home Audience 5 Intrauterine device with hormones. Installation, removal and features of the spiral. Mirena spiral: pros and cons

Intrauterine device with hormones. Installation, removal and features of the spiral. Mirena spiral: pros and cons

There are different methods of contraception. Some women protect themselves from unwanted pregnancy with help oral contraceptives. Others use a condom, while others resort to injection methods protection. There are also special patches and rings that prevent the process of fertilization. And not the last place in this list is occupied by the spiral. The Mirena system has been especially popular recently. Not all women experience side effects from its use. Some people simply don't notice the spiral and consider it an excellent remedy for contraception.

Composition and description

The Mirena intrauterine device not only protects against unwanted pregnancy, but also treats. It contains the hormonal substance levonorgestrel in the amount of 52 ml. The secondary component in the spiral is polydimethylsiloxane elastomer.

The appearance of the intrauterine therapeutic system resembles the letter “T”, placed in a special conductor tube, which has a white core and has an elastomeric hormonal filling. The spiral body is equipped with a loop on one side and two arms on the other. Threads are attached to the loop, with the help of which the spiral is removed from the vagina.

Pharmacological properties

The Mirena therapeutic intrauterine device (side effects from using the product are described in detail in the instructions for use, and they should be studied before using the system) has a local gestagenic effect by releasing levonorgestrel into the uterine cavity. This makes it possible to use the hormonal substance in a minimum daily dosage.

Over time, levonorgestrel accumulates in the endometrium, and its high content reduces the sensitivity of progesterone and estrogen receptors. As a result, the endometrium does not perceive estradiol and has an antiproliferative effect.

The Mirena IUD (side effects and contraindications must be taken into account before using the therapeutic system) when used affects morphological changes in the endometrium. Causes a rather weak reaction of the body to the presence of a foreign body. Affects the thickening of the lining of the cervical canal, which prevents sperm from penetrating into the uterus. The spiral prevents the process of fertilization, suppresses the activity of sperm and their motor functions. There are ladies for whom the product inhibits ovulation.

The use of Mirena does not have any effect negative impact on the female reproductive apparatus. As a rule, after removing the IUD, a woman becomes pregnant within a year.

During the first time of using a therapeutic intrauterine system, spotting may occur. bloody issues. Over time, suppression of the endometrium leads to a decrease in the duration of menstruation and a decrease in their abundance. The effect of the IUD on a woman’s body does not affect the functioning of the ovaries or the amount of estradiol in the plasma.

The use of the spiral in the treatment of idiopathic menorrhagia is allowed, but provided that the woman does not have gynecological and extragenital diseases, as well as ailments with severe hypocoagulation.

After 90 days after insertion of the IUD into the uterus, the volume menstrual flow decreases by 88%. If there is menorrhagia that was caused by fibroids, then the result of treatment with the therapeutic system is not pronounced. Reducing the duration of menstruation reduces the likelihood of iron deficiency anemia. Reduces negative symptoms of dysmenorrhea.

Indications and contraindications

What other reviews can you hear about Mirena? Side effects are very rare. According to women, the IUD can cause negative symptoms not only due to its improper use, but also due to the individual intolerance of the body. In this case, doctors advise removing the therapeutic system and selecting other methods of contraception.

The main indications for the use of the Mirena therapeutic system (side effects after using this spiral are observed in many women, only in some women they disappear over time, while in others the negative symptoms worsen, which forces the woman to abandon this medical device) are protection against unwanted pregnancy and idiopathic menorrhagia. The intrauterine device is recommended to prevent endometrial hyperplasia, which can occur with estrogen replacement therapy.

The use of Mirena should be avoided during pregnancy and if there is even the slightest suspicion of pregnancy. Do not use the spiral for gynecological inflammatory diseases. The intrauterine system should be abandoned if there are diseases genitourinary system, postpartum endometritis, cervical dysplasia, as well as malignant and benign formations in organism.

Do not use the IUD after a septic abortion, with cervicitis, bleeding of various origins, anomalies uterine organ, liver diseases and hypersensitivity to components that are part of the therapeutic system.

Mirena should be used only after consultation with a specialist if the patient suffers from migraines, severe headaches and if there is arterial hypertension. The coil is used with extreme caution in case of jaundice, poor circulation, and after a stroke or myocardial infarction.

It is believed that in small doses, levonorgestrel can penetrate into the milk of a nursing mother, but if the baby is six weeks old, it is not capable of harming the baby. Therefore, to use the spiral during the period breastfeeding required additional consultation specialist

"Mirena". Instructions for use, dosage

The spiral is inserted into the uterine cavity. Its service life is five years. At the very beginning of using the spiral, the daily release rate of levonorgesrel is 20 mcg. Over time, this figure decreases. After five years it is 11 mcg per day. The approximate average daily release rate of the hormonal substance is 14 mcg.

The therapeutic uterine system can be used in women who have used hormonal hormones in their treatment replacement therapy. The most important thing is that the drugs used in treatment contain estrogen, not progestogen. If the Mirena spiral is installed properly, it is equal to 0.1%.

The Mirena product is sold in sterile packaging. If the product did not have sterile packaging when purchased, it should not be used. There is also no need to store IUDs removed from the cervix, since they still contain remnants of the hormonal substance.

The sterile packaging of the spiral is opened only before introducing the product into the woman’s body. Mirena should only be installed experienced doctor with relevant experience in this field. Before introducing a therapeutic system, the doctor must familiarize the woman with contraindications and possible negative effects. Conduct a gynecological examination. Take a gynecological smear. Send the lady for a blood test. The doctor examines the mammary glands before installing the Mirena product. Side effects (the instructions warn about all the negative consequences that often occur after insertion of the spiral) will be minimized if the patient is examined and the therapeutic system is installed correctly.

During the examination of the patient, it is necessary to exclude pregnancy, as well as infectious and inflammatory in nature. All detected diseases must be eliminated before introducing the IUD into a woman’s body.

Before inserting the IUD, the uterus and the parameters of its cavity are studied. It is considered correct to place the Mirena at the bottom of the uterine organ. In this case, a uniform effect of the active substance of the product on the uterine environment is ensured.

The first time a woman is examined after installation of the spiral is after 3 months, then once a year. If necessary, the patient is examined more often.

If a woman is of childbearing age, then the spiral is installed within seven days from the beginning critical days. Mirena can be replaced with another intrauterine device at any convenient time. It is permissible to install an IUD immediately after an abortion that was performed in the first trimester.

After delivery, the IUD can be inserted six months after the involution of the uterus. If involution occurs with a delay, then you should wait for its completion. If the installation of an IUD occurs with complications, severe pain or is accompanied by bleeding, then it should be performed as soon as possible. ultrasonography to eliminate the possibility of perforation.

During estrogen replacement therapy, to maintain endometrial functions, women diagnosed with amenorrhea are fitted with the Mirena coil at any time. In patients with prolonged menstruation, the therapeutic system is administered into last days menstruation. The IUD is not used for postcoital contraception.

The Mirena therapeutic system is removed carefully, pulling out the threads with forceps. If the threads cannot be detected, then a traction hook is used to remove the spiral. Sometimes the cervix needs to be dilated to remove the IUD.

System, if not side effects, removed after five years. If the lady wants to continue to use this method contraception, a new IUD is inserted immediately after removal of the previous system.

Hormonal IUD "Mirena". Side effects

Negative symptoms in patients may appear in the first days after the introduction of the therapeutic system into the uterus. This is how the body gets used to the foreign element. As a rule, if the spiral is used for a long time, the side effects soon disappear.

Quite often, side effects after installing Mirena include the following symptoms:

bleeding, both vaginal and uterine;
spotting, bloody discharge;
ovarian cysts;
oligo- and amenoria;
Bad mood and nervousness;
demotion sexual desire;
migraine;
painful sensations lower abdomen and back area;
nausea;
acne;
tension and soreness in the mammary glands;
weight gain;
hair loss;
swelling.

If negative phenomena occur, you should consult a gynecologist. When using the Mirena therapeutic system, many people experience side effects almost immediately, but gradually the body gets used to the foreign element.

special instructions

Women during treatment with the Mirena therapeutic system should pay attention to the appearance of signs venous thrombosis. If they appear, it is recommended to consult a doctor and take all measures to treat this disease.

Many women experienced side effects when using the therapeutic system. Reviews of the Mirena IUD note that when used this method contraception in women, weight increased and acne appeared on the skin. If negative symptoms appear, the contraceptive should be removed from the body and replaced with another.

The IUD should be used with caution by women with heart valve problems. In this case, there is a risk of septic endocarditis. Such patients are prescribed a course of antibiotics on the days of manipulations associated with the installation and removal of the IUD to prevent the occurrence of this disease.

Small doses of levonorgestrel can affect glucose tolerance, so women with diabetes mellitus When using spirals, you must regularly take blood sugar tests.

In 20% of cases, Mirena can cause oligo- and amenorrhea. If a woman does not have her period for more than six months, then pregnancy must be completely excluded. Amenorrhea in women can be observed throughout the year if the IUD is used along with other hormonal agents in estrogen replacement therapy.

Mirena IUD is removed in case of infectious and bacterial diseases vagina, endometritis, pain and bleeding. The therapy system should be removed from the uterus if it is not inserted correctly.

The doctor notifies the woman about how to check the threads of the product immediately after he has installed the Mirena spiral. According to reviews, side effects after insertion of the IUD should alert the lady. If they appear, you should immediately visit a doctor to exclude possible complications and pathologies. Many patients are satisfied with the contraceptive, as it affects the absence of heavy periods and reliable contraception over five years of operation.

Cost of intrauterine device

The Mirena spiral not only protects against unwanted pregnancy, but also treats. This explains the increased interest of women in this product. You can buy it at the pharmacy. The cost of a therapeutic vaginal system ranges from 9-12 thousand rubles.

More than 80 million women around the world use intrauterine devices (IUDs) as a means of contraception and treatment of uterine diseases. This contraceptive prevents 92-99% of pregnancies and is often recommended for use by healthy women of reproductive age who have given birth.

Spiral - from the sixteenth century to the present day

The prototype of the intrauterine device is silver balls, which were inserted into women in China and Japan back in the sixteenth century. In 1909, the German scientist Richter proposed using another intrauterine insert - silk threads twisted into a ring. In 1958, the first plastic spiral appeared - the Jack Lipps loop. Not a very reliable thing - one in five women with a plastic IUD became pregnant. Reliability has improved since 1968, when the contraceptive effects of copper were discovered. And since 2001, the IUD has been “stuffed” with gestagens - analogues female hormone progesterone. Thus, IUDs began to not only prevent pregnancy, but also treat many hormone-related conditions. women's diseases– fibroids, endometriosis, adenomyosis. Nowadays, gynecologists use more than 50 types of IUDs. We will talk about the most modern, hormone-containing Mirena spiral, which works for 5 years. Why do they install such a spiral?

What does a hormonal IUD look like and work?

Hormonal IUD Mirena is made in the shape of the letter T, which allows it to be securely fixed in the body. One of the edges of the spiral is equipped with a thread loop designed for extraction. In the center of the intrauterine device, the tube contains a hormone in the amount of 52 mg, which gradually enters the endometrium of the uterus through the membrane. Store the system at room temperature in a dark place. It must be installed before the end of the 3-year period from the date of issue.

The hormonal IUD prevents pregnancy in several ways:

Suppresses the growth of the endometrium - cells of the uterine mucosa in which the fertilized egg is implanted. Irritation of the endometrium leads to the production of prostaglandins, which increase uterine tone. As a result, the embryo cannot implant.
Increases the amount of macrophage substances that have a toxic effect on sperm.
Strengthens uterine contractions and fallopian tubes, which “adjust” the fertilized egg. As a result, the egg prematurely enters the endometrium, which is not prepared to receive it, and is not implanted.
Condense cervical mucus in the cervix until viscosity. Sperm cannot overcome this barrier in the narrow cervical canal.
Partially suppresses ovulation.

The active substance of the system is levonorgestrel, an analogue of progestron. in the first year it is released from the spiral at a rate of 20 mcg per day, then its intensity gradually drops to 10 mcg per day. The Mirena hormonal coil concentrates the substance in the endometrium of the uterus, so that one thousandth of the substance enters the blood plasma. Levonorgestrel is completely broken down and eliminated within 24 hours, without having a destructive effect on the woman’s body.

How to insert the coil

The insertion and removal of the IUD can only be entrusted to a gynecologist on days 1-2 of the cycle. The abundance of menstrual discharge will not allow injury to the cervix. Before inserting the spiral, the doctor must:

Gynecological examination
Mammography (it is important to exclude oncological diseases chest)
Colposcopy - examination of the vagina and cervix with a colposcope (this is a binocular device with lighting)
Ultrasound of the pelvic organs
Take smears from the vagina and cervical canal, which is especially important for oncocytology.

Place the spiral under aseptic conditions. How do you know if it is being administered correctly? First, the doctor must treat the cervix with a disinfectant solution, then measure its depth, insert the IUD, trim the antennae from the spiral and disinfect the cervix again. After installation of the system, a maintenance course of antibiotics is prescribed so that the coil takes root well in the body. After 3-5 days, an examination and ultrasound are scheduled, the hormone begins to act, and you can begin sexual activity.

The IUD can come out of the uterus randomly. Repeated examinations should be carried out every six months, and during each menstruation you should check to see if the IUD has come out (this happens rarely, but vigilance will not harm anyone).

Pros and cons of Mirena

Pros:

Effective and long-lasting contraception - about 98% within 5 years
Spiral renders local action without affecting other organs, unlike oral contraception
After removing the IUD, 80% of women regain their ability to conceive within 1-2 menstrual cycles
Fast insertion procedure
Affordable price compared to OK, spread over 5 years of use
Prevents cancer and growth of the endometrium (endometriosis)
Restores the condition of the endometrium during menopause, when removing the ovaries
Increases hemoglobin levels in the blood
Normalizes iron metabolism
Reduces pain during menstruation
Stops the growth of fibroids. True, not everyone. There are fibroids that do not allow the installation of an intrauterine device. Such important aspects women's health Only a good gynecologist can take into account.

Minuses:

Not everyone can afford a one-time expenditure of 150-250 euros. The Mirena uterine device is manufactured by the German concern Schering from high-quality materials using precision equipment. This high tech medical product can't be cheap. Beware of suspiciously profitable offers on the Internet.
There is a risk of developing menorrhagia ( heavy menstruation with blood loss above normal 150 ml)
In women who frequently change partners (for example, in sex work), the risk of inflammatory processes increases
An incorrectly installed IUD causes pain and bleeding.
The first few months after insertion of the IUD, your periods are heavier.
An IUD does not protect against STDs, unlike a condom.
There are cases of expulsion (loss) of the spiral
Hormone-containing IUDs stimulate breast tumors that have already arisen but have not yet been identified.

An important question for women is: does the spiral affect weight? Yes, in the first year after Mirena installation, every tenth patient experiences weight gain. Then body weight normalizes.

Who is suitable for the Mirena spiral?

Indications for use:

Breastfeeding women who need contraception
Healthy women who have given birth and require long-term contraception
For those who are contraindicated
Women with high tolerance to gestagenic drugs
Suffering from heavy, painful periods
Women who need prevention of fibroids, endometriosis, endometrial hyperplasia. IUD hormones have in this case healing effect.

Who should not have an IUD inserted?

Unfortunately, this convenient type of contraception has many contraindications, absolute and those that can be neutralized or minimized.

Absolute contraindications:

Pregnancy – established or suspected
Miscarriage within the last three months before installation of the system
Experienced ectopic pregnancy
Inflammatory, infectious processes in the pelvis
Uterine bleeding of unknown etiology
Malignant tumors of the mammary glands, uterus and genitals
Pathological features and deformations of the uterus: cervical stenosis, ectopia, cervicitis, dysplasia, bicornuate uterus, fibromatosis
Young age (under 18 years old)
Some age-related changes endometrium
Endometritis after childbirth
Tuberculosis of female organs.

Contraindications that need to be discussed with your doctor:

Postpartum period from several days to 4 weeks
Thrombosis, thromboembolism pulmonary artery, trophoblastic disease
Breast cancer in the past 5 years
High risk of inflammatory and infectious diseases: frequent change sexual partners, STDs, HIV
Serious liver diseases (hepatitis, cirrhosis, pyelonephritis and others)
Hypersensitivity to IUD components
Heart attacks, strokes and others acute diseases of cardio-vascular system
Arterial hypertension
Diabetes
Severe migraines of unknown etiology.

Side effects and complications

Common side effects The use of IUDs are those that appear in every tenth - every hundredth patient:

Cycle changes. In 20% of women the number increases menstrual days, in 60-70% menstruation becomes more abundant. After 3-6 months the cycle returns to normal. After about a year, amenorrhea may appear - absence of menstruation (in 15%). Rare and mild bleeding was observed in 60% of patients
Disorders nervous system: headache, depressive states, short temper, nervousness, lack or decreased libido
Weight gain
The appearance of rashes, acne, comedones, urticaria, less often - furunculosis
Digestive dysfunction: diarrhea, nausea, abdominal pain, vomiting
Spotting scanty discharge, pelvic pain
Inflammation of the vulva, vaginal mucosa (vulvovaginitis)
Breast engorgement and pain
Back pain
Increased blood pressure
Emergence functional cysts ovaries (12%). This painful attack goes away in the first year after the installation of the IUD. Virtually no surgical intervention is required.

Frequent side effects usually appear clearly in the first three to four months after insertion of the IUD, then the intensity decreases or disappears.

Side effects include expulsion of the IUD (expulsion of the IUD from the uterus). Gynecologists advise feeling the threads in the vagina after every period. If they are there, everything is fine.

Rare side effects(in every hundredth - every thousandth patient).

Quincke's edema
Growth or loss of body hair – hirsutism ( increased hairiness), alopecia (baldness)
Frequent mood swings (emotional lability)
Bloating
Edema of the extremities
Eczema
Perforation of the uterus (perforation)
Penetration of the uterus (ingrowth of the spiral into the wall)
Ectopic pregnancy.

Are pregnancy and Mirena compatible?

No contraception is 100% effective. If you are in the 1% of “lucky” women on whom the IUD did not work, you must first exclude ectopic pregnancy. During a normal pregnancy, the IUD can be removed if the threads are preserved. If there are no threads, the coil is often left in place until delivery. The doctor informs the woman about the risks and consequences, after which a decision is made to save the fetus. In the future, such a pregnancy must be carefully monitored. There are few observations of fetal development with IUD, because There are few such pregnancies themselves. Theoretically possible Negative consequences for the fetus if it is a girl. Such consequences are called “virilization” - the manifestation of male sexual characteristics in women (male hair growth, male skeleton, acne, clitoral hypertrophy, urogenital sinus, atrophy of the labia minora, etc.).

And about the compatibility of lactation and the IUD. Levonorgestrel, the active ingredient in Mirena, enters the bloodstream in small quantities and can pass into the baby’s milk. However, the concentration is so low that doctors rule out harm to the child.

Women's opinions about the Mirena IUD are strikingly varied. One writes: “No libido, no sex, no husband, but there is a brutal appetite and weight gain,” another rejoices: “As much as the IUD costs, I feel like a human being. There are no heavy periods and no fear of pregnancy.” Do you need the Mirena IUD or not? This choice belongs to you and partly to your doctor after jointly calculating the possible consequences.

And finally, the last question - is there really only one hormonal IUD on the market? Are there any analogues? The Mirena IUD, produced by the German concern Schering, has a Finnish competitor, Levonova (manufactured by the Leiras concern). It has the same principle of action, the same main substance - levonorgestrel.

7 ratings, average: 4,43 out of 5)

"Mirena". It not only acts as a contraceptive, but in addition can be prescribed for the treatment of certain female genital diseases.

What is this

Mirena is considered a highly effective contraceptive that has a therapeutic effect. Produces this drug Finnish company Bayer. The system is a T-shaped frame that, once installed, releases the hormone levonorgestrel. The contraceptive in question has a local effect. This spiral is installed for 5 years, then it is removed and a new one is introduced if desired. Let's look at what kind of hormone this is - levonorgestrel. This is a synthetic progestogen that converts, minimizes and prevents fertilization of the egg.

Operating principle

The Mirena system works in the same way as the classic ones oral methods contraception. Immediately after insertion of the IUD, levonorgestrel is released into the uterus. It has the following effects on a woman’s body:

ovulation becomes slower; the intrauterine membrane changes, and the fertilized egg cannot attach to the wall;
the mucus in the cervix becomes denser - this prevents sperm from getting closer to the egg;
sperm under the influence of the hormone become less mobile, and because of this they cannot reach their “destination”.

The therapeutic effect lies in the reaction of the endometrium to this hormone - the genital receptors of the mucous layer gradually lose sensitivity to gestagens and estrogens. As a result, sensitivity to estradiol, which promotes endometrial growth, decreases, and the mucous layer becomes thinner.

Did you know? Scientists are unable to develop birth control pills for men, containing testosterone, which could stop sperm production 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 administered by a gynecologist.

Important!Before installing the spiral, you should undergo an examination, which will confirm the absence of contraindications to the use of the drug.

What day of the cycle is it placed on?

It is recommended to introduce a hormonal IUD in the first days. After childbirth, if the uterus contracts well, the system can be used after 1.5 months. It is allowed to replace Mirena on any day of the cycle. To prevent the endometrium from growing too much, it is recommended to install the drug in question at the end of the cycle.

Administration technique

First, the doctor inserts a gynecological speculum into the uterine cavity. Then the cervix is treated with a specialized tampon with an antiseptic. Controlling the process with a mirror, he inserts a special tube into the uterus, in the middle of which there is a spiral. After the gynecologist has checked the correct placement of the “arms” of the spiral, he removes the tube and speculum. This completes the procedure, and the woman is given 30 minutes to rest.

Features of application

Let's consider when Mirena spirals should not be installed, as well as the negative consequences after insertion.

Contraindications

You cannot install the system:

if you are allergic 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 there was a septic abortion less than 3 months ago;
in the presence of inflammation in the pelvic organs;
for uterine cancer;
if there is cervicitis;
with uterine bleeding of unknown etiology;
with pathologies that deform the uterine cavity;
if you have liver disease;
if the woman is over 65 years old;
with thromboembolism of any organs, thrombophlebitis;
in the presence of dysplasia;
if available ;
if you have previously been treated for breast cancer.

Side effects

Among the main side effects of the Mirena spiral are:

central nervous system disorder: migraine, depression, irascibility;
violations menstrual cycle of different nature;
Cysts may appear on the ovaries;
infections in the pelvis;
allergy;
breast tenderness;
nausea, abdominal pain;
painful sensations in the back area;
weight gain and acne.

Important!If painful sensations arise during sex, then you should not hesitate to go to the doctor.

Does it hurt?

The insertion process is sensitive, but there is no severe pain. Mirena is thicker than other IUDs due to the hormone reservoir. If pain sensitivity high, then it is possible local anesthesia. The contraceptive should not be administered “forcibly” if the cervical canal is narrowed or there are other obstacles. In such cases, the cervical canal is expanded under local anesthesia.

When the coil is removed

The intrauterine contraceptive device must be removed 5 years after installation. The procedure is performed in the first days of menstruation to avoid conception. If you plan to introduce a new spiral, then removing the old one is allowed any day. By removing Mirena in the middle of the cycle and not installing a new one, a woman can become pregnant if she 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 IUD, ovulation is almost not delayed.

Mirena spiral: 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;
installs quickly;
is not expensive compared to birth control pills for 5 years of use;
Mirena prevents many gynecological diseases and is effective against endometriosis.

Disadvantages of this contraceptive:

menorrhagia may develop;
you need to spend a lot of money at once to buy a spiral;
inflammation may appear if you frequently 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

Efficiency of the method

The effectiveness of the method can be compared to sterilization. Clinical researches showed that in 1 year there are only 2 cases of pregnancy per 1 thousand women.

Did you know?The idea of creating intrauterine devices appeared in 1926. Silkworm threads and silver rings were used for production.

How quickly can you get pregnant after removal?

Mirena does not affect the functioning of the ovaries, so a girl can become pregnant almost immediately after its removal. Very rarely this process lasts for 3-6 months.

Is there protection against diseases?

Mirena, like other hormonal contraceptives, does not protect females from sexually transmitted diseases.

Use after childbirth

You can insert Mirena after childbirth only after 3-6 weeks, when the uterus has recovered and returned to its previous size. Studies have shown that it is safe for breastfeeding women to have an intrauterine device inserted.

Use after abortion

After an induced abortion or a spontaneous abortion at short notice, if there are no signs of infection, Mirena can be installed after a week.

Can it be reinstalled?

Research has shown that it is safe to install the system in question two or more times in a row.

So, Mirena is effective drug for a number of pathologies that occur in a woman’s body. The IUD also reliably protects against unwanted pregnancy. However, it requires special installation, has contraindications and side effects, so it is important to consult a doctor and conduct some examinations before introducing it.

Contraception occupies an important place in the life of every woman who wants to protect herself from possible pregnancy. There are several types of contraception, but gynecological doctors believe that the most safe method contraception is considered an intrauterine device, which can protect a woman from an unplanned pregnancy with a 99.9% probability. Among the large assortment of intrauterine devices, the Mirena device is especially popular, reviews from specialist doctors are positive, since its use not only protects a woman from conceiving a child, but can also be prescribed according to medical indicators, for a number of gynecological diseases.

Mirena spiral - what is it?

Intrauterine device (IUD) Mirena is a method of contraception that contains a hormone that increases the viscosity of mucus in the cervical canal, which allows for persistent contraceptive effect. The Mirena hormonal IUD allows the hormone levonorgestrel to be released daily from the cylinder of the IUD, thereby preventing sperm from entering the uterine cavity. This type of contraception allows women to protect themselves from pregnancy for 5 years. After a period of time has passed, the spiral is removed, and reproductive system is completely restored, which allows the woman to plan a pregnancy.

In gynecology, the Mirena coil is often placed on those women who have a history of benign hormone-dependent tumors, as well as pathological growths of the endometrium. Specialists in the field of gynecology confirm the high contraceptive and therapeutic effect of Mirena. It is important to note that if the spiral is indicated for fibroids or endometriosis, then the effect of its use will be noticeable only on initial stages diseases. Mirena spiral - reviews from specialists and women themselves - are ambiguous, since the effect of its use depends on many factors. That is why, before installing the IUD, a woman needs a thorough diagnosis, as well as high-level consultation. qualified specialist.

Mirena IUD, the instructions indicate that only an experienced doctor should install an intrauterine contraceptive device. Before installation, it is important to undergo a series of gynecological examinations, this will help eliminate possible complications of further use. contraceptive. Like anyone else medical drug, the Mirena spiral has its advantages and disadvantages, but in any case, if a woman wants to install this type contraception requires an individual approach.

Advantages of the Mirena IUD

Among the advantages of the Mirena intrauterine device, doctors in the field of gynecology note the following advantages:

Protects against pregnancy for 5 years.
Reduces the amount of discharge during menstruation.
Reduces pain during menstruation.
Well suited for those women for whom oral hormonal contraceptives are contraindicated.
Protects against development benign tumors in the endometrium.

The intrauterine hormonal device Mirena is considered one of the most popular, since it has been used for more than 20 years in different countries peace.

Disadvantages of the Mirena IUD

Side effects from Mirena are quite rare, and in almost all cases they go away on their own, without medical care, within several weeks or months after the installation of the spiral. After a woman has been installed the Mirena hormonal device, she may experience the following symptoms:

Bloody vaginal discharge between periods.
Periodic pain and discomfort in the lower abdomen and lower back.
Appearance acne on the face.
Frequent mood swings.
Decreased sexual desire.
Formation of a cyst in the ovaries (occurs in 10% of women who use Mirena) In the first months after the installation of the IUD, a woman may experience spotting. But such discharge usually goes away on its own within 2 to 3 months.

Approximately 5% of women using this type of contraception experience uterine bleeding, but their occurrence is most often associated with improper installation of the IUD. The Mirena hormonal device can often provoke the development of inflammatory process in the uterine mucosa. The reason for the appearance of such diseases is non-compliance with antiseptic rules during the installation of the system or the low professionalism of the doctor who installed the spiral.

What do doctors think about the Mirena IUD?

The Mirena intrauterine device has been widely used in gynecology for more than 20 years and is considered the safest method of contraception. During this time, the Mirena spiral has collected quite a few reviews from both practicing doctors and women themselves. Reviews about the spiral are mixed, since some women are quite satisfied with the result of its action, while others have had side effects in the form of bleeding. Therefore, there is no clear answer regarding the Mirena spiral, and everything depends on the woman’s body, the quality of the installation of the spiral and the qualifications of the specialist who performed this procedure.

Specialists in the field of gynecology have come to the same conclusion that this type of contraception should be installed only after a thorough diagnosis female body. If there are no contraindications to the Mirena spiral, then the doctor should familiarize the patient with possible complications or sensations after the installation of the spiral. In cases where, after installing the Mirena spiral, a woman developed severe pain lower abdomen, heavy bleeding, you need to see a doctor as soon as possible. Installation of the IUD should only be done by an experienced, qualified specialist, since in 60% of cases side effects after using this type of contraception develop due to the doctor’s fault. Therefore, it is very important to choose the right clinic and doctor who will perform this procedure.

Latin name: Mirena
ATX code: G02BA03
Active substance: Levonorgestrel
Manufacturer: Bayer Schering Pharma Oh,
Finland
Conditions for dispensing from a pharmacy: On prescription

Mirena is an intrauterine hormonal system that is installed for contraceptive or therapeutic purposes.

Indications for use

For contraception
In the presence of myomatous nodes and endometriosis
For the implementation of preventive therapy for hyperplasia of the endometrial layer of the uterus or for HRT (hormone replacement therapy).

Compound

One intrauterine system (IUD) contains 52 mg of the main hormonal component, represented by levonorgestrel. Additionally, a polydimethylsiloxane elastomer is present.

Medicinal properties

Mirena - contraceptive hormonal agent, which is installed intrauterinely, exhibits a local gestagenic effect. Thanks to levonorgestrel released from the IUD, the susceptibility of certain receptors in the endometrial layer of the uterus (estrogen and progesterone) is significantly reduced, this manifests itself in a pronounced antiproliferative effect.

The Mirena intrauterine device affects the inner layer of the uterus, so there may be a slight local reaction to existing foreign body. Under the influence of hormones, the mucous membrane lining cervical canal, compacts, which prevents the entry of male germ cells into the uterus, inhibits physical activity sperm. In some cases, suppression of ovulatory function is observed.

With Mirena, the nature of menstrual-like discharge also changes. During the first months of using this contraceptive, scanty bleeding occurs. Such periods with the spiral are normal. With the gradual development of the pharmacological action of the Mirena spiral, when the inhibition of proliferative processes reaches maximum performance, there is a period of minor bleeding, which subsequently turns into amenorrhea or oligomenorrhea.

The Mirena spiral for fibroids has an antiestrogenic effect, therapeutic effect hormone-releasing IUD manifests itself in a significant reduction in existing nodes, reducing the risk of developing serious consequences for health In addition, the fibroid will not grow in the future and surgical intervention will not be needed.

In case of adenomyosis, Mirena will help eliminate the disease.

The Mirena spiral for endometriosis will help normalize menstruation (the amount of blood released will decrease). During menstruation, the severity of painful prolapses will decrease.

After three months of using the intrauterine hormonal system, blood loss is significantly reduced, from approximately 62 to 94%, and after six months this figure is 71-95%. Due to the ability of the Mirena IUD to change the nature of menstrual-like discharge, the intrauterine hormonal device is used in medicinal purposes, namely with idiopathic menorrhagia. This treatment can even compare with conservative ways impact.

After the Mirena intrauterine device is installed, the release of its hormonal component is immediately observed and active absorption by the mucous membranes occurs. This effect is evidenced by the level of the hormone in plasma. The release rate of levonorgestrel after installation of the IUD is initially 20 mcg per day, and then gradually decreases, reaching 10 mg per day after five years.

When hit synthetic hormone into the general bloodstream it binds with blood proteins: 40-60% with albumin, 42-62% with selective transporters of sex hormones. Approximately 1-2% of general dosage levonorgestrel is recorded in the bloodstream in the form of a free steroid.

After installing the IUD inside the uterus, active substance detected in the blood after an hour, the highest level is observed after two weeks. As a result of numerous studies, it was concluded that the concentration of levonorgestrel is associated with a woman’s weight. With low body weight or increased rates selective transporters of sex hormones, the level of the active component of the Mirena IUD in the blood is higher.

Levonorgestrel undergoes a transformation process involving a special isoenzyme. Unchanged synthetic gestagen is excreted only in small amounts. Its total clearance from blood plasma is 1 ml per minute per 1 kg of body weight. The half-life of metabolic products does not exceed 24 hours.

Release form

The Mirena system is represented by a milky-white hormonal-elastomer core, which is located on the body T-shaped, its coating is an opaque homogeneous membrane (regulates the release of gestagen). The T-shaped body with two arms has a loop to which a thread is attached, thanks to which the Mirena coil is removed.

The IUD is placed in a guide tube and is free of any visible impurities. Mirena is produced in sterile blister packs made of a special material called TYVEK or polyester. Inside one blister there is a Mirena intrauterine device, instructions are attached.

Mirena: detailed instructions

Price: from 11495 to 14294 rubles.

The Mirena IUD is installed inside the uterus, which is where it manifests itself pharmachologic effect over the next 5 years. average speed the process of eliminating the synthetic hormone during the entire period of use is approximately 14 mcg per day.

If the intrauterine system was positioned correctly, the Pearl index usually does not exceed 0.2% over 12 months. The same figure over 5 years can reach 0.7%. The drug Mirena shows high degree protection against pregnancy compared with conservative (barrier) contraceptive measures and the use of spermicides.

The contraceptive should be removed after 5 years; this procedure may be accompanied by unpleasant symptoms: pain in the lower abdomen, possible opening uterine bleeding(minor). In some cases, local anesthetics may be used to avoid severe consequences.

What to do before installing the spiral

Before a contraceptive device is installed, you should be examined by a gynecologist to exclude the presence of diseases that are contraindicated for use and pregnancy.

The specialist first determines the position of the uterus itself, as well as its approximate dimensions, this will help to correctly position the IUD, which will facilitate the uniform effect of levonorgestrel on the endometrial layer, as well as ensure maximum effectiveness of the drug.

Procedure for installing an IUD

Installation of the contraceptive must be carried out according to the instructions:

Removal of the intrauterine system

If an intrauterine contraceptive device was installed more than 5 years ago, it is necessary to resort to its removal, since contraceptive effect is significantly reduced. Moreover, with long-term use intrauterine devices Inflammatory diseases of the internal genital organs may develop.

The IUD is removed in compliance with aseptic rules. It is pulled out using a thread that is grabbed with gynecological forceps. It is also possible to use a traction hook (if the threads are not visible), in some cases it will be necessary to expand the cervical canal. Will it hurt during removal, is bleeding possible after it, you should ask your gynecologist

After removing the drug from the uterine cavity, it will be necessary to carefully examine it and evaluate its integrity. In some cases, complications may occur (parts of the IUD may remain in the uterus), and gynecological intervention is inevitable.

Use during pregnancy and pregnancy

The IUD should not be used during pregnancy.

Is it possible to get pregnant with the IUD? Yes, this is not excluded. If the Mirena coil is installed and pregnancy occurs, it is necessary to remove it as soon as possible, since the use contraceptive IUDs the likelihood of miscarriage or premature delivery increases.

It is worth noting that removing these contraceptives or probing the uterus can also lead to miscarriage. If the system cannot be removed without consequences, it is worth considering the option of terminating the pregnancy. If a woman becomes pregnant and does not want to have an abortion and does this in order to save the life of the child, it is worth informing her about possible consequences, which can be observed when the spirals are not removed. Pregnancy with the Mirena spiral should proceed under the strict supervision of a gynecologist. If uncharacteristic symptoms appear (pain, fever) and go copious discharge, you need to see a doctor immediately.

During use of the drug, a teratogenic effect on the fetus is possible; birth defects development.

Levonorgestrel, which contains the Mirena hormonal spiral, enters mother's milk in low doses, but this in no way affects the growth and development of a child on breastfeeding. This tool With medicinal properties will reliably protect against unwanted pregnancy.

Contraindications

Excessive sensitivity to components
Suspicion of pregnancy
Chronic inflammatory gynecological ailments
Infection of the genitourinary system
Development of endometritis after childbirth
Previous septic abortion (occurred within the previous 3 months)
Diagnosing cervicitis
Cervical dysplasia
Oncological processes occurring in the internal genital organs
Hormone-dependent neoplasms
Frequent uterine bleeding of unknown origin
Abnormalities of the uterus, including fibroadenoma, which provoke deformation of its cavity
Liver pathologies.

Precautionary measures

After installing Mirena, the next examination must be completed after 4-12 weeks, each subsequent one after a year. If necessary (if indicated), a full examination by a gynecologist should be carried out regularly.

Levonorgestrel, even in small amounts, can lead to increased glucose tolerance, so a woman with diabetes should regularly monitor her sugar levels. In case of heart defects, installation and removal of the coil must be carried out in parallel use antibacterial drugs. Thus, it will be possible to prevent the occurrence of septic endocarditis.

Possible complications

Complications may develop after the IUD is installed.

Perforation and penetration of the uterus

These phenomena are extremely rare. Perforation or penetration of the IUD into the walls of the uterus is usually recorded precisely when the doctor installs the IUD. Such complications are most often diagnosed after a recent delivery, during the lactation period, or with an atypical location of the uterus itself. In case of perforation and penetration, it will be necessary to remove the system; this should be done as soon as possible to prevent the development of pathological conditions.

Ectopic pregnancy

This complication is rare; if the diagnosis is confirmed, surgery should be performed immediately. Ectopic pregnancy can be recognized by paroxysmal painful sensations in the lower abdomen, as well as symptoms of internal bleeding (lethargy, pale skin, severe dizziness, increased or decreased heart rate). The risk of developing such a complication increases if there is a history of infectious and inflammatory gynecological diseases.

Infectious and inflammatory diseases

There is a high probability of developing such complications during the first month of using the IUD.

The risk of infection increases when changing sexual partners.

In case of chronic infectious and inflammatory diseases and frequent relapses, it is not recommended to install a spiral.

Expulsion IUD

Spiral loss is a common occurrence. In this regard, a woman should check for the presence of threads after each menstrual-like bleeding (it is during menstruation that the IUD most often falls out). Signs of the onset of expulsion are pain in the abdominal area, as well as the onset of uterine bleeding. It will be necessary to remove the IUD if it falls out, as its contraceptive effect is reduced. What is best to use for contraceptive purposes should be checked with your doctor.

Functional cysts

The pathology usually occurs without any symptoms; often the presence of cysts can be indicated by pain and heaviness in the abdomen during sexual intercourse. Typically, cysts resolve on their own without treatment, but if this does not happen, an ultrasound scan will be required.

Many women are interested in whether amenorrhea can develop. This phenomenon is not uncommon and occurs within six months after the installation of the IUD. If monthly menstruation disappears, pregnancy should be ruled out. The menstrual cycle is restored after Mirena is removed.

Cross-drug interactions

Increased biochemical transformation of levonorgestrel is caused by some enzyme inducers, anticonvulsants, and antibacterial agents.

Side effects

Among the most common side effects are changes in the cyclicity of menstrual-like bleeding. By the end of the first month of use, amenorrhea or infrequent bleeding may develop.

Violations on the part of the following may also be observed:

SSS: sudden jump HELL
Immune system: rash development angioedema
NS: migraine-like headaches, depression
Reproductive system: tenderness and engorgement of the mammary glands, uncharacteristic discharge from the genital tract, vulvovaginitis, cystic changes in the ovaries, prolapse of the IUD, perforation of the uterus
Dermatological manifestations: acne, alopecia, development of hirsutism
Gastrointestinal tract: epigastric pain, very severe nausea.

If you have the described side symptoms, your doctor may advise you to remove the IUD and switch to birth control pills, after taking a short break. It will improve noticeably when you take the pills. general state, most adverse reactions will disappear.

Overdose

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Storage conditions and shelf life

Mirena should be stored in original packaging away from direct sunlight at a temperature of no more than 30 C. The drug is valid for 3 years from the date of manufacture.

Analogues

Jaydess

Bayer Schering Pharma, Germany

Price from 4340 to 5255 rub.

Jaydess - IUD, is an analogue of Mirena, as it contains the same hormonal component - levonorgestrel. Which of these drugs is best should be checked with your doctor. Jaydess is used as both a therapeutic and a contraceptive drug.

Pros:

Releases small amounts of hormone
Can be used for hepatitis B
Reliable modern contraceptive.

Minuses:

Placed for three years
Difficult to find in the pharmacy chain.