Mirena Accent Photo

What is the MIRENA® IUD?

The MIRENA® IUD is a hormone-releasing system placed into your uterus to prevent pregnancy for up to 5 years. It is T-shaped and contains a hormone called levonorgestrel. Levonorgestrel is a progestin hormone often used in birth control pills. The MIRENA® IUD releases the levonorgestrel mostly into the uterus and only small amounts of it enter your blood. There are 2 brown threads are attached to the stem of the T.

Although the Mirena® IUD is effective for 5 years, you can have it removed at any time and it’s contraceptive action is almost immediately reversed. You may try to conceive anytime afterwards. It is very effective in preventing pregnancy and less than 1 in 100 women become pregnant each year while using it.

Who should not use the MIRENA® IUD?

Do not use Mirena® if you:

  • might be pregnant
  • have had a serious pelvic infection called pelvic inflammatory disease (PID)
  • have had a serious pelvic infection in the past 3 months after a pregnancy
  • have more than one sexual partner or your partner has more than one partner
  • have an untreated pelvic infection now
  • can get infections easily. For example, you have problems with your immune system, leukemia, AIDS, or intravenous drug abuse
  • might have cancer of the uterus or cervix
  • have bleeding from the vagina that has not been explained
  • have liver disease or liver tumor
  • have breast cancer now or in the past
  • have had a tubal pregnancy or know you are at high risk for a tubal pregnancy
  • have an intrauterine device in your uterus already
  • have a condition of the uterus that distorts the uterine cavity, such as large fibroid tumors
  • are allergic to levonorgestrel, silicone, or polyethylene.

Be sure and tell your doctor if you:

  • recently had a baby or if you are breast feeding
  • are diabetic
  • were born with heart disease or have problems with your heart valves
  • have problems with blood clotting or take medicine to reduce clotting

The Mirena® IUD does not protect against HIV / AIDS or other sexually transmitted diseases, and in fact, may worsen an STD if you are exposed.


Your physician can place the Mirena® IUD into your uterus during an office visit. You will need to be up to date on your Pap tests and will have to have an appointment specifically for the placement of the IUD since it takes a bit of preparation for a successful placement. Assuming you are not allergic to aspirin or ibuprofen, you should take one of these products approximately 1 hour before the procedure to decrease the discomfort. Your doctor may prescribe medication beforehand if you wish, to minimize any discomfort associated with insertion.

For insertion, you will be positioned in the same way as when you have a Pap test. The cervix and vagina will be cleansed with an antiseptic solution to decrease any risk of contamination of the IUD from vaginal bacteria. Next, he may give you a numbing injection into the sides of the cervix to reduce the possibility of pain, depending upon your anatomy. He will use a thin metal instrument to measure the interior length of the uterus so that the IUD can be setup correctly. A thin plastic tube containing the Mirena IUD is slid through the cervical canal and is positioned at the top of the uterine cavity. The tube is removed, leaving the IUD within the uterus. Your doctor will then trim the strings of the IUD so that they do not hang out of the vaginal opening. For follow up, plan on returning after your next period and he will check the placement of the IUD and trim the IUD strings to the appropriate final length.

Once the IUD is in place, it will be your responsibility to check for the IUD strings after each menses. You can check that the Mirena® is in place by feeling for the threads at the top of your vagina with your fingers. This will confirm that it has not become dislodged or expelled.

Side Effects of the Mirena IUD

The Mirena® IUD may cause a change with your periods. For the first 3 to 6 months, your monthly period may become irregular. You may also have frequent spotting or light bleeding. A few women have heavy bleeding during this time. After your body adjusts, the number of bleeding days is likely to decrease, and you may even find that your periods stop altogether.

There are several common side effects of MIRENA®:

  • Cramps, dizziness, or faintness while MIRENA® is being inserted. This is common. Sometimes, the cramping is severe
  • Missed menstrual periods. About 2 out of 10 women stop having periods after 1 year of MIRENA® use. The periods come back when MIRENA® is removed. If you do not have a period for 6 weeks during MIRENA® use, contact your health care provider.
  • Changes in bleeding. You may have bleeding and spotting between menstrual periods, especially during the first 3 to 6 months. Sometimes the bleeding is heavier than usual at first. However, the bleeding usually becomes lighter than usual and may be irregular.

Side Effects: There are a number of uncommon, but serious side effects that can occur when using the Mirena® IUD®

  • Life-threatening infection. Life-threatening infection occurs rarely within the first few days after MIRENA® is inserted. Call your health care provider if you develop severe pain within a few hours after insertion.
  • Perforation. The MIRENA® IUD may go through the uterus. This is called a uterine perforation. If your uterus is perforated, you may need surgery to remove the IUD. Perforation can cause internal scarring, infection, or damage to other organs.
  • Expulsion. MIRENA® may come out by itself. This is called expulsion. You may become pregnant if MIRENA® comes out. Use a backup birth control method like condoms and call your health care provider if you notice that the MIRENA® IUD has come out.