contraceptives IUD mirena

Contraceptives IUD and Mirena

What is an IUD?

An IUD or IUCD (intra uterine contraceptive device) is a form of contraceptive and involves a device being placed inside the uterus (womb) to prevent pregnancy. IUD is a small plastic device in the shape of a ‘T’ with plastic strings attached. The device releases the hormone progesterone (levonorgestrel) into the uterus.

Why Consider an IUD?

IUDs are a popular type of long acting, reversible contraception. IUD’s can offer long-term contraception for up to 5 years after insertion.

Further, the IUD can be removed at any point of time ensuring an immediate return to fertility.

Other Benefits of IUD?

It is also often used to treat heavy and painful periods. Benefits over the other contraceptive methods are

  • Menstrual bleeding reduction
  • Menstrual pain decreases in about 3-6 months of its insertion
  • Pelvic inflammatory disease risk decreased
  • Endometrial cancer risk is decreased
  • Elimination of adverse effects associated with oestrogen based contraceptive

IUD do not offer any protection towards sexually transmitted devices.

About Mirena

Mirena is a contraceptive intrauterine device used by women to prevent unwanted pregnancy. When placed in the uterus, the IUD releases the hormone progestin that makes the cervical mucus more viscous and the endometrium thinner so as to avoid the entry of sperms into the fallopian tubes. Mirena is also considered to partially suppress ovulation.

Mirena Procedure Consideration

The procedure is more suitable for women who have had a vaginal delivery as women who have not had a vaginal delivery may find it painful. For these women, it is possible to insert the Mirena under sedation as a Day Stay procedure. Prior to your appointment, it is recommended you take take two panadol or ponstan one hour before.

 After the Mirena Procedure

Most women will experience minor pelvic cramps for about 24 hours. Panadol alone is enough to control the cramps. There may be light bleeding for a few days. It is advisable that you avoid intercourse, tampons, baths and swimming for 48 hours to minimise the risk of infection.

If for whatever reason, you are not satisfied with the Mirena, it can be easily removed.

When is Mirena not Appropriate

The use of Mirena may be inappropriate if you have any of the following conditions:

  • Cancers in breast, uterus, cervix and liver
  • Uterine abnormalities such as fibroids,
  • Pelvic infection or pelvic inflammatory disease,
  • Abnormal vaginal bleeding or vaginal inflammation
  • A lower genital tract infection.

Potential Side Effects

Some women can:

  • Find their first period is a lot lighter but continue a lot longer
  • Experience irregular bleeding or spotting for the first 3-6 months
  • 95% of women will find menstruation is a lot lighter and less painful.
  • 30% of women will not have any periods as long as the Mirena is in.

Copper (Non-hormonal) IUD

Copper IUD’s are also available. Patients requiring these devices are generally seen across 2 visits to the clinic. The first visit will be a consultation and assessment only. Doctor will discuss the pros and cons of the IUD with you at this visit and also other contraceptive options that may suitable to you. Insertion is usually done on the third or fourth day of your periods.


Dr Sobia Mohyuddin

MCPS, FCPS, MRCOG, Consultant Obstetrics & Gynaecology

Doctor Sobia Mohyuddin is a highly skilled and experienced Obstetrician and Gynecologist, with 25 years of training and experience in renowned, large institutions. She holds the position of Associate Professor and Fellow at the College of Physicians and Surgeons Pakistan. She is also a member of the Royal College of Obstetricians and Gynecologists (UK).