Indications 

Mirena intrauterine device (IUD) is used to provide up to 8 years of pregnancy prevention and up to 5 years of treatment for heavy periods in women opting for intrauterine contraception. 

Mirena is a hormonal IUD that gradually releases levonorgestrel, a hormone similar to those naturally produced by women. This hormone prevents pregnancy by thickening cervical mucus to block sperm entry into the uterus, inhibiting sperm movement to impede fertilization, and thinning the uterine lining to reduce the likelihood of egg attachment.  

Uses and Dosage 

Before using Mirena IUD, thoroughly read the patient information leaflet provided by your pharmacist. Should you have any inquiries, seek guidance from your doctor or pharmacist. 

Mirena IUD is intended to be placed inside the uterus by a health care provider during an office visit. Its placement duration ranges from 5 to 8 years, with the flexibility for removal by a healthcare professional at any time to accommodate changing plans. 

Discomfort or lightheadedness may occur during IUD insertion, along with slight vaginal bleeding. Inform your doctor if these symptoms persist beyond 30 minutes. 

A follow-up appointment must be arranged 4 to 6 weeks after Mirena IUD is inserted to ensure it remains in the correct position. 

Mirena IUD may occasionally shift or come out on its own. After each menstrual period, ensure it remains correctly positioned. Refer to the patient information leaflet or consult your healthcare provider for guidance on carefully checking its position.  

If the device comes out or if you cannot feel the threads, promptly contact your doctor, and use a backup form of non-hormonal birth control (e.g., condoms, spermicide) until further instructions from your doctor. 

Mirena IUD should be removed within 5 or 8 years of insertion. If continued contraception is desired, a new device can be inserted during the removal procedure. 

Side Effects 

Common Side Effects 

• Pelvic pain, painful or irregular menstrual periods, changes in bleeding patterns or flow 
• Swelling, itching, or infection in the vagina 
• Temporary pain, bleeding, or dizziness during IUD insertion 
• Ovarian cysts (pelvic pain resolving within 3 months) 
• Stomach pain, nausea, vomiting, bloating 
• Headache, migraine, depression, mood swings 
• Back pain, breast tenderness, or pain 
• Weight gain, acne, oily skin, changes in hair growth, loss of interest in sex 
• Puffiness in the face, hands, ankles, or feet 

Tell your doctor if these common side effects persist or intensify. 

Serious Side Effects 

• Severe cramps or pelvic pain, discomfort during sexual intercourse 
• Extreme dizziness or a light-headed sensation 
• Severe migraine headache 
• Heavy or persistent vaginal bleeding, sores, watery or foul-smelling discharge 
• Pale skin, weakness, easy bruising or bleeding, fever, chills, or other signs of infection 
• Jaundice (yellowing of the skin or eyes) 
• Sudden numbness or weakness, especially on one side of the body, confusion, vision problems, sensitivity to light 

Contact your doctor right away if you experience any severe side effects. 

Seek immediate medical attention for intense lower abdominal or side pain, as it may indicate a tubal pregnancy. 

Mirena IUD could get stuck in the uterine wall or create a hole in the uterus (perforation). If this happens, the IUD may not effectively prevent pregnancy, and it could potentially shift outside the uterus, leading to scarring, infection, or harm to other organs. Surgical removal by a doctor may be necessary in such cases. 

Allergic Reactions 

Although rare, a severe allergic reaction to Mirena IUD can occur. Medical help should be sought immediately if any of the following symptoms appear: 

• Hives 
• Difficulty in breathing 
• Swelling of the face, lips, tongue, or throat 

This list does not include all potential side effects of Mirena IUD. If you exhibit any effects that are not listed here, notify your doctor. 

Cautions 

Before receiving Mirena IUD, inform your doctor if you have any known allergies, particularly to levonorgestrel, any other progestins (e.g., norethindrone, desogestrel), or any components and parts of this device. 

Inform your doctor about your medical history to evaluate the appropriateness of Mirena IUD for you, especially highlighting any past occurrences of: 

• Bleeding or blood disorders 
• High blood pressure 
• Abnormal breast exam or cancer (especially endometrial or breast cancer) 
• Depression 
• Diabetes 
• Severe headaches or migraines 
• Heart problems (e.g., heart valve disease, irregular heartbeat, previous heart attack) 
• Liver disease, including tumors 
• Ectopic pregnancy 
• Stroke 
• Unexplained vaginal bleeding 
• Uterus problems (e.g., fibroids, pelvic inflammatory disease-PID) 
• Conditions that weaken the immune system or increase infection risk (e.g., HIV, leukemia, IV drug abuse) 
• Recent pregnancy or current breastfeeding 

Certain medications may impact the blood levels of levonorgestrel, potentially reducing the effectiveness of Mirena IUD. Inform your healthcare provider about all prescribed and over-the-counter medicines, vitamins, and herbal products you take or initiate/stop during treatment. 

Mirena IUD elevates the risk of a severe pelvic infection, often associated with sexually transmitted diseases. This device does not provide protection against sexually transmitted diseases (STDs), including HIV and AIDS. Using a condom may aid in safeguarding against these infections. 

Before undergoing an MRI test, inform the testing personnel about your use of Mirena IUD, as adjustments to the MRI procedure may be necessary. 

Avoid using Mirena IUD if pregnant. Promptly inform your doctor if pregnancy occurs. Retaining the IUD during pregnancy may lead to severe infection, miscarriage, premature birth, or maternal death. The hormone in the IUD may also induce undesired effects in a female newborn. 

Mirena IUD is suitable for use during breastfeeding. Levonorgestrel is unlikely to affect the quality or quantity of breast milk or the health of the nursing baby, although rare cases of decreased milk production have been reported. However, there is an increased risk of uterine complications from IUD insertion while breastfeeding.