The Hormone Releasing Intrauterine Device (Mirena IUD)

on . Posted in Contraception

Download a PDF copy of the SHFPACT Info Sheet on the Hormone Releasing Intrauterine Device (Mirena IUD) here

What is a hormone releasing IUD?
The hormone releasing IUD is a small plastic device which is inserted into the uterus (womb) by a doctor and is used to prevent pregnancy.  It contains a hormone called levonorgestrel in its stem. A very small amount of this hormone is released continuously over 5 years. 

How does it work?
The hormone releasing IUD works mainly by preventing fertilisation. It does this by thickening the mucus in the cervix to prevent sperm penetration; interfering with sperm movement; and thinning the lining of the uterus. 

How effective is it?
The hormone releasing IUD is 99.8% effective at preventing pregnancy. 

How long does it last?
It is effective for 5 years. 

How is an IUD removed?
Removal of an IUD is done by a doctor. It is a relatively quick and straightforward procedure.

What are the advantages of a hormone releasing IUD?

  • It is a highly effective contraceptive (99.8%)
  • It does not require any day to day action on your part.
  • It is long acting.
  • The effect is rapidly reversible after removal.
  • It is a very cost effect method over time.
  • It can be used by breast feeding women.
  • It decreases menstrual bleeding and pain (many women experience very light periods or no periods).

What are the disadvantages?

  • It must be inserted and removed by a doctor
  • As with any procedure there is always a small risk of complications.
  • The insertion procedure can be uncomfortable.
  • IUDs provide no protection against sexually transmissible infections.
  • You may experience light bleeding and spotting for 3 to 6 months after insertion.
  • Your periods may be irregular.
  • Some women may have factors in the structure of their uterus that prevent IUD insertion, and this may not be apparent until insertion is attempted.

What are the possible problems which may occur with a hormone releasing IUD?

  • There is a small risk of pregnancy occurring with an IUD (less than 1 in 100). If pregnancy does occur there is a slightly increased risk of it occurring in the fallopian tube.
  • Infection: There is a small risk of infection at the time of insertion (about 1 in 500).
  • Expulsion: In about 5% of cases the uterus will expel the device. Women need to check that the IUD is still in place by feeling for the IUD string after each period. If the string is not present women this may indicate that the IUD has moved or been expelled.
  • Perforation: This is a rare event (approximately 2 in 1000 insertions) which occurs when the IUD passes through the wall of the uterus into the pelvic area. This will require minor surgery under a general anaesthetic to remove

What happens in the IUD insertion process at SHFPACT?

Initial consultation appointment 

  • There will be an initial consultation with a doctor to determine if a hormone releasing IUD is a suitable option for you. The method and insertion procedure will be explained, a Pap smear will be done if it is due, and swabs may also be collected if required. It is best to ask any questions or raise concerns at this point.
  • A prescription for the IUD will be given to you. You will need to go the chemist and have this filled then bring the IUD with you to the clinic on the day of insertion.
  • The hormone releasing IUD needs to be inserted on day 1 to 7 of your menstrual cycle (day one being the first day of your period) or at any time if you are currently using the oral contraceptive pill or another hormonal method of contraception.
  • Following your initial consultation you will need to make an appointment for the insertion.

Insertion appointment

  • You will be encouraged to arrange to be driven home and to rest up after the procedure for the remainder of the day (you may need to organise care for young children, time off work etc.). You will probably be fine to return to normal activities the following day.
  • You will be at the clinic for up to an hour to an hour and a half. If parking please ensure you have left enough time.
  • The doctor will run through the procedure and make sure the process is clear.
  • An uncomplicated insertion procedure takes about 15 mins. You will be asked to stay at the clinic for a minimum of 20 minutes following the procedure. If you are not feeling well you will be asked to remain until the staff caring for you feel that you are well enough to leave.

After insertion

  • There may be cramping and/ or bleeding in the first few days afterwards
  • Spotting may occur for up to 3 months after insertion
  • We advise that nothing should enter the vagina for 3 days afterwards in order to reduce the risk of infection– no tampons, no sex, no water (showering is ok).
  • You will need to return to the clinic for a check-up at 4- 6 weeks after insertion.
  • You should contact the doctor if:
    • You suspect you might be pregnant.
    • You experience excessive pelvic pain or tenderness, fever or chills, offensive discharge or deep pain with intercourse.
    • You can’t feel the string or can feel the plastic of the device. 

Who do I go to for IUD insertion?
IUDs are only inserted by doctors who have done IUD training. The clinic at SHFPACT provides IUD insertion services. Some GPs and most gynaecologists also provide this service. 

Download a PDF copy of the SHFPACT Info Sheet on the Hormone Releasing Intrauterine Device (Mirena IUD) here

References:

  • Contraception: An Australian clinical practice handbook 3rd Ed
  • Contraception – Intrauterine Devices/ Family Planning QLD
  • Hormone-Releasing IUD (Mirena) Fact sheet/ Family Planning NSW
  • Guillebaud, J & MacGregor, A. 2013. Contraception: Your questions answered. 6th ed. Churchill Livingstone

 

 

 

 

 

 

 

 

 

 

 

 

 

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For urgent concerns where SHFPACT is unable to respond in the time required please see your GP or the Walk-in Clinic at the Canberra Hospital, or call HealthDirect on 1800 022 222. For assistance in an emergency please call 000 or 112 (digital mobile phone) or 106 (TTY, text based emergency number).

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