Mirena Insertion & Removal (IUCD)

What is a Mirena IUCD?

The IUCD is a contraceptive device which contains a slow-release form of the hormone progesterone. A low steady rate of the hormone is absorbed by the uterus and this leads to a thinning of the lining in the womb which makes it difficult to fall pregnant and reduces periods. It is licensed for use for five years, after which time it should be replaced.

When it first goes in you may notice some side effects such as headaches, mood changes and breast tenderness. These normally settle after a few weeks.

The other common side effect is irregular bleeding. This often goes on for the first few months but usually settles to light periods or no periods at all by six months.

There are some more significant risks:

• One in 500 risk of perforation into the pelvic cavity.
• One in 20 risk of expulsion (check for strings each month and see your own doctor if you cannot feel them).
• Small risk of infection – mainly immediately after insertion.

Contraception failure is less than one per cent over five years, but if you fall pregnant while the IUCD is in the uterus then there is a five to eight per cent chance of an ectopic pregnancy and you should have an early ultrasound to exclude a tubal pregnancy. If the pregnancy is in the uterus, then ideally the IUCD should be pulled out to lessen the risks of infection in the pregnancy.

An IUCD should not be used if a woman is already pregnant, if she has recently had pelvic inflammatory disease or incomplete miscarriage, or if she has cancer of the cervix, ovaries or endometrium.

Because of the small risk of infection, it is not a good contraceptive method in a woman with frequent sexual partners who does not use additional barrier methods for safe sex practices.

Mirena Insertion Pros and Cons

Although we can insert the Mirena, it is important that the pros and cons of this as a method of contraception or cycle control have been thoroughly discussed beforehand with your own doctor, who will need to provide you with a referral and script for the device which you should purchase and bring to the appointment. A consultation with our doctor is necessary on the day to discuss the procedure and we will perform an ultrasound to check the correct placement of the IUCD before you go home. Ongoing follow-up will be with your own GP or specialist.

IMPORTANT POINTS

You will need to bring the Mirena IUCD with you to the appointment.

We suggest you take two Naprogesic or Ponstan tablets one hour before the appointment.