The Mirena IUD, what you need to know

MirenaIUD

My name is Stephanie Mitelman, and I am a certified sexuality educator. In this blog I will be addressing readers’ questions on sexuality, health, and relationships. Please don’t be shy to send me a question you have! I will be happy to answer one every month!

I just had the Mirena IUD inserted. My doctor explained the basics, but what else do I need to know?

This is a great question. More and more women are having the Mirena intra uterine device inserted. There are many things to know.

MirenaIUDFirstly, The Mirena system is different from traditional IUD’s because they are not copper, and they also contain a synthetic form of progesterone that is slowly released into the body. One advantage here is for women who have a hormonal imbalance, such as estrogen dominance, which this helps to balance out. The Mirena is also now being recommended for women who have heavy bleeds due to fibroids or adenomyosis (an irregular growth of the uterine lining), as well as younger women, and those who have not had vaginal births.

While every woman is different, the great majority of women who use Mirena are satisfied with the contraception, as well as the other benefits.  If any side effects are experienced, it is likely to be in the first three months and then they may subside.

Here are some other things to consider:

  • The majority of women will have a significant reduction in menstruation or a complete absence from six months to a year’s time after insertion. But the first couple of months will probably be an increase in menstruation, with the first two to three months being much heavier and sporadic. The reason this is happening is that the Mirena thins out the endometrial lining. This is how the contraception primarily works. If there is no lining, then a fertilized egg (zygote) can not attach to the uterine wall and grow. The progesterone also acts as an additional barrier.
  • It is important to know that the low dose of progesterone in Mirena does not stop ovulation like other forms of birth control. So while using the Mirena, you will still ovulate (release an egg), and will still have the cyclical changes you may have normally experienced, for example change in appetite or bowel movements through the cycle.
  • Another important point to know is that you are likely to feel at least some cramping in the first couple of months This is normal as the uterine wall is decreased. And it is also good to know that anything that thins out this endometrial lining also helps to reduce endometrial cancer.
  • It is also possible however that some women experience a vaginal infection, likely bacterial vaginosis after insertion, or even on and off throughout the use of the Mirena. For some women, having a foreign object inserted into the body creates an imbalance and overgrowth of bacteria, which can lead to an odor and discomfort. The incidence of bacterial vaginosis is higher in women with the Mirena. If you experience this, it is important to see a doctor. Too many women assume any difference in the vagina is a yeast infection, and treat inappropriately. Bacterial vaginosis can be treated naturally, but most cases will need a prescription for vaginal antibiotics. It is also especially important to stop sexual intercourse if there is an infection, as penetration tends to make the infection worse, as well as exposing your partner to the antibiotics if being used. Treat the case fully, then resume sexual intercourse.
  • Another important issue to understand with the Mirena is how it affects our sexuality. For some women, it may increase or decrease sex drive because of the low does of progesterone. Additionally it may affect the sexual arousal response (lubrication), and some women find they are less lubricated than before even when turned on. It is recommended to use a water based lubricant to ease this problem and make the sex feel better. This is the case with most women anyways, but especially true for some Mirena users.
  • There are also some concerns about a partner feeling the Mirena inside. This is a possibility, and it can depend on the depth of the position, but is not usually reported as a major concern. If this is happening, then you can change positions to an angle that is not likely to reach the back of the vagina. Additionally, some practitioners are more likely to leave the strings of the Mirena long so that they coil around the cervix, rather than cutting them short which can be pointy when touched.

For some women, these are a lot of drawbacks. But for others, who are being treated for extremely heavy bleeds, or who need a contraception that is effective for 5 years that does not require daily thought, all these problems become minor. And finally, the insertion is not complicated. Lots of women fear the pain associated, but the procedure is extremely quick and only slightly uncomfortable when you have a skilled doctor. Plus, it is effective as a contraception immediately, and can be removed by your doctor at any time.

Stephanie Mitelman, MA, CSE

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7 Comments

  • I recently had my Mirena removed after almost four years, thanks to a friend of mine who shared her experience with the Mirena and opened my eyes to the profound ways in which it was affecting me. I had such terrible side effects from it, but I had never connected the dots to realize that the Mirena was the root cause of all my ailments, and neither had my doctor. While the Mirena may be a good option for many women, for me, my friend, and so many others I have connected with online, it was like poison. I am a new person since having it removed, or rather, I am back to my old self, whom I had missed so much. I truly believe that great things can happen when women share their experiences, and I am forever grateful to the friend who opened up to me about her situation, and in so doing, rescued me from the throws of the Mirena. I would seriously caution anyone contemplating the Mirena, to think again.

  • Hi- Thank you for your response. I agree that we all learn from one another. And I think your point is an important one that we need to be active and informed consumers of any products and medications when it comes to our bodies. Thank you for sharing your experience with our readers. While the Mirena is a very positive option for many women, it is also not the case for others.
    all my best,
    Stephanie

  • You’ve explained here that some women with Mirena are less lubricated even when turned on. I had the Mirena inserted approximately 4 months ago and have recently been experiencing much less of my natural lubrication even while very aroused and while being sexually stimulated. This is very noticeable, uncomfortable and frustrating. My partner has commented on a few occasions that he feels he just doesn’t turn me on anymore. I told him that I think it’s this
    i.u.d. He said that he doesn’t beleve that it is associated with this birth control because for awile shortly after it was inserted I was constantly sexually excited and very naturally lubricated. That has somewhat subsided, but now, even when excited and stimulated, I hardly produce any of my natural lubrication. Will this correct itself and get better again with time? Many times, because of so much frustration, I have seriously considered going to get this i.u.d. removed. If there’s a strong possibility that this will correct itself with time, I’ll continue to wait through it. I look forward to your reply. 🙂 Thank you.

  • Hi Maria, Thank you for your message. I can understand your frustration. I can not however say whether or not the issue of lubrication will correct itself itself. Every body is different and the hormones in the Mirena affect us all in unique ways. A simple solution however to less lubrication is to add a little lubrication. Please be sure to use a water based lube if you are using condoms for protection as well. I would also explain to your partner that vaginal lubrication is not the only sign of arousal. He should not use that as his only measure of whether or not he is turning you on. And all women, whether or not they have an IUD lubricate varied amounts at different times of the month, and in different periods of their life. This combined with hormonal fluctuations can have an impact on the lubration response, which may have very little to do with how aroused you are. I would keep the channels of communication open and develop another signal with your partner to let yhim know how aroused you are without only using this as a gauge. I hope these issues work out for you, or you work on the alternatives I have suggested here. All my best, Stephanie

  • Just had my mirena inserted a week ago and yesterday started my period. Today it is really heavy and I passed a thick dense clot. I got my mirena to control prolonged uterine bleeding. This is worrying me

  • Hi Stephanie,

    I am looking to have my mirena removed as we are looking to start trying for our second baby. We now live in montreal but are originally from SE Asia where GPs can remove them. Is this the case in montreal or do you need to see an obstetrician?

    Thanks

  • Worst Enemy!!!! My mom had the paragard for over 20 years and it was the best thing ever for her. I was considering getting that, but instead I got the Mirena :/ The first visit to my OBG was to trim the strings. Then because I had very bad periods with horrible cramps I decided to get it removed. When I went to the OBG again to get it out she COULDN’T she told me it was basically stuck in there and couldn’t get a hold of the strings. She said I need it surgery to get it remove. I freaked out completely, I cried like no other because this happen while my husband was deployed in Kuwait and I was by myself with my two kids. All this happen in July 2014 and by October I had my first panic attack EVERRR I have never suffer from anxiety and depression in my entire life. I still have it right now, but thank god I have my surgery this month on the 16th to get it remove. I went to the doctors and they told me to get it remove because that I will make me feel much better. Apparently I’m suffering from estrogen dominance because of the mirena. I’m taking the lowest dosage of Zoloft because of how bad my anxiety was and the thoughts I was having. I know what’s wrong with me now after going to therapy and all of them telling me the same thing, but still is so hard to fight your own brain specially since I’ve never suffer from this. So FYI for some women works for some others like me doesn’t. I pray god that to go back to my normal self after the surgery and good luck with all of the ladies out there with the mirena. I really don’t wish what’s happening to me to anybody!!!! Don’t forget that even if you do research you never know how your body is going to react.