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The Mirena intrauterine device (IUD) is an implant that people can use as a birth control method for up to 6 years. It may also offer up to 5 years of relief to those who have heavy periods.

This IUD works by releasing a hormone that works to prevent pregnancy. This form of birth control might be a good option for people who find it difficult to remember to take a pill every day. However, it can cause various side effects.

This article explores the Mirena IUD in more detail and answers some frequently asked questions. It also looks at the differences between Mirena and the copper IUD and lists some alternative contraceptive methods.

The Mirena IUD is a small, T-shaped plastic device that a qualified healthcare professional places inside a person’s uterus. The device prevents pregnancy and can treat heavy periods.

Preventing pregnancy

Mirena contains 52 milligrams of levonorgestrel — a type of hormone that alternative birth control pills frequently use. Mirena works by releasing the levonorgestrel into the uterus very slowly over 6 years.

Levonorgestrel enters the bloodstream and stops a person from becoming pregnant by thickening the cervical mucus so sperm cannot penetrate it. The hormone also inhibits sperm movement and thins the uterine lining, so an egg is less likely to attach.

Helping heavy periods

Mirena can help those with heavy periods by making the lining of the uterus thinner. The company claims that females using Mirena to ease heavy menstrual bleeding showed an 80% reduction in bleeding after 3 months. After 6 months, this reduction increased to more than 90%.

Learn more about heavy menstrual bleeding here.

Mirena states that the IUD is 99% effective for pregnancy prevention for up to 6 years. Annually, less than one pregnancy occurs in every 100 people.

The company also claims that its product is the only hormone-releasing IUD that the Food and Drug Administration (FDA) has approved to treat heavy periods.

A 2019 survey found that 39% of respondents had forgotten to take their birth control pill at least once in the last month. As the Mirena IUD is in position at all times, a person does not need to rely on remembering to take pills.

Mirena claims that a person may experience bleeding, pain, or dizziness during and after the placement of the device. If symptoms persist for 30 minutes after the device fitting, Mirena suggests that a person inform a doctor as soon as possible. The doctor will ensure that the device is in the correct place and has not dislodged.

Common side effects of the Mirena IUD include:

  • Bleeding changes: This includes bleeding or spotting between periods, especially in the first few months.
  • Missed periods: Sometimes, periods stop entirely after approximately 1 year. If a person thinks that they may be pregnant, they should take a urine-based pregnancy test.
  • Ovarian cysts: These cysts can be painful, but they do not often require medical intervention. In some cases, though, surgical removal may be necessary.
  • Pain: Pain can occur in the abdomen or ovaries.
  • Headaches or migraine episodes: These can sometimes be severe or come on suddenly.
  • Vulvovaginitis: This is an infection of the outer part of the vagina.
  • Vaginal discharge: Some people may experience excessive discharge.

Some of the more severe risks when using the Mirena IUD include:

If a person does not have healthcare insurance, the upfront cost of Mirena IUD can be high.

Many health insurance providers cover the cost of an IUD device. However, a person should contact their plan provider to confirm coverage.

If a person does not have insurance, they may be eligible to apply for the Bayer US Patient Assistance Foundation. If they meet the criteria, the organization may cover the full cost of any medications, including an IUD device.

Anyone considering a Mirena IUD should first discuss it with a healthcare professional. If they decide to go ahead with the fitting, this will take place in a primary care physician’s office or clinic.

A person will first need to remove all clothing from below the waist and lie on their back, usually placing their feet in stirrups. A healthcare professional will often cover the lower part of the individual’s body to try to make them feel more comfortable.

During the fitting, the doctor will clean the vagina and cervix. They will then slide a plastic tube containing the Mirena IUD into the uterus. The doctor will remove the tube, leaving the Mirena inside. Threads hang from the IUD to aid removal later, but the doctor will cut the threads to an appropriate length for now.

The doctor may also show a person how to do a thread check, which they should do once a month to check that the Mirena IUD is still in place. If an individual cannot feel the threads, or if they feel more than just the thread, they should contact their doctor right away.

A doctor will typically offer a follow-up appointment 4–6 weeks after placement.

Here, we look at some frequently asked questions about the Mirena IUD.

Is Mirena removable?

Yes, a doctor or qualified healthcare professional can remove the device at any time.

Does Mirena cause weight gain?

Weight gain is a possibility, but this is not a common side effect of Mirena.

Can a person still use tampons?

Yes, individuals can still use tampons alongside Mirena. There will be no interaction between the two, as the IUD placement is in the uterus, whereas tampons sit inside the vagina.

Can a sexual partner feel Mirena during sex?

Sexual partners should not feel the device during sex, as the IUD is in the uterus. A sexual partner may feel the threads, but if they can also feel the Mirena IUD, a person should contact their doctor, as the fitting may be incorrect.

What is the difference between the Mirena IUD and the copper IUD?

There is very little difference between the two IUDs. Both claim to be highly effective, but doctors also prescribe the copper IUD as emergency contraception.

However, a 2017 study found that those using Copper IUDs were more likely to experience expulsion and pregnancy.

The Centers for Disease Control and Prevention (CDC) list the following alternative birth control options:

  • Implant: A doctor will insert this device under the skin in a person’s arm. It will release hormones over 3 years.
  • Injections: A person will receive an injection of hormones into the buttocks every 3 months.
  • Oral birth control pills: People take these either daily or after sex.
  • Skin patch: A person wears this on the abdomen, buttocks, or upper body, and it releases hormones into the bloodstream.
  • Vaginal ring: This device sits inside the vagina for 3 weeks and releases hormones.
  • Condoms: Both male and female condoms are available.
  • Diaphragm or cervical cap: This device covers the cervix and blocks sperm from entering. A person must place the lid at the correct position just before having sex.
  • Spermicides: These are available in the form of foams, creams, gels, films, tablets, or suppositories. A person must apply spermicides inside the vagina about 1 hour before having sex.
  • Sterilization: This permanent form of birth control involves surgery to close or tie together a person’s fallopian tubes.

The insertion of the Mirena IUD into a person’s uterus can prevent pregnancy or help with heavy menstrual bleeding. A doctor or healthcare professional can remove the device at any time.

The Mirena IUD is usually available through an individual’s healthcare insurance. In other cases, a person can consider using a financial help scheme.

As many varieties of birth control are available, a person may find it helpful to get advice from a doctor on which type best meets their needs.