The Mirena spiral is a hormonal intrauterine system used both for contraception and for the treatment of many gynecological diseases. Who can put Mirena according to the instructions and in what situations is its use justified?
Operating principle
The hormonal coil contains a synthetic progestogen - levonorgestrel, which is released in small doses every day (20 mcg each).
The instruction describes the coil as follows: Mirena looks like a double-sided hook in the shape of the letter "T", which will be located in the uterine cavity. There is also a long guide tube with which the doctor can install the system. After the expiration of the period of use or in the event of various complications, the spiral is removed using special threads that absolutely do not interfere with everyday life.
The Mirena Navy operates in this way:
- The substance released in a spiral has a binding effect on the secret, which leads to a thickening and an increase in the viscosity of the latter. This prevents sperm from entering the uterine cavity and prevents subsequent fertilization.
- If spermatozoa have entered the uterus, then levonorgestrel inhibits their mobility. This makes it harder for sperm to reach the egg and prevent fertilization. If fertilization nevertheless occurred, then the spiral mechanically prevents the fetal egg from attaching.
- The drug prevents the maturation of follicles and the formation of dominant among them.
- Levonorgestrel has an antiproliferative effect - it inhibits the growth of endometrial tissue, which leads to a decrease in the duration and volume of menstruation. Due to this effect, the Mirena Navy is used in the treatment of many gynecological diseases. When using the drug, first there is an increase in discharge during menstruation, but then they become more scarce and may stop altogether.
- Mirena does not affect fertility after extraction and does not change the level of estradiol in the blood.
- It does not have a strong local reaction to the presence of a foreign body in the uterine cavity.
Pearl index: 0.1-0.5. It shows the reliability of the contraceptive method and is calculated by the number of pregnancies in 100 girls per year with regular sex life. The lower the index, the more reliable the method.
Indications and contraindications for the use of the spiral
Mirena is used in such situations:
- Contraception.
- Treatment of gynecological diseases: idiopathic menorrhagia (abundant and prolonged uterine bleeding).
- Prevention of endometrial hyperplasia in women taking estrogens as replacement therapy.
Contraindications:
- Pregnancy.
- Inflammation of the endometrium and cervix (endometritis and cervicitis).
- Neoplasms of the genitals.
- Uterine bleeding of unknown cause.
- Anomalies of the uterus.
- Hypersensitivity to the components of the Mirena Navy.
There are a lot of contraindications: a doctor's consultation is required.
Undesirable effects on the background of Mirena
Concerning side effects, their occurrence cannot be predicted in advance. Most often, women go to the doctor with complaints of an increase in the duration of menstruation, irregular bleeding. By the end of the first year of the spiral, these phenomena cease or become insignificant.
There may also be reactions from various organs and systems:
- headache;
- stomach ache;
- nausea;
- depressed mood;
- depression.
From the reproductive system:
- infections;
- chest pain;
- selection change.
Complications: what is the danger of a spiral for a woman
Complications due to the use of Mirena rarely occur and most often due to non-compliance with the recommendations of the doctor or when setting up a low-quality hormonal coil.
Spiral dropout
The most common complication that usually occurs in the first months of using the system. It is accompanied by pains in the lower abdomen, which are not relieved by taking analgesics and antispasmodics. If such symptoms appear, you should immediately consult a doctor.
To clarify the location of the spiral, ultrasound of the pelvic organs is prescribed. Next, the issue of the need to save the system is decided (sometimes the spiral does not fit in size, is installed incorrectly, etc.). It is possible to remove the IUD with the further appointment of another contraception. The same spiral is not used twice.
Sometimes the coil falls out without obvious symptoms, and this can lead to an unwanted pregnancy. If the conception of a child occurs against the background of the IUD, then cases of ectopic pregnancy and early miscarriages are often recorded.
Perforation of the uterus
According to doctors, the most rare and severe complication is perforation of the uterus with a spiral. This usually happens due to incorrect, rough formulation of a contraceptive by a doctor. In the first hours (with complete perforation), a woman experiences weakness, pressure drops, pulse and breathing quicken, cold sticky sweat on her body. These symptoms indicate intra-abdominal bleeding and require urgent medical attention!
With incomplete perforation, all symptoms can develop over several days and also require an immediate appeal to a gynecologist!
Preparation for the introduction of the hormonal coil
If you decide to use Mirena, then before setting it up, you need to undergo a series of studies that will allow you to judge possible contraindications.
Standard diagnostic scheme before installing the coil:
- Smears from the vagina (on the flora - to exclude possible inflammation and the spread of infection, on cytology - to make sure that there are no various diseases of the cervix (cancerous and precancerous) and the possibility of installing a hormonal coil).
- Ultrasound of the pelvic organs.
- A blood test for hCG (human chorionic gonadotropin) to exclude pregnancy.
When can Mirena be placed?
The insertion procedure is painless, but may cause some discomfort. Before installing the system, the doctor will conduct all the necessary studies, once again check the presence or absence of pregnancy. Mirena is inserted into the uterus with the help of a conductor that is already on the spiral. Next, the doctor fixes the IUD in the uterine cavity with special antennae, which should be in the vagina. The length of the antennae is minimal and does not bring discomfort to a woman, although sometimes they are felt by a partner during sex.
When installing a spiral, a woman should visit a gynecologist in the first 7 days of her cycle (1st day of the cycle - 1st day of the onset of menstrual bleeding). During this period, the cervix is slightly ajar, which facilitates the installation of the IUD. Also at this time, the likelihood of pregnancy is minimized.
After childbirth, the spiral can be installed at least 2 months later. It depends on the individual characteristics of the woman's body. After the baby is born, the uterus should return to its original size. This phenomenon is called uterine involution (in some women, this process takes 4 months).
If a woman decides to install a spiral after an abortion, then the doctor should observe the patient for at least a week to rule out possible infection and complications.
The Mirena spiral is installed for up to 5 years and is not recommended for further use after the expiration date.
Post-IUD Surveillance
After the introduction of the Mirena spiral, monitoring the patient's condition is very important. You need to pay attention to the pressure, pulse, skin color and, of course, the sensations of a woman. This is necessary to clarify the correct location of the helix and to recognize complications that could arise during setting.
With perforation of the uterus, a woman feels pain in the lower abdomen, pressure drops, pulse and breathing quicken. All these symptoms indicate intra-abdominal bleeding.
If a woman feels comfortable, then she needs to visit a doctor on his recommendation for periodic examinations and monthly check for the presence of spiral tendrils near the cervix.
It happens that at first a woman feels good, but later the condition worsens: there is a pulling pain in the lower abdomen, nausea, discomfort in the chest, uterine bleeding.
If you have any symptoms that worry you, you should immediately consult a doctor. What may seem insignificant to you may turn out to be a significant symptom in a progressive worsening condition!
Only a gynecologist removes the IUD, since self-extraction can harm the mucous membrane of the genital organs and lead to undesirable consequences(eg infections). Removal is performed during menstruation, after a preliminary gynecological examination. To remove the spiral, the doctor needs to pull on the antennae, and the IUD will come out of the uterine cavity. According to patients, the removal of the spiral does not bring significant discomfort or pain.
There are both direct indications for removal, and the woman's own desire. Be sure to remove the IUD in such conditions:
- Spiral expiration date.
- Inflammation of the uterine appendages.
- Growth or its primary occurrence.
- Spiral drop.
- Conception of a child.
Pregnancy with an IUD: are there any chances?
The intrauterine device is not a 100% guarantee of preventing unwanted pregnancy. Sometimes cases of attachment of the fetal egg in the uterus and its further development are recorded. A woman can suspect such a condition by pulling paroxysmal pains in the abdomen that radiate to the sacrum, a change in the menstrual cycle in the form of a delay or the appearance of acyclic discharge. You should immediately consult a doctor and clarify the presence or absence of pregnancy. After the examinations, the doctor establishes a diagnosis (ectopic or uterine pregnancy, term) and makes a joint decision with the patient about prolonging or terminating the pregnancy.
Answers to frequently asked questions
Can Mirena fall out?
Yes, Mirena can fall out. It depends on the competence of the doctor installing the spiral, compliance with the recommendations of the gynecologist after setting, and a number of other factors. If you suspect a prolapse, you should immediately consult a doctor.
What to do if the tendrils of the spiral are not visible in the vagina?
The tendrils of the helix should not be visible, but they should be accessible to the woman for tactile recognition. If a woman does not find the antennae with her fingers, then she should immediately consult a doctor to locate or clarify the loss of the spiral. It is advisable for a woman to feel the antennae of the spiral after menstruation, since there is a risk of asymptomatic loss, which means that there is a possibility unplanned pregnancy. The sooner a woman goes to the doctor with her concerns, the sooner it will be possible to judge the possibility of pregnancy and further tactics.
Who should install and remove the coil?
Only a qualified obstetrician-gynecologist can install and remove the coil.
Is it possible to put Mirena to nulliparous women?
Is it possible to put Mirena in diabetes mellitus?
Yes, you can. Diabetes mellitus is not a contraindication to the setting of the spiral.
What happens if Mirena is not removed in time?
Mirena is a hormonal drug. After the expiration date, levonorgestrel is not released and does not exert its hormonal effect. The incidence of complications associated with long-term wearing of the spiral also increases:
- inflammation of the uterine appendages;
- violation of the reproductive health of women;
- inflammation of the cervix;
- violation of the biocenosis of the vagina, etc.
Can Mirena be used for emergency contraception?
No, a hormonal IUD is not used for emergency contraception after intercourse has already taken place. There are many other drugs to prevent unwanted pregnancy.
Is it possible to put Mirena to a nursing mother?
Yes, you can. The spiral does not affect lactation, levonorgestrel does not penetrate into breast milk and, accordingly, the drug is not dangerous for the child.
In contact with
The Mirena plastic coil contains progesterones in the core, which are secreted daily into the carrier's body at a dosage of 25 mcg. This principle of action provides a quick and effective treatment of endometrial pathologies and guarantees high-quality protection against unwanted pregnancy.
The IUD includes a core made up of hormonal substances and a plastic case in the form of the letter "T". The soft shell prevents the active components from leaking, due to which the medicine enters the body evenly.
Threads are fixed at the end of the case, with their help the Mirena hormonal coil is removed. The device is inserted into a tube that allows you to easily and quickly install the device inside the vagina.
The composition of the hormonal intrauterine device Mirena includes levonorgestrel.
After implantation, the hormone at a dosage of 25 mcg is released daily into the uterine cavity. After 3 years of use, the concentration of the drug drops to 15 mcg per day. One spiral contains 53 mg of the drug substance.
How does it work
Protection against unwanted pregnancy is achieved through a small but constant local inflammation, which develops due to the introduction of the device inside. This reaction of the body does not allow the endometrium to gain a foothold for the implantation of the embryo.
The device operates as follows:
- Inhibits the natural growth of the endometrium;
- The uterine glands begin to work weaker;
- The submucosal layer thickens.
In addition, the Mirena intrauterine plastic spiral thickens the natural mucus in the uterine cavity, which prevents the embryos from fixing to the walls. The hormonal components of the drug inhibit the activity of spermatozoa, prevent their penetration into the egg.
Pros and cons
The advantages of the device include:
- Effective therapeutic effect;
- Long-term protection against fertilization;
- Soft effect of active substances on organs;
- Rapid recovery of reproductive functions;
- Quick installation;
- Prevention and treatment various kinds pathologies.
- The price of one spiral is from 12 thousand rubles;
- There is a risk of menorrhagia;
- High risk of inflammation with frequent changes of sexual partner;
- If the device is installed incorrectly, internal bleeding is possible;
- Abundant menstruation after the introduction;
- Does not protect against infectious pathologies.
Intrauterine hormonal coil "Mirena" is recommended:
- To protect against fertilization;
- With menorrhagia of the idiopathic type;
- As a prevention of gynecological pathologies.
Most often, the Mirena hormonal plastic coil is installed to control menorrhagia. Pathology is characterized by severe internal bleeding due to the absence of the endometrium. Blood loss is noticeably reduced already within 5-6 months of regular use of the device.
Contraindications
The IUD is contraindicated in the detection of:
- pregnancy;
- Infectious diseases of the urinary system;
- Precancerous formations on the reproductive organs;
- Intrauterine bleeding of unknown origin;
- Deformations of the uterine walls due to a large tumor;
- Pathological failure menstrual cycle;
- Pathological condition of the liver;
- In old age (after 60 years);
- Allergic reaction to components of Mirena analogues.
In addition, Mirena should be used with caution when:
- hypertension;
- myocardial infarction;
- Diabetes mellitus 1-2 degree;
- Diseases of the cardiovascular system;
- Migraines of unknown etiology.
If there is at least one of the contraindications, after installing the spiral, you should carefully monitor the state of health. If you experience any side effects or if you feel worse, contact your gynecologist.
Installation
It is forbidden to introduce the Mirena spiral on your own without the help of a gynecologist. Before installation, the patient must take tests and undergo diagnostics to check if there are any contraindications.
The following diagnostic measures are prescribed:
- Blood and urine analysis;
- HCG analysis;
- Gynecological and surgical examination;
- Blood test for the detection of genital infections;
- Ultrasound of the reproductive organs;
- Colposcopy.
When the Mirena intrauterine device is introduced as a contraceptive, the procedure is carried out during the first week of a new cycle. If the installation is done for treatment, then the day does not matter. In the postpartum period, a spiral can be inserted one month after childbirth, when the uterus recovers. The day of the procedure is scheduled individually.
The whole procedure takes no more than 25 minutes. The doctor inserts a speculum into the uterine cavity. The walls of the uterus are treated with an antiseptic preparation for disinfection, after which a spiral is inserted through the cervix using a special tube.
After installation
After the introduction of the spiral, the patients complain that menstruation decreases or stops completely.
When using the device, the disappearance of menstruation is normal. The core of the device contains hormones that stop the growth of the endometrium. Therefore, menstruation becomes scarce or stops altogether.
The opposite effect is also possible after the installation of the IUD, the amount of menstruation released can increase by 2-3 times. Abundant discharge is observed for the first 40-50 days. No need to worry, this is also a normal reaction to the release of hormones in the female body.
Adverse reactions
Mostly adverse reactions appear due to the restructuring of the menstrual cycle. There may also be negative reactions from nervous system:
- Migraine;
- Aggressiveness;
- Irritability;
- Mood swings.
The annotation to the device states that if a negative reaction occurs, additional drug therapy is not needed. All symptoms disappear 1–2 months after implantation.
It is worth seeking help from a gynecologist only in case of the following symptoms:
- Complete absence of menstruation for 60 days;
- Acute pain in the lower abdomen that is permanent;
- Fever;
- Pain and discomfort during sex;
- Changes in color, smell and consistency of secretions;
- During menstruation, a large amount of blood is released .
Complications
An invasive procedure using a hormonal system can cause a number of complications. Therefore, before installing the spiral, it is worth exploring the options for negative reactions associated with the installation of a contraceptive.
The most common complication is the loss of the spiral from the uterine cavity. Expulsion usually occurs during the menstrual cycle. To avoid this, it is recommended to regularly check the threads after menstruation.
Expulsion is accompanied by pain in the groin and profuse bleeding. After falling out or displacement, Mirena no longer has a therapeutic effect on the body. Therefore, during intercourse, pregnancy can occur.
Perforation
When using Mirena, penetration of the uterine wall is rarely observed. Most often, this can happen due to improper installation of the spiral, or if the girl has recently given birth and is breastfeeding. If the spiral is installed too early after childbirth, injuries to the uterine walls are possible.
infections
The risk of infection increases after insertion of the device, when the uterine cavity becomes inflamed. During this period, the reproductive organs are susceptible to infection, so doctors do not recommend changing sexual partners and often having sex.
If an infectious disease is detected during the diagnosis, then the IUD is not installed. Infections are the main contraindication. Also, a complication due to the use of Mirena is considered an ectopic pregnancy, amenorrhea or ovarian cyst.
Removal and replacement
After 3-4 years, the spiral must be changed or removed, since the release of the hormone from the core of the device into the uterine cavity ends.
The extraction of funds is done on the 2nd day of menstruation to prevent accidental fertilization and infectious diseases. If the Mirena coil was removed on the 15-17th day of the cycle and a new one was not introduced, the risk of conception increases.
The intrauterine plastic spiral Mirena is removed with threads. If they were not in the vagina, then the spiral is taken out with tweezers.
Removing the device may make you feel unwell. The condition is a completely adequate response to the cessation of the release of hormones into the blood and normalizes after a few hours.
Possibility of conception
The onset of an unplanned pregnancy with an established spiral is not uncommon. If the pregnancy is confirmed, you need to check whether the embryo is properly fixed. If the implantation of the embryo was successful, further actions are discussed with the pregnant woman on an individual basis.
If the pregnant woman decides to continue bearing, then the spiral is removed.
A coil left in the uterine cavity for the period of bearing a fetus increases the risk of miscarriage or premature birth. In some cases, the coil cannot be safely removed. Then there is the question of induced abortion. If the procedure is refused, the doctor informs the patient that in the future there may be problems with the child's health.
If the spiral has not been removed and has been in the uterus throughout the pregnancy, secondary sexual characteristics may appear in the fetus. However, this phenomenon is extremely rare.
While maintaining pregnancy, a woman should be regularly examined by a gynecologist. If you experience suspicious symptoms (pain, bleeding, fever), you should immediately seek medical help.
After childbirth
"Mirena". She not only acts as a contraceptive, but in addition can be prescribed for the treatment of certain female genital diseases.
What is it
Mirena is considered a highly effective contraceptive that has a therapeutic effect. This drug is manufactured by the Finnish company Bayer. The system is a T-shaped frame that releases the hormone levonorgestrel after insertion. The considered means of contraception has a local effect. This spiral is installed for 5 years, then it is removed and, if desired, a new one is introduced. Consider what kind of hormone - levonorgestrel. This is a synthetic progestogen that converts, minimizes and prevents the fertilization of the egg.
Operating principle
The Mirena system works in the same way as classic oral contraceptive methods. Immediately after the introduction of the spiral into the uterus, levonorgestrel is released. It has the following effect on the body of a woman:
- ovulation becomes slower; the intrauterine membrane changes, and the fertilized egg cannot attach to the wall;
- the mucus that is in the cervix becomes denser - this prevents the spermatozoa from approaching the egg;
- sperm under the action of the hormone become less mobile, and because of this, they cannot reach their “destination”.
Did you know? Scientists fail to develop birth control pills for men, containing testosterone, which could stop the production of sperm and at the same time preserve sexual function.
Indications
Mirena is used in the following cases:
- as protection against unwanted pregnancy;
- with idiopathic menorrhagia;
- for the prevention of pathological growth of the endometrium.
Instructions for use
According to the instructions for use, the Mirena spiral can only be inserted by a gynecologist.
Important!Before installing the spiral, you should undergo an examination that will confirm the absence of contraindications to the use of the drug.
On what day of the cycle put
It is recommended to introduce a hormonal spiral in the first days. After childbirth, if the uterus contracts well, it is allowed to use the system after 1.5 months. Replace "Mirena" is allowed on any day of the cycle. To prevent too much growth of the endometrium, the drug in question is recommended to be installed at the end of the cycle.
Insertion technique
First, the doctor inserts a speculum into the uterine cavity. Then a specialized swab with an antiseptic treats the cervix. Controlling the process with a mirror, he introduces a special tube into the uterus, in the middle of which there is a spiral. After the gynecologist has checked the correct location of the "shoulders" of the spiral, he removes the tube and mirror. This completes the procedure, and the woman is given 30 minutes to rest.
Application features
Consider when it is impossible to install the Mirena spirals, as well as the negative consequences after the introduction.
Contraindications
You can not install the system:
- with allergies to the components of the drug;
- if a woman is or is not sure that there is no pregnancy;
- in the presence of endometritis after childbirth;
- if less than 3 months ago there was a septic abortion;
- in the presence of inflammation in the pelvic organs;
- with oncology of the uterus;
- if there is cervicitis;
- with uterine bleeding of unknown etiology;
- with pathologies that deformed the uterine cavity;
- if there are liver diseases;
- if the woman is over 65 years old;
- with thromboembolism of any organs, thrombophlebitis;
- in the presence of dysplasia;
- if available ;
- if previously treated for breast cancer.
Side effects
Among the main side effects of the Mirena spiral are:
- disorder of the central nervous system: migraine, depression, irascibility;
- menstrual irregularities of a different nature;
- cysts may appear on the ovaries;
- infections in the pelvis;
- allergy;
- soreness of the chest;
- nausea, abdominal pain;
- pain in the back;
- weight gain and acne.
Important!If during sex there are painful sensations, then you should not hesitate to go to the doctor.
Does it hurt
The insertion process is sensitive, but there are no strong pain sensations. Mirena is thicker than other coils due to the hormone reservoir. If pain sensitivity is high, then local anesthesia is possible. The contraceptive should not be administered "through force" if the cervical canal is narrowed or there are other obstructions. In such cases, the cervical canal is expanded under local anesthesia.
When the coil is removed
The intrauterine device must be removed 5 years after insertion. The procedure is carried out in the first days of menstruation to avoid conception. If you plan to introduce a new spiral, then it is allowed to remove the old one on any day. By removing Mirena in the middle of the cycle and not installing a new one, a woman can become pregnant if she has had sex within 7 days before removing the contraceptive. During these 7 days, fertilization was possible, so that the egg could enter the uterus and attach to its wall. After removing the spiral, ovulation is almost not delayed.
Spiral "Mirena": pros and cons
Pros of Mirena:
- good effect;
- acts locally, so there are practically no systemic changes in the body;
- after removal, the ability to fertilize is quickly restored;
- installed quickly;
- it is not expensive compared to birth control pills for 5 years of use;
- "Mirena" prevents many gynecological diseases, is effective in endometriosis.
- menorrhagia may develop;
- you need to spend a lot of money at a time to buy a spiral;
- inflammation may appear if you often change sexual partners;
- if installed incorrectly, Mirena can cause pain and bleeding;
- in the first months after installation, there may be heavy periods;
- does not protect against sexually transmitted infections.
FAQ
Method efficiency
The effectiveness of the method can be compared with sterilization. Clinical studies have shown that in 1 year for 1 thousand women there are only 2 cases of pregnancy.
Did you know?The idea of creating intrauterine devices appeared in 1926. Silkworm threads and silver rings were used for making.
How fast can you get pregnant after removal
Mirena does not affect the functioning of the ovaries, so a girl can become pregnant almost immediately after removing it. Very rarely, this process stretches for 3-6 months.
Is there protection against disease?
Mirena, like other hormonal contraceptives, does not protect females from sexually transmitted diseases.
Use after childbirth
You can enter "Mirena" after childbirth only after 3-6 weeks, when the uterus recovers and returns to its previous size. Studies have shown that it is safe for breastfeeding women to administer intrauterine device.
Use after an abortion
After an artificial abortion or spontaneous abortion for a short time, if there are no signs of infection, it is allowed to install Mirena in a week.
Can it be reinstalled?
Studies have shown that it is safe to install the system in question two or more times in a row.
So Mirena is effective drug with a number of pathologies that occur in the body of a woman. Also, the spiral reliably protects against unwanted pregnancy. However, it requires a special setting, has contraindications and side effects, so it is important to consult a doctor and conduct some examinations before its introduction.
The site provides reference information for informational purposes only. Diagnosis and treatment of diseases should be carried out under the supervision of a specialist. All drugs have contraindications. Expert advice is required!
General characteristics
Therapeutic intrauterine system Mirena as an intrauterine contraceptive (IUD)
Therapeutic intrauterine system (hormonal intrauterine system, hormonal intrauterine device, Navy) Mirena refers to intrauterine hormonal contraceptives.In the 1960s and 1970s, copper-containing IUDs appeared, the efficiency of which was even higher. However, the problem of metrorrhagia (uterine bleeding) was not solved by the second generation of intrauterine contraceptives.
And finally, in the second half of the 70s, the first hormone-containing intrauterine contraceptives appeared - a new, third generation of IUDs. These medicines combine the positive aspects of the IUD and hormonal oral contraceptives.
Hormone-containing intrauterine contraceptives are more effective than others contraceptives this group. In addition, they do not lead to uterine bleeding. Against the background of the use of hormone-containing intrauterine contraceptives, menstrual bleeding becomes less abundant.
Description of the dosage form
The Mirena intrauterine hormonal system has a T-shaped body that provides a stable location in the uterine cavity. At one end, the body has a loop to which threads are attached to remove the system. On the body there is a hormonal-elastomer core, which is a substance of white or almost white color. The core is covered with a translucent membrane that regulates the flow of the active substance into the uterine cavity.The active hormonal substance of the system - the progestogen drug levonorgestrel - is presented in an amount of 52 mg. Auxiliary substance - polydimethylsiloxane elastomer.
The Mirena intrauterine hormonal system is located in the cavity of the conductor tube. The conductor and body of the drug do not have impurities.
Each package of Mirena contains one intrauterine hormonal system, placed in a vacuum plastic-paper shell.
The acquired dosage form of Mirena before use should be kept in a place protected from sunlight, at room temperature (15-30 degrees). The shelf life is three years.
Metabolism of the active substance in the body
The hormonal IUD Mirena begins to secrete levonorgestrel immediately after being placed in the uterine cavity. The release rate of the active substance after administration is 20 µg/day, by the end of the fifth year it decreases to 10 µg/day.The distribution of levonorgestrol characterizes Mirena as a drug of predominantly local action. The highest concentration of the substance is stored in the endometrium (the lining of the uterus). In the myometrium (in the muscular membrane), the concentration of levonorgestrel barely reaches 1% of the concentration in the endometrium. The concentration of levonorgestrel in blood plasma is 1000 times less than in the endometrium.
The active substance enters the bloodstream approximately one hour after the introduction of the system. The maximum concentration of levonorgestrel in the blood serum is reached after two weeks.
Body weight significantly affects the concentration of the active substance in the blood plasma. In women with reduced weight (37-54 kg), the concentration of levonorgestrol in the blood is on average one and a half times higher.
The active substance is almost completely metabolized (broken down) in the liver, and excreted through the kidneys and intestines.
Operating principle
The most important contraceptive effects of the Mirena intrauterine hormonal system are due to a weak local reaction to a foreign body in the uterine cavity, and mainly to the local influence of the progestogen drug levonorgestrol.There is a suppression of the functional activity of the epithelium of the uterine cavity: the normal growth of the endometrium is inhibited, the activity of its glands decreases, transformations occur in the submucosa - all these changes ultimately prevent the implantation of a fertilized egg.
Other important contraceptive effect is an increase in the viscosity of the mucus secreted by the glands of the cervix, and a thickening of the mucous membrane of the cervical canal, which prevents the penetration of spermatozoa into the uterine cavity.
In addition, the Mirena drug inhibits sperm motility in the uterine cavity and in the fallopian tubes.
In the first months of use, due to the restructuring of the uterine mucosa, irregular spotting is possible. But in the future, inhibition of the proliferation of the endometrial epithelium leads to a pronounced decrease in the volume and duration of menstrual bleeding, up to amenorrhea (cessation of menstruation).
Indications for use
The Mirena intrauterine hormonal system is intended, first of all, to prevent unwanted pregnancy. In addition, the drug is used for excessively heavy menstrual bleeding of unknown etiology (in cases where the possibility of oncological diseases of the female genital area is excluded).
As a local progestogen drug, the Mirena intrauterine device is used to prevent hyperplasia (growth) of the endometrium during estrogen replacement therapy (this kind of treatment is indicated after surgery to remove both ovaries, as well as with severe menopause).
Contraindications
Mirena is an intrauterine contraceptive, so it is categorically contraindicated in inflammatory diseases of the female genital area, such as:- acute and chronic inflammatory diseases of the pelvic organs;
- infectious lesions of the lower urinary tract;
- postpartum endometritis;
- septic abortion that took place less than three months before installation.
As an intrauterine contraceptive, Mirena is also contraindicated in cervical dysplasia, malignant neoplasms of the body and cervix, congenital or acquired changes in the configuration of the uterine cavity (including fibromyomas).
Insofar as active substance the drug is metabolized in the liver, the Mirena intrauterine hormonal system is contraindicated in oncological pathology of this organ, as well as in acute hepatitis and cirrhosis. If jaundice of unknown origin has previously occurred, the drug should be used with great caution.
Since levonorgestrol is a gestagenic drug, Mirena is contraindicated in all gestagen-dependent oncological diseases(primarily for breast cancer).
The systemic effect of levonorgestrol on a woman's body is weak. Nevertheless, the Mirena intrauterine hormonal system should be used with extreme caution in cases where progestin preparations are contraindicated. This is especially true for severe circulatory disorders (heart attacks, strokes), severe migraine attacks in history (including those that may indicate severe disorders of cerebral circulation), arterial hypertension, severe forms of diabetes mellitus, thrombophlebitis and a tendency to thromboembolic complications.
In such cases, the degree of risk (the severity of the symptoms of the disease, which is a relative contraindication to prescribing the drug) and the benefits of its use should be correlated. The issue of using Mirena is decided in consultation with a professional, and during the use of the spiral, constant medical supervision and laboratory control are necessary.
Mirena is contraindicated in pregnancy (diagnosed or suspected) and in case of hypersensitivity to the components of the drug.
Side effects
Common Side Effects
Common side effects include associated symptoms that appear at least in every hundred, and no more than in every tenth patient using the spiral. Women using Mirena most often experience unpleasant symptoms from the central nervous system, such as: nervousness, irritability, bad mood, decreased libido, headache.
From the side gastrointestinal tract patients are often worried about pain in the abdomen, nausea, vomiting.
Among the adverse effects on appearance, acne and weight gain are most commonly observed.
Often, patients make many complaints about the state of the reproductive system and mammary glands: pain in the pelvic area, spotting, vulvovaginitis, tension and soreness mammary glands.
Back pain resembling sciatica is relatively common.
All the symptoms described above are most pronounced in the first months of using the Mirena IUD, then their intensity decreases, and in the vast majority of cases, unpleasant symptoms disappear completely.
Rare side effects
Rare side effects include associated signs of use medicinal product, appearing no more often than every hundredth patient, and no less than every thousandth.Rare adverse side effects of Mirena include the following:
- emotional lability (frequent mood swings);
- the appearance of edema;
- alopecia (baldness);
- hirsutism (increased hairiness);
- skin itching;
Very rare side effects
Very rare effects of the drug Mirena (less than one in a thousand) include allergic reactions in the form of a rash and urticaria. When such signs appear, other possible reasons skin allergies and, if necessary, stop using the IUD.Instructions for use
Insertion of the intrauterine device Mirena
Sterile vacuum packaging opened immediately before installing the system. A prematurely opened system must be disposed of as medical waste. Only a doctor with sufficient experience in carrying out such manipulations can install the Mirena intrauterine system.
Before installing the Mirena coil, you should consult with a gynecologist and get information about all the risks and possible adverse side effects.
Having decided on the installation of the Mirena IUD, a woman must undergo an examination of the mammary glands and mammography, as well as a gynecological examination, including a study of the pelvic organs and colposcopy (or at least a cervical smear analysis).
It is necessary to exclude oncological pathology of the female genital organs, pregnancy and sexually transmitted infections. All inflammatory gynecological diseases should be completely cured by the time of installation.
It is extremely important before installing the Mirena coil to determine the location of the uterus in the small pelvis, as well as the size and configuration of the uterine cavity. The correct placement of the IUD in the uterine cavity guarantees the effectiveness of the Mirena system, and prevents its expulsion (expulsion).
For women of childbearing age, Mirena is placed in the first seven days of the menstrual cycle.
If there are no medical contraindications, the Mirena IUD can be installed immediately after an artificial or spontaneous abortion in the first trimester of pregnancy.
Surgical intervention is extremely rare.
Amenorrhea
Amenorrhea is a common complication of the Mirena IUD. As a rule, it develops gradually during the first six months of using a contraceptive.
With the disappearance of menstrual bleeding, pregnancy should be excluded (conduct a routine test). If the test is negative, you can not repeat it in the future. The normal menstrual cycle will resume after the removal of Mirena.
Spiral Removal
After 5 years of use, the Mirena coil should be removed. In cases where, after removing the IUD, a woman is going to continue contraceptive measures, the Mirena coil should be removed at the beginning of the menstrual cycle. If the IUD is removed in the middle of the cycle, and before that unprotected sexual intercourse took place, then the woman is at real risk of becoming pregnant.If a woman wishes to continue using the IUD, a new IUD can be inserted immediately after removal. In cases where, after removing the IUD, a new intrauterine contraceptive is immediately installed, manipulations can be performed at any period of the cycle.
After removal of the Mirena IUD, the integrity of the spiral should be checked, since if it is difficult to remove the product, the substance sometimes slips into the uterine cavity.
Installation and removal of the Mirena coil may be accompanied by pain and bleeding of varying severity. In some cases, fainting is possible. In women with epilepsy, insertion or removal of a coil may cause a seizure.
Mirena intrauterine device and pregnancy
The drug has a very high efficiency. In cases where an unwanted pregnancy does occur, an ectopic pregnancy should be ruled out first. In uterine pregnancy, the question of its interruption is raised.If the woman decides to keep the child, then the spiral is carefully removed from the uterine cavity. In cases where it is not possible to remove the intrauterine system, the woman is warned about the possible risks of pregnancy with an IUD in the uterine cavity (spontaneous premature termination of pregnancy).
The possible adverse effect of the drug on the development of the fetus should be taken into account. There are very few cases of bearing a child with the Mirena intrauterine system due to the high contraceptive properties of the drug. However, a woman is advised to report that there are no clinical data on the occurrence of fetal pathology under the influence of this drug.
Application for lactation
The active substance of the Navy Mirena in small concentrations penetrates the blood plasma, and can be excreted during lactation, so that the content of levonorgestrel in breast milk is about 0.1% of the daily dose of the substance secreted by the system. It is unlikely that such a dose could affect the general condition of the infant. Experts say that the use of Mirena during lactation six weeks after birth is quite safe for a breastfed baby.
Frequently asked Questions
The cost of Mirena is quite high. I have heard that the use of the helix comes with a lot of unpleasant side effects. Is there any positive effect of the drug on the body?
The Mirena intrauterine hormonal system has the following therapeutic (not contraceptive) effects:- a decrease in the volume and duration of uterine bleeding (idiopathic - that is, not caused by any concomitant pathology);
- increased hemoglobin levels;
- normalization of iron metabolism in the body;
- general strengthening action);
- reduction of pain syndrome during painful menstruation;
- prevention of endometriosis and uterine fibroids;
- prevention of hyperplasia and endometrial cancer.
Is it possible to use the Mirena coil for myoma to treat a tumor?
The Mirena therapeutic system inhibits the growth of the fibroid tumor node. However, additional examination and consultation with a doctor is necessary. Much depends on the size of the nodes and their location. For example, submucosal fibroid nodes that change the configuration of the uterine cavity are an absolute contraindication for the use of the Mirena IUD.Does Mirena help with endometriosis?
The intrauterine system releases a hormone into the uterine cavity that inhibits endometrial proliferation - this is the basis for the ability of the Mirena spiral to prevent the development of endometriosis.In recent years, works have appeared that testify to the therapeutic effect of the Mirena spiral in endometriosis. Clinical data are rather contradictory. In addition, it should be noted that the treatment of endometriosis with hormonal IUDs is not used in all countries.
From the standpoint of evidence-based medicine, the Mirena spiral for endometriosis, like any other hormonal therapy, can only give a temporary result. The Russian National Guidelines for Gynecology recommend starting with surgical treatment as the most radical.
However, in each case, a thorough examination and consultation of doctors is necessary - a gynecologist, surgeon and endocrinologist.
My periods completely stopped six months after the installation of the Mirena spiral. This is fine? Will I be able to get pregnant after the coil is removed?
Amenorrhea (cessation of menstruation) is a normal reaction of the body to the action of the Mirena hormonal system, which occurs in every fifth woman using the spiral. As a rule, this condition develops gradually.At the first disappearance of menstrual bleeding, pregnancy should be excluded. The effectiveness of the drug is very high, but experts still recommend taking the test. If the test result is negative, then you don't have to worry. After the removal of the Mirena spiral, menstruation will be restored, and a normal pregnancy can be expected.
Is there any pain, discharge or uterine bleeding after the installation of the Mirena coil?
Immediately after the installation of Mirena, a slight pain syndrome and spotting are possible. Severe pain and bleeding may indicate that the IUD has not been inserted correctly. In this case, the Mirena coil must be removed.Pain, discharge or uterine bleeding a considerable time after the installation of the Mirena coil may indicate the onset of expulsion (expulsion of the drug from the uterine cavity) or an ectopic pregnancy. Therefore, if such symptoms appear, you should immediately consult a doctor.
Does Mirena affect weight? I really want to buy the Mirena intrauterine device, but I'm afraid to lose shape (there is a tendency to be overweight).
Weight gain is a fairly common unpleasant side effect of the Mirena spiral. However, it should be noted that not everyone is getting fat. According to clinical data, at least nine out of ten women do not even notice a slight increase in weight after the insertion of an IUD.In addition, weight gain is one of the side effects of Mirena, most pronounced in the first months after installation. As a rule, in the future, the tendency to be overweight, caused by a hormonal drug, disappears.
According to the existing tendency to be overweight, it is impossible to judge the possibility of weight gain after installing the Mirena spiral, since the appearance of this side effect and the degree of its severity depends on the individual response to the hormonal drug.
I was protected by hormonal preparations. There are no side effects, but I often forget to take pills. What is the best way for me to switch from pills to Mirena?
If you have taken pills irregularly, then there is a risk of pregnancy, which should be excluded when prescribing Mirena.In addition, it is necessary to undergo a complete gynecological examination (examination of the pelvic organs, colposcopy) and check the condition of the mammary glands.
If there are no contraindications to the use of the IUD, it is best to insert the spiral on the fourth or sixth day of the menstrual cycle. On the day of installation of the Mirena spiral, contraceptive pills are canceled.
When does pregnancy occur after Mirena removal?
Clinical data indicate that 80% of women who want to have a baby become pregnant in the first year after the removal of the Mirena coil. This is even slightly above the usual level of fertility (fertility).Of course, it takes some time to restore the normal state of the reproductive system, which is individual for each woman.
For patients for whom pregnancy is undesirable, doctors advise immediately after removing the Mirena spiral to take measures to prevent conception, since in many women the likelihood of pregnancy appears immediately after the system is terminated.
Where to buy a Mirena coil?
The Mirena intrauterine device can be bought at a pharmacy. The drug is dispensed by prescription.The site is a medical portal for online consultations of pediatric and adult doctors of all specialties. You can ask a question about "Spiral Drop" and get a free online consultation with a doctor.
Ask your questionQuestions and Answers for: Spiral Dropout
2014-03-19 01:52:36
Ludmila asks:
Hello. I had Mirena for endometriosis over a month ago. I feel good, tell me, how many kg can I lift so that there is no displacement or loss of the spiral?
Responsible Wild Nadezhda Ivanovna:
It is believed that adaptation to the contraceptive takes place within 3 months, so during this period you need to take care. How much you can lift is individual, but mostly up to 3 kg. although this is not official data. There is no official data, the woman leads a normal life, a follow-up examination after 3 months.
2013-07-01 17:34:45
Gallina asks:
I'm 47 years old. In 2003, I was diagnosed with uterine fibroids, they did not treat me, I was observed by a doctor, I had an ultrasound scan and two diagnostic curettage. In February 2012, bleeding began, they cleaned it, I was in the hospital for 3 weeks. In March 2012, a Mirena coil was put in, it didn’t take root - it fell out in August. All the time for 5 months there was a bloody (sometimes abundant pink) daub. After the spiral fell out, the menstruation went only in October, the duration was about 3 weeks, again scraping and treatment. The next menstruation in December, followed by daubing, after ultrasound - endometriosis of the uterine cavity 28 mm with curettage and re-installation of the Mirena spiral + depo-prover 150 mg. The spiral stood for 3 months, fell out in March 2013. Primolut-nor was prescribed 1 tablet in the morning and evening. All the same, a pink daub is observed almost daily, sometimes blood clots up to 1 cm long come out. The doctor says that while we wait - maybe the body gets used to it, and so it is necessary to prepare for the operation. Advise - maybe something else to try or is it all so hopeless?
Responsible Wild Nadezhda Ivanovna:
Do a control ultrasound. But, in order to give recommendations, an inspection is needed. Perhaps Visanne is suitable, or it may make sense to give buserin, or other drugs
2013-06-13 15:59:27
Elena asks:
Hello, tell me, I put the multi-lot spiral, it stood for a year, and today I went to the toilet, I was scared what it was, I looked at the spiral, I was shocked, what could be the reason for the fall of the spiral and when should menstruation start now, unless I accidentally got pregnant?
Responsible Gritsko Marta Igorevna:
You've had a helix fall out, which happens sometimes. Menstruation should begin on time, the spiral should not affect the timing of menstruation.
2012-09-27 16:54:18
Eugene asks:
Good time of the day. A year costs the Nova-T spiral. There are no inconveniences. For a year I have never tried to find "mustache". Been using the mouth guard for a couple of months. ago and wondered about the "antennae", because I read that if the bezel is in contact with the "antennae", this is not very good. I decided to check how far sh.m. I groped for it with my finger, but I didn’t grope for the “antennae”, but the fallout of the spiral would hardly have gone unnoticed. While there is no way to go to the doctor, check the spiral, again I called her and she said that the absence of "antennae" is not an indicator of prolapse. And the use of a cap can somehow affect the displacement of the spiral?
Responsible Purpura Roksolana Yosipovna:
In principle, no, if the spiral was displaced, there would be pain or discharge. If something objectively bothers you, then you need to check the placement of the spiral on the ultrasound.
2011-07-03 16:09:35
Julia asks:
Hi! dizziness. monthly should be only after 2 weeks. the spiral will be removed after 2 weeks, the smear was bad. I need to heal. if there is a pregnancy, then I want to leave, and the doctor said that the miscarriage will be 99%. .whether really there will be a miscarriage, or all the same hopes it is more?
2010-08-11 09:13:16
Natalia asks:
I have been put on a Mirena hormonal coil several times already, but 3-4 months pass and it falls out. The spiral was placed due to enterobiasis, severe bleeding during menstruation. Tell me what way out can be in my situation and what is the reason for the spiral to fall out. Thank you.
Responsible Klochko Elvira Dmitrievna:
Good afternoon. So you don’t need to put more - it just doesn’t suit you, choose other methods of treatment. The reasons are mainly in the anatomy.
2014-12-24 11:56:27
Valentina asks:
Hello. Tell me, please, what is the difference between the Navy Multiload ku-375 and Multiload ku-250? The names are the same, but the producing countries are different: the Netherlands and Switzerland.
1.Do both models contain copper?;
2.Which one is T-shaped?;
The doctor told me: “I have different spirals, but I will put you one so that your head probably doesn’t hurt”, well ... you know what I mean)). I only know that I have a Swiss spiral (I was told so ), and not a T-shaped, but more reliable, of a different shape, since according to the doctor, T-shaped ones are more prone to falling out, but the one I have is not. This, of course, is encouraging. I just still have fear " fly in."
So what model do I have (it’s inconvenient just to call a doctor about this)?
P.S. To my question, how to check if the spiral is in place, the doctor said not to shove your fingers there and not to check anything yourself, but in a month for another examination. Is she right? Thank you.
Responsible Bosyak Yulia Vasilievna:
Hello Valentine! I don’t understand, why not ask the attending physician about what kind of spiral he put in ?! What is inconvenient in this is your health. You can get pregnant with an IUD installed only if it is displaced. If you have established and are still afraid, then you should have chosen another method of contraception. Check the location of the coil yourself, if it is correctly installed, does not cause discomfort, discharge, etc. no need. A month later, you need to undergo a follow-up examination, so your doctor's tactics are correct.
2014-03-07 19:19:35
Mila asks:
Good afternoon. Six months ago I put a copper-containing spiral. And everything was fine, no pain, heavy menstruation. Only now the delay of menstruation is 8 days and the test showed a positive result. Was at the doctor, it turned out that the spiral fell out. So far, it is not clear from the ultrasound whether there is a pregnancy or not, but the test showed it. How is it possible that I did not feel the prolapse of the IUD and the pregnancy is definitely there or not, and uterine or ectopic if there is?
Responsible Sitenok Alena Ivanovna:
Good afternoon, Mila! Answering your questions online is like guessing on coffee grounds! You need to do an ultrasound of the pelvic organs in the near future, and you will receive answers to all your questions!
2013-12-07 04:31:17
Svetlana asks:
Hello! I put the spiral "Vector" (silver), because. I am allergic to base metals. The spiral was put in 3 months after the birth. I breastfeed. The weight of the child is 7 kg. Menstruation after the installation of the spiral came on time, lasted 6 days, of which 3 days were very plentiful. I drank an infusion of nettle. On the last day of menstruation (already smeared, there was no heavy bleeding), the spiral fell out. There was no discomfort after the installation of the spiral, the prolapse was painless, without any sensations. Why did the drop happen? Is this method of contraception right for me?
