Mirena is a hormonal intrauterine device (IUD) that can provide long-term birth control (contraception).
The device is a T-shaped plastic frame that's inserted into the uterus, where it releases a type of the hormone progestin. To prevent pregnancy, Mirena:
Mirena prevents pregnancy for up to five years after insertion. It's one of several hormonal IUDs with Food and Drug Administration approval.
Mirena offers effective, long-term contraception. It can be used in premenopausal women of all ages, including teenagers.
Among various benefits, Mirena:
Mirena can decrease menstrual bleeding after three or more months of use. About 20 percent of women stop having periods after one year of using Mirena.
Mirena can also decrease:
Because of these noncontraceptive benefits, Mirena is often prescribed for women with:
Mirena isn't appropriate for everyone. Your health care provider may discourage use of Mirena if you have:
Tell your health care provider if you:
Less than 1 percent of women who use Mirena will get pregnant in a year of typical use.
If you do conceive while using Mirena, you're at higher risk of an ectopic pregnancy — when the fertilized egg implants outside the uterus, usually in a fallopian tube. However, because Mirena prevents most pregnancies, women who use it are at lower risk of having an ectopic pregnancy than are other sexually active women who are not using contraception.
Mirena is generally safe. But it's important to remember that:
Side effects associated with Mirena include:
It's also possible to expel Mirena from your uterus. You may be more likely to expel Mirena if you:
Your health care provider may recommend removal of Mirena if you develop:
Your health care provider will evaluate your overall health and do a pelvic exam before inserting Mirena. You may be screened for STIs.
Mirena can be inserted:
If you have Mirena inserted more than seven days after the start of your period, be sure to use backup contraception for one week.
Taking a nonsteroidal anti-inflammatory medication, such as ibuprofen (Advil, Motrin IB, others), one to two hours before the procedure can help reduce cramping.
Mirena is typically inserted in a health care provider's office.
Your health care provider will insert a speculum into your vagina and clean your vagina and cervix with an antiseptic solution. Special instruments might be used to gently align your cervical canal and uterine cavity and to measure the depth of your uterine cavity.
Next, your health care provider will fold Mirena's horizontal arms and place the device inside an applicator tube. The tube is inserted into your cervical canal, and Mirena is carefully placed in your uterus. When the applicator tube is removed, Mirena will remain in place.
Your health care provider will trim Mirena's strings so that they don't protrude too far into the vagina, and may record the length of the strings.
During Mirena insertion, you may experience cramping, dizziness, fainting or a slower than normal heart rate.
Once a month, check to feel that Mirena's strings are protruding from your cervix. Be careful not to pull on the strings.
About a month after Mirena is inserted, your health care provider may re-examine you to make sure Mirena hasn't moved and to check for signs and symptoms of infection.
While you're using Mirena, contact your health care provider immediately if you:
It's also important to contact your health care provider immediately if you think Mirena is no longer in place. Your provider will check the location of Mirena and, if it's displaced, remove it if necessary.
Mirena can remain in place for up to five years. To remove Mirena, your health care provider will likely use forceps to grasp the device's strings and gently pull. The device's arms will fold upward as it's withdrawn from the uterus.
Light bleeding and cramping is common during removal. Rarely, removal can be more complicated.
The Mirena intrauterine device (IUD) is inserted into the uterus by a health care provider using a special applicator. Short strings connected to the device extend beyond the cervix into the vagina and allow for device removal.