Mirena
A Mirena is a plastic device measuring around 2cm. It is placed inside the uterus with small strings extending out through the cervix.
When & why
A Mirena is commonly used for women with heavy periods. More than 80% of women will have an improvement in their periods with the use of Mirena. Some women will not menstruate at all.
In New Zealand, women with heavy bleeding may qualify for a funded Mirena, such as when a blood iron or haemoglobin is found (iron deficient and/or anaemic). Otherwise, a Mirena costs around $400.
A Mirena lasts 5 years. If you are planning a pregnancy, the mirena can be removed with the use of a speculum, the strings are grasped and the device carefully pulled out. Fertility will return rapidly.
A mirena is also a highly effective contraceptive. It causes contraception in a number of ways:
thickening the cervical mucus so sperm cannot enter the uterus.
stopping sperm reaching the fallopian tube where fertilisation of an egg occurs.
thinning the lining of the uterus (endometrium) so an embryo cannot implant.
The chances of inadvertently falling pregnant when a Mirena is inside are less than 1 in 500.
How
How is a Mirena inserted?
A Mirena is placed inside the uterus, generally as a procedure when you are awake. A local anaesthetic may be used in the cervix to numb this area. Women generally describe the procedure as uncomfortable. For those who cannot tolerate it being placed awake, a general anaesthetic can be arranged.
Side effects
What should I expect after a Mirena?
Common side effects are irregular bleeding, irregular spotting, strings being retained inside the cervix or uterus. Less common side effects are nausea, pain, breast tenderness, and headache.
Side effects of Mirena will typically settle over 3 to 6 months. You are encouraged to be patient and to give the Mirena 6 months before having it removed.
Related symptoms
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Commonly caused by hormone therapies, including oral contraceptives. Persistent bleeding may be due to genital tract infections, polyps, or cervical cancer.
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High volume, long-lasting periods with flooding, clotting or anaemia. Causes can include fibroids, polyps, hyperplasia, PCOS, infection, or endometriosis.
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Women may have problems with tubal blockage, endometriosis, ovulation, egg numbers or quality. Men may have issues with sperm quantity or quality.
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Causes include endometriosis, infection, instability of the lining of the womb, ovarian cysts, perimenopause, PCOS, polyps, and early pregnancy.
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Causes include constipation, anal fissures, IBS and severe endometriosis. Extremely painful periods and pain with deep intercourse may also occur.
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Pain, discomfort or cramps around the time of menstruation. Can be due to prostaglandin production, or caused by endometriosis or adenomyosis.
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Defined as pelvic pain lasting more than 6 months. Causes can include ovarian cysts and urinary tract infections, but can be elusive and hard to diagnose.
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Periods that last more than 7 days. Causes include fibroids, polyps, hyperplasia or cancer of the uterus, PCOS, genital tract infection, and endometriosis.
Related conditions
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Adenomyosis occurs when the inside lining of the uterus is found within the muscular wall of the uterus, enlarging it.
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When endometrial tissue, which should only be found in the uterus, also grows outside the uterus, causing severe pain.