when checking the strings.

During the procedure, you may cramp, feel dizzy or faint. Your heart rate might be slower than usual.

After the procedure

About a month after you get Mirena, your healthcare professional may do another pelvic exam. This is to make sure Mirena hasn’t moved and to check for infection.

Some health professionals might ask you to check your vagina monthly to feel that Mirena’s strings are still there.

While using Mirena, contact your health professional right away if you:

Also contact your healthcare professional right away if you think Mirena is no longer in place. Your health professional will check for Mirena. If it’s out of place, it might need to be taken out.

Removal

Mirena can stay in place for up to eight years. To remove Mirena, your healthcare professional uses a gloved hand or forceps to grasp the device’s strings and gently pull. The device’s arms will fold upward as it leaves the uterus.

Light bleeding and cramping are common during removal. Rarely, removal can be harder to do.

© 1998-2024 Mayo Foundation for Medical Education and Research (MFMER). All rights reserved.

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