Side effects of the Mirena spiral reviews. Indications for use. The cost of Mirena is quite high. I have heard that the use of the helix comes with a lot of unpleasant side effects. Is there any positive effect of the drug on
"Mirena". She 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 therapeutic effect. Produces this drug Finnish company Bayer. The system is a T-shaped frame that releases the hormone levonorgestrel after insertion. The considered means of contraception has a local effect. This spiral is installed for 5 years, then it is removed and, if desired, a new one is introduced. Consider what kind of hormone - levonorgestrel. This is a synthetic progestogen that converts, minimizes and prevents the fertilization of the egg.
Operating principle
The Mirena system works in the same way as the classic oral methods contraception. Immediately after the introduction of the spiral into the uterus, levonorgestrel is released. It has the following effect on the body of a woman:
- ovulation becomes slower; the intrauterine membrane changes, and the fertilized egg cannot attach to the wall;
- the mucus that is in the cervix becomes denser - this prevents the spermatozoa from approaching the egg;
- sperm under the action of the hormone become less mobile, and because of this, they cannot reach their “destination”.
Did you know? Scientists are failing to develop birth control pills for men containing testosterone that 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 inserted by a gynecologist.
Important!Before installing the spiral, you should undergo an examination that will confirm the absence of contraindications to the use of the drug.
On what day of the cycle put
It is recommended to introduce a hormonal spiral in the first days. After childbirth, if the uterus contracts well, it is allowed to use the system after 1.5 months. Replace "Mirena" is allowed on any day of the cycle. To prevent too much growth of the endometrium, the drug in question is recommended to be installed at the end of the cycle.
Insertion technique
First, the doctor inserts a speculum into the uterine cavity. Then a specialized swab with an antiseptic treats the cervix. Controlling the process with a mirror, he introduces a special tube into the uterus, in the middle of which there is a spiral. After the gynecologist has checked the correct location of the "shoulders" of the spiral, he removes the tube and mirror. This completes the procedure, and the woman is given 30 minutes to rest.
Application features
Consider when it is impossible to install Mirena spirals, as well as Negative consequences after the introduction.
Contraindications
You can not install the system:
- with allergies 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 less than 3 months ago there was a septic abortion;
- in the presence of inflammation in the pelvic organs;
- with oncology of the uterus;
- if there is cervicitis;
- with uterine bleeding of unknown etiology;
- with pathologies that deformed the uterine cavity;
- if there are liver diseases;
- if the woman is over 65 years old;
- with thromboembolism of any organs, thrombophlebitis;
- in the presence of dysplasia;
- if available ;
- if previously treated for breast cancer.
Side effects
Among the main side effects spiral "Mirena" stands out:
- disorder of the central nervous system: migraine, depression, irascibility;
- menstrual irregularities of a different nature;
- cysts may appear on the ovaries;
- infections in the pelvis;
- allergy;
- soreness of the chest;
- nausea, abdominal pain;
- pain in the back;
- weight gain and acne.
Important!If during sex there are painful sensations, then you should not hesitate to go to the doctor.
Does it hurt
The insertion process is sensitive, but strong pain missing. Mirena is thicker than other coils due to the hormone reservoir. If pain sensitivity high, local anesthesia is possible. The contraceptive should not be administered "through force" if the cervical canal is narrowed or there are other obstructions. In such cases, the cervical canal is expanded under local anesthesia.
When the coil is removed
The intrauterine device must be removed 5 years after insertion. The procedure is carried out in the first days of menstruation to avoid conception. If you plan to introduce a new spiral, then it is allowed to remove the old one on any day. By removing Mirena in the middle of the cycle and not installing a new one, a woman can become pregnant if she has 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 spiral, ovulation is almost not delayed.
Spiral "Mirena": 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;
- installed quickly;
- is not expensive compared to birth control pills for 5 years of use;
- "Mirena" prevents many gynecological diseases, is effective in endometriosis.
- menorrhagia may develop;
- you need to spend a lot of money at a time to buy a spiral;
- inflammation may appear if you often change sexual partners;
- when not correct installation 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
Method efficiency
The effectiveness of the method can be compared with sterilization. Clinical researches showed that in 1 year for 1 thousand women there are only 2 cases of pregnancy.
Did you know?The idea of creating intrauterine devices appeared in 1926. Silkworm threads and silver rings were used for making.
How fast can you get pregnant after removal
Mirena does not affect the functioning of the ovaries, so a girl can become pregnant almost immediately after removing it. Very rarely this process stretches for 3-6 months.
Is there protection against disease?
Mirena, like other hormonal contraceptives, does not protect females from diseases that are sexually transmitted.
Use after childbirth
You can enter "Mirena" after childbirth only after 3-6 weeks, when the uterus recovers and returns to its previous size. Studies have shown that it is safe for breastfeeding women to insert an intrauterine device.
Use after an abortion
After an artificial abortion or spontaneous abortion for a short time, if there are no signs of infection, it is allowed to install Mirena in a week.
Can it be reinstalled?
Studies have shown that it is safe to install the system in question two or more times in a row.
So Mirena is effective drug with a number of pathologies that occur in the body of a woman. Also, the spiral reliably protects against unwanted pregnancy. However, it requires a special setting, has contraindications and side effects, so it is important to consult a doctor and conduct some examinations before its introduction.
The hormonal intrauterine device is a means of preventing unwanted pregnancy, which has relatively few contraindications and side effects and also has some medicinal properties.
When compared with conventional, non-hormonal systems that are inserted into the uterine cavity, it is more reliable for contraceptive purposes. And its impact is largely aimed not at preventing the fertilized egg from gaining a foothold in the uterus, but initially preventing spermatozoa from penetrating there. This becomes possible due to the dense mucus that forms in the cervical canal. And unlike the non-hormonal one, the hormonal coil in some cases can suppress ovulation and always affects the endometrium in such a way that it remains thin, not at all suitable for development. gestational sac. And such an endometrium is very good for women with heavy menstrual bleeding and endometriosis. In the coming months after the intrauterine device was placed hormonal system, menstrual flow will become scarce. Or maybe even completely disappear. This is also the norm. Endometriosis will not develop for the same reason, it remains very thin. There will also be no hyperplasia.
But there are still disadvantages - the cost of the Mirena hormonal intrauterine device is from 9,000 rubles and more. And yet, it does not guarantee the absence of cysts in the ovaries. It's pretty frequent occurrence after the installation of the IUD. Cysts are formed mainly functional. And in most cases, they do not require any treatment and do not cause discomfort. Pass on their own within 2-4 menstrual cycles.
The hormonal spiral has pros and cons of the installation precisely because of its imperfection. But the ideal method of contraception has not yet been invented. At the same time, this Navy is in the first place in terms of efficiency. It is even more effective than oral contraceptives. Apparently because there can be no risk of pregnancy due to missing a contraceptive, as is the case with oral forms. Thinking about what is better hormonal pills or hormonal spiral, you need to remember that the IUD is placed once and can stand in the uterus for 5 years. No need to worry about buying the drug, take it on time. What about diarrhea or vomiting? After all, they can reduce the effectiveness of tableted contraceptives. Yes, and other drugs may be incompatible with them. With a spiral in this regard, it is still easier.
The hormonal spiral of Mirena and Levonov, the second in Russia is less known and popular, is well suited for women who cannot take estrogen drugs. This contraceptive does not contain estrogen and acts locally. The hormone levonorgestrel enters the blood in a minimal amount. But at the same time, it must be remembered that there are conditions when an additional intake of this hormone into the body can be dangerous. So, hormonal spirals have contraindications in the form of various oncological diseases, including breast cancer. Therefore, it would be logical to be well examined before installing such an expensive contraceptive.
As for what side effects the hormonal spiral has, they are mostly reversible, only the first cycles after the installation of the system are of concern. This may be a small weight gain, especially if there are nutritional errors, intermenstrual discharge, pain in the pelvic area. The risk of side effects is higher in women who have various inflammatory diseases pelvic organs, genital infections. Such an IUD should not be inserted at all until recovery occurs. In addition, the spiral is not suitable for women who do not have a permanent sexual partner. After all, the Navy is a kind of conductor pathogens into the uterus. You need to understand this and take care of your health.
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 doctors in the field of gynecology believe that the most safe method contraception are considered intrauterine devices, which allow with a probability of 99.9% to protect a woman from an unplanned pregnancy. Among the large assortment of intrauterine devices, the Mirena spiral is especially popular, the reviews of specialist doctors about which are positive, since its use not only protects a woman from conceiving a child, but can also be prescribed according to medical indicators, with a number of gynecological diseases.
Mirena coil - what is it?
Intrauterine device (IUD) Mirena is a method of contraception, which includes a hormone that allows you to increase the viscosity of mucus in the cervical canal, which allows you to provide persistent contraceptive effect. The Mirena hormonal coil allows the hormone levonorgestrel to be released daily from the coil cylinder, thereby preventing the penetration of spermatozoa into the uterine cavity. This type of contraception allows women to be protected from pregnancy for 5 years. After a period of time has elapsed, the spiral is removed and reproductive system completely restored, which allows a woman to plan a pregnancy.
In gynecology, the Mirena spiral is often placed in those women with a history of benign hormone-dependent tumors, as well as pathological growth of the endometrium. Specialists in the field of gynecology confirm the high contraceptive and healing effect 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 illness. Mirena spiral - the reviews of specialists and the women themselves - are ambiguous, since the effect of its use depends on many factors. That is why, before installing the spiral, a woman needs a thorough diagnosis, as well as advice highly qualified specialist.
Mirena spiral, the instruction indicates that only an intrauterine contraceptive should be installed experienced doctor. Before installation, it is important to undergo a series of gynecological examinations, this will help eliminate possible complications of further use. contraceptive. Like any other medical preparation, the Mirena coil has its advantages and disadvantages, but in any case, if a woman wants to install this species contraception requires an individual approach.
Benefits of the Mirena Navy
Benefits intrauterine device Mirena, 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 who are contraindicated in oral hormonal contraceptives.
- Protects against development benign tumors in the endometrium.
The Mirena intrauterine hormonal coil is considered one of the most popular, since it has been used for more than 20 years in different countries peace.
Mirena Navy Disadvantages
Side effects from Mirena appear quite rarely, and in almost all cases they disappear on their own, without medical care, within a few weeks or months after the establishment of the spiral. After a woman has a Mirena hormonal coil installed, she may experience the following symptoms:
- Bloody discharge from the vagina between periods.
- Periodic pain and discomfort in the lower abdomen, lower back.
- Appearance acne on the face.
- Frequent mood swings.
- Decreased sex drive.
- Formation of a cyst in the ovaries (occurs in 10% of women who use Mirena) In the first months after the establishment of the spiral, the woman may experience spotting bloody issues. But such discharge usually disappears 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 incorrect installation of the spiral. The Mirena hormonal spiral can often provoke development itself inflammatory process in the uterine mucosa. The reason for the appearance of such diseases is non-compliance with the rules of antisepsis during the period of the system installation 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 of the spiral are ambiguous, 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 unambiguous answer about the Mirena spiral, and everything depends both on the woman's body, and on the quality of establishing 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 spiral is established. In cases where, after the establishment of the Mirena spiral, a woman has severe pain in the lower abdomen, profuse bleeding you need to see a doctor as soon as possible. It is necessary to establish a spiral only with an experienced qualified specialist, since in 60% of cases side effects after using this type of contraception develop through the fault of the doctor. Therefore, it is very important to choose the right clinic and doctor who will carry out this procedure.
In the world, more than 80 million women 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 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 invested in women in China and Japan in the sixteenth century. In 1909, the German scientist Richter proposed the use of 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 - every fifth woman with a plastic IUD became pregnant. Reliability has increased since 1968, when the contraceptive effect of copper was discovered. And since 2001, the Navy has been "stuffed" with gestagens - analogues female hormone progesterone. So the IUD began not only to prevent pregnancy, but also to treat many hormone-related female 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 has been working for 5 years. Why put such a spiral?
What does the hormonal spiral look like and work?
The Mirena hormonal coil 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 for extraction. In the center of the intrauterine device, the tube contains a hormone in the amount of 52 mg, measuredly entering the endometrium of the uterus through the membrane. Store the system at room temperature in a dark place. It must be delivered before the end of the 3-year period from the date of issue.
The hormonal spiral prevents pregnancy in several ways at once:
- It inhibits the growth of the endometrium - the cells of the uterine mucosa, in which the fertilized egg is fixed. Irritation of the endometrium leads to the production of prostaglandins, which increase uterine tone. As a result, the embryo cannot be fixed.
- Increases the amount of macrophage substances that are toxic to spermatozoa.
- Strengthens the contractions of the uterus and fallopian tubes, which "adjust" the fertilized egg. As a result, the egg prematurely enters the endometrium unprepared for its reception and is not fixed.
- condense cervical mucus in the cervix to a viscosity. Spermatozoa cannot overcome this barrier in the narrow cervical canal.
- Partially suppresses ovulation.
The active substance of the system is levonorgestrel, an analogue of progestrone. in the first year, it is released from the spiral at a rate of 20 μg per day, then its intensity gradually drops to 10 μg 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 cleaved and excreted during the day, without having a devastating effect on the woman's body.
How to insert a spiral
The introduction and removal of the IUD can only be entrusted to a gynecologist, on the 1-2 day of the cycle. The abundance of monthly discharge will not allow to injure the cervix. Before leading the spiral, the doctor must:
- Gynecological examination
- Mammography (important to exclude oncological diseases chest)
Colposcopy - examination of the vagina, cervix with a colposcope (this is a binocular apparatus with lighting) - Ultrasound of the pelvic organs
- Take swabs from the vagina and cervical canal which is especially important for oncocytology.
Put the spiral in aseptic conditions. How do you know if it's entered correctly? First, the doctor must treat the cervix disinfectant solution, then measure its depth, insert the IUD, cut the antennae from the spiral and again disinfect the cervix. After installing 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 prescribed, the hormone begins to act, you can start having sex.
The IUD can voluntarily exit the uterus. Repeated examinations should be carried out every six months, and during each menstruation, look to see if the spiral has come out (this is rare, but vigilance will not hurt anyone).
Pros and Cons of Mirena
Pros:
- Effective and long-term contraception - about 98% within 5 years
- The spiral has a local effect, without affecting other organs, unlike oral contraception
- After removing the spiral, 80% of women restore the ability to conceive in 1-2 menstrual cycles
- Fast insertion procedure
- Affordable price compared to OK, spread out over 5 years of use
- Prevents cancer and overgrowth of the endometrium (endometriosis)
- Restores the state of the endometrium with menopause, with the removal of the ovaries
- Increases the level of hemoglobin in the blood
- Normalizes iron metabolism
- Reduces pain during menstruation
- Stops the growth of fibroids. True, not all. 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:
- A one-time expenditure of 150-250 euros is not affordable for everyone. The Mirena uterine spiral is made by the German concern Schering from high-quality materials, on precise equipment. This high tech medical product cannot be cheap. Beware suspicious advantageous offers in the Internet.
- There is a risk of developing menorrhagia ( heavy menstruation with blood loss above the norm of 150 ml)
- Women who change partners frequently (for example, in sex work) have an increased risk of inflammatory processes
- Incorrectly placed coil causes pain and bleeding
- The first few months after the insertion of the IUD, there are more abundant periods.
- An IUD does not protect against STDs, unlike a condom
- There are cases of expulsion (falling out) of the spiral
- Hormone-containing IUD stimulates breast tumors that have already arisen, but have not yet been identified.
An important question for women - does the spiral affect weight? Yes, in the first year after the installation of Mirena, every tenth patient has an increase in weight. Then body weight returns to normal.
Who is Mirena suitable for?
Indications for use:
- Breastfeeding women who need contraception
- Healthy women who have given birth and require long-term contraception
- For those who are contraindicated OK
- Women with high tolerance to progestin drugs
- Those who suffer from heavy, painful periods
- Women who need prevention of fibroids, endometriosis, endometrial hyperplasia. IUD hormones have a therapeutic effect in this case.
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 the system was installed
- 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 deformities of the uterus: cervical stenosis, ectopia, cervicitis, dysplasia, bicornuate uterus, fibromatosis
- Young age (up to 18 years old)
- Some age-related changes endometrium
- Endometritis after childbirth
- Tuberculosis of the female organs.
Contraindications to discuss with your doctor:
- Postpartum period from a few days to 4 weeks
- Thrombosis, thromboembolism pulmonary artery, trophoblastic disease
- Breast cancer in the last 5 years
- high risk of inflammation 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 IUD applications are those that appear in every tenth - every hundredth patient:
- Cycle changes. In 20% of women, an increase in the number 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 - the absence of menstruation (in 15%). Rare and weak bleeding was observed in 60% of patients.
- Disorders of the nervous system: headache, depressive states, irascibility, nervousness, lack or decrease in libido
- Weight gain
- The appearance of rashes, acne, comedones, urticaria, less often - furunculosis
- Digestive dysfunction: diarrhea, nausea, abdominal pain, urge to vomit
- Smearing meager discharge, pelvic pain
- Inflammation of the vulva, vaginal mucosa (vulvovaginitis)
- Breast engorgement and pain
- Back pain
- Increase in blood pressure
- emergence functional cysts ovaries (in 12%). This painful misfortune passes in the first year after the installation of the IUD. Virtually no surgical intervention required.
Frequent side effects are usually pronounced in the first three to four months after the introduction of the IUD, then the intensity decreases or disappears.
Side effects include expulsion of the spiral (expulsion of the spiral from the uterus). Gynecologists advise to feel the threads in the vagina after every menstruation. If they are in place, everything is fine.
Rare side effects(for every hundredth - for 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 (growing of the spiral into the wall)
- Ectopic pregnancy.
Are pregnancy and Mirena compatible?
No contraception guarantees 100% effectiveness. If you are in the lucky 1% that the IUD did not work on, you must first rule out an ectopic pregnancy. At normal pregnancy the spiral can be removed if the threads are preserved. If there are no threads, the coil is often left standing until delivery. The doctor informs the woman about the risks and consequences, after which a decision is made to preserve the fetus. In the future, such a pregnancy should be carefully monitored. There are few observations of fetal development with IUDs, because few such pregnancies themselves. Theoretically, negative consequences for the fetus are possible if it is a girl. Such consequences are called "virilization" - the manifestation of male sexual characteristics in women (hair growth along male type, male skeleton, acne, clitoral hypertrophy, urogenital sinus, labia minora atrophy, etc.).
And about the compatibility of lactation and the IUD. Levonorgestrel - active substance Mirena - enters the blood in a small amount and can enter the child with milk. However, the concentration is so low that doctors rule out harm to the child.
The opinions of women about the Mirena Navy are striking in a wide range. One writes: “No libido, no sex, no husband, but there is a brutal appetite and weight gain,” the other rejoices: “How much the spiral costs, I feel like a person. No heavy periods and fear of pregnancy. Do you need a Mirena Navy or not? This choice belongs to you and partly to your doctor after a joint calculation of the possible consequences.
And finally, the last question - is there really only one hormonal coil on the market? Are there any analogues? The Mirena Navy, manufactured by the German concern Schering, has a Finnish competitor Levonova (manufactured by the Leiras concern). She has the same principle of action, the same basic substance - levonorgestrel.
7 ratings, average: 4,43 out of 5)
pharmachologic effect
In terms of its effectiveness as a contraceptive, Mirena is comparable to the sterilization of a woman. It is as effective as today's most effective copper-containing intrauterine devices and oral contraceptives ( contraceptive pills). Research ( clinical trials) found that during the year for every 1000 women using Mirena, there are only two cases of pregnancy. In women with excessive menstrual bleeding, Mirena causes a significant decrease in their intensity as early as three months after insertion into the uterus. Menstrual bleeding in some women stops altogether.
Indications for use
Mirena is used for contraception (to prevent pregnancy), to treat idiopathic menorrhagia (excessive menstrual bleeding), and to prevent endometrial hyperplasia (excessive growth of inner shell uterus) during replacement therapy estrogen.
Contraindications
Mirena should not be used for any of the conditions listed below.
Pregnancy or suspicion of it.
Existing or recurrent inflammatory diseases of the pelvic organs. infections lower divisions urinary tract.
Postpartum endometritis.
Septic abortion within the last three months.
Cervicitis.
Diseases accompanied by increased susceptibility to infections. Dysplasia of the cervix.
Malignant neoplasms of the uterus or cervix.
Progestogen-dependent tumors, including breast cancer.
Pathological uterine bleeding unclear etiology.
Congenital or acquired anomalies of the uterus, including fibroids, leading to deformation of the uterine cavity.
Acute diseases or tumors of the liver.
Hypersensitivity to the components of the drug.
Mirena may be used with caution after consultation with a specialist, or your doctor may discuss the need to remove it if you have or experience one of the following conditions for the first time shortly after insertion of the system into the uterus:
Migraine, focal migraine with asymmetric vision loss or other symptoms suggestive of transient ischemia brain,
unusually severe headache;
Jaundice;
Expressed arterial hypertension;
Severe circulatory disorders, including stroke and myocardial infarction.
Pregnancy and lactation
Contraindicated.
Mirena is contraindicated during pregnancy or suspected pregnancy.
Pregnancy in women who have Mirena installed is an extremely rare phenomenon. But if
Mirena leaves the uterine cavity, you are no longer protected from pregnancy and must
use other methods of contraception until you have consulted with your doctor.
While using Mirena, some women do not have menstrual bleeding. The absence of menstruation is not necessarily a sign of pregnancy.
If you are not having your period and have other signs of pregnancy (nausea, fatigue, breast tenderness) at the same time, you should see your doctor for an examination and pregnancy test.
If you become pregnant while using Mirena, Mirena should be removed as soon as possible. If Mirena remains in your uterus during pregnancy, your risk of miscarriage, infection, or premature birth. You can also discuss the feasibility of a medical abortion. The hormone contained in Mirena is released into the uterine cavity. This means that the fetus is exposed to a relatively high local concentration of the hormone, although the hormone enters it in small quantities through the blood and placenta. At present, the effect of such amounts of the hormone on the fetus is unknown, since cases of pregnancy in women with Mirena in the uterus are very rare. Due to the intrauterine use and local action of the hormone, the possibility of a virilizing effect on the fetus must be taken into account. However, to date, evidence of birth defects caused by the use of Mirena, in cases where the pregnancy was maintained until natural childbirth, are missing.
You can breastfeed your baby while using Mirena. Levonorgestrel has been found in trace amounts in breast milk lactating women. About 0.1% of a dose of levonorgestrel can enter the child's body during breastfeeding. None dangerous influences on the growth and development of the child when used six weeks after the birth of Mirena was not detected. Mirena does not affect the quantity and quality of breast milk.
Check with your doctor before taking any medications while pregnant or breastfeeding.
Dosage and administration
Before the introduction of Mirena
Before the introduction of Mirena, a swab from the vagina can be taken, an examination of the mammary glands is performed, and, if necessary, other studies are carried out, for example, aimed at detecting infections, including sexually transmitted ones.
To determine the position and size of the uterus, a gynecological examination should be performed.
When to install Mirena
Mirena can be inserted into the uterus no later than seven days after the onset of menstrual bleeding. It can also be installed in the uterus immediately after a medical abortion; while the doctor must be sure that there is no genital infection. Mirena should not be placed earlier than six weeks after delivery. Mirena can be replaced new system any day of the menstrual cycle. Mirena is not used as a contraceptive used after sexual intercourse. To protect the inner layer of the uterus during Mirena, you can install Mirena at any time in women with menstruation. last days menstrual bleeding or withdrawal bleeding. amenorrhea (not having periods)
How Mirena is installed After a gynecological examination, a special instrument, the so-called vaginal mirror, is inserted into the vagina and the cervix is treated antiseptic solution. Mirena is then inserted into the uterus through a thin, flexible plastic tube. You may feel the insertion of the system, but it should not cause you much pain. Before the introduction, if necessary, you can apply local anesthesia cervix.
Some women experience pain and dizziness after inserting the system.
If after a half-hour stay in a calm position, these phenomena do not disappear, it is possible that the intrauterine system is not positioned correctly. A gynecological examination must be performed; if necessary, the system is removed. In some women, the use of Mirena causes allergic skin reactions.
With the correct installation of Mirena, carried out in accordance with the instructions for use, the Pearl index (an indicator reflecting the number of pregnancies in 100 women using a contraceptive for 1 year) is about 0.2%. The cumulative rate, reflecting the number of pregnancies in 100 women using a contraceptive for 5 years, is 0.7%. After removing Mirena, you should check the system for integrity. In case of difficulties with the removal of the IUD, isolated cases of slipping of the hormonal-elastomer core on the horizontal arms of the T-shaped body were noted, as a result of which they were hidden inside the core. Once the integrity of the IUD is confirmed, additional intervention this situation does not require. Limiters on the horizontal arms usually prevent the core from completely separating from the T-body.
Side effect
When using Mirena, as with any other medicines, adverse reactions (HP) may occur, although their appearance is not necessary in all patients. Listed below are HPs that have been reported with Mirena for the indications "contraception (prevention of pregnancy)" and "treatment of idiopathic menorrhagia (excessive menstrual bleeding)".
Possible HP in women using Mirena for the indication “prevention of endometrial hyperplasia (excessive growth of the inner lining of the uterus) during estrogen replacement therapy” was observed with the same frequency, except in cases indicated by footnotes (*,**).
Very frequent HP (> 1/10):
Headache
Abdominal/pelvic pain
Change in bleeding pattern, including increase and decrease in bleeding intensity, spotting, oligomenorrhea and amenorrhea
Vulvovaginitis*
Discharge from the genital tract*
Frequent HP (more than 1/100 and less than 1/10):
Depressed mood / depression
Migraine
Nausea
hirsutism
Backache**
infections upper divisions genital tract
ovarian cysts
Dysmenorrhea
Breast pain**
IUD expulsion (full or partial)
Infrequent HP (more than 1/1000 and less than 1/100):
Alopecia
Rare HP (more than 1/10000 and less than 1/1000):
Perforation of the uterus
HP with unknown frequency:
Hypersensitivity including rash, urticaria and angioedema
Increased arterial pressure
* "Often" for the indication "prevention of endometrial hyperplasia during estrogen replacement therapy."
** "Very common" for the indication "prevention of endometrial hyperplasia during estrogen replacement therapy".
The partner can feel the threads during intercourse.
If a woman with Mirena placed becomes pregnant, the relative risk of ectopic pregnancy increases.
The risk of perforation is increased in breastfeeding women.
There have been cases of sepsis (very severe systemic infections that could be fatal) at the time after the insertion of the IUD.
The risk of breast cancer when using Mirena for the indication "prevention of endometrial hyperplasia (excessive growth of the inner lining of the uterus) during estrogen replacement therapy" is unknown. Cases of breast cancer have been reported (frequency unknown).
The following adverse events or effects have been noted in connection with the insertion or removal of Mirena:
Soreness of the procedure, bleeding during the procedure, dizziness or syncope (fainting) associated with a vasovagal reaction during insertion. The procedure may induce seizures (convulsions) in patients with epilepsy.
If you develop any of these or other side effects, you should consult a doctor.
Overdose
Interaction with other drugs
If you are using any drugs for a long time (for example, anti-epileptic cytochrome P450 isoenzymes involved in the metabolism medicines, such as anticonvulsants(eg, phenobarbital, phenytoin, carbamazepine) and agents for treating infections (eg, rifampicin, rifabutin, nevirapine, efavirenz). The effect of these drugs on the effectiveness of Mirena is not known, but it is believed that it is not significant, since Mirena has mainly local action.Application features
The results of some recent studies show that women taking progestogen-only contraceptives may slight increase risk venous thrombosis; however, these results are not definitive. However, if signs of thrombosis of the veins and arteries appear, you should immediately consult a doctor. Symptoms of venous or arterial thrombosis include: unilateral pain and/or swelling in the leg; sudden strong pain V chest, regardless of whether she gives in left hand; sudden onset of severe respiratory failure; sudden cough; unusually severe prolonged headache; sudden partial or total loss vision; double vision; slurred or difficult speech; dizziness; collapse (sometimes seizure); weakness or very significant loss of sensation that suddenly appeared on one side or in one part of the body; movement disorders; sharp pain in a stomach. Signs of the formation of a blood clot in the vessels of the eye include unexplained partial or complete loss of vision and any other unexplained violations of it.
To date, it has not been established whether there is a connection between varicose veins veins or superficial thrombophlebitis(inflammation of the veins with the formation of a blood clot) with the phenomenon of venous thromboembolism.
nulliparous women
Mirena is not the first choice for young women who have never been pregnant and for postmenopausal women with age-related uterine shrinkage.
infections
The guide tube helps protect the Mirena from microbial contamination during insertion into the uterus, and the Mirena guide is designed to minimize the risk of infection. Despite this, the risk of infection pelvic organs immediately after the introduction of the system into the uterus and over the next four months increased. Pelvic infections in patients using intrauterine systems are often referred to as sexually transmitted diseases. The risk of infection is increased if a woman or her partner has multiple sexual partners. If a pelvic infection is detected, it should be treated promptly. These infections can interfere with fertility and increase the risk of ectopic pregnancy in the future.
In exclusively rare cases severe infection or sepsis (a very severe infection that can lead to lethal outcome) may occur shortly after IUD insertion. With recurrent infection of the pelvic organs or their acute infection resistant to treatment for several days, Mirena should be removed. If you have got constant pain in the lower abdomen, fever, pain associated with sexual intercourse, or unusual bleeding, consult your doctor immediately.
If severe pain or fever continues to develop shortly after insertion, you may have a serious infection that should be treated immediately.
Oligo- and amenorrhea
Oligo- and amenorrhea in women of childbearing age develops gradually in 57% and 16%
cases by the end of the first year of using Mirena, respectively. If you don't have a period within six weeks of starting last menstrual period pregnancy should be excluded. Repeat pregnancy tests for amenorrhea are not necessary unless there are other signs of pregnancy. When Mirena is used in combination with permanent estrogen replacement therapy, most women gradually develop amenorrhea during the first year of Mirena use.
Expulsion (prolapse of the intrauterine system)
Contractions of the muscles of the uterus during menstruation sometimes lead to displacement of the intrauterine system or even to push it out of the uterus, which leads to the termination of the contraceptive effect. TO possible symptoms prolapse includes pain and bleeding that is unusual for you. If Mirena has shifted in the uterine cavity, its effectiveness is reduced. It is recommended to check the threads with your fingers, for example, when you take a shower. If you find signs of displacement or prolapse of the intrauterine system, or if you do not feel the threads, you should avoid sexual intercourse or use other methods of contraception, and consult a doctor as soon as possible. Mirena reduces the intensity of menstrual bleeding; an increase in their intensity may indicate a fallout of the system.
Perforation and penetrapy
Perforation or penetration of the body or cervix intrauterine contraceptive occurs rarely, mainly during installation, and may reduce the effectiveness of Mirena. In these cases, the system should be removed. The risk of perforation is increased in breastfeeding women, and may occur if placed in postpartum period or women with fixed bend uterus backwards (toward the intestines).
The risk of perforation is increased in breastfeeding women and may also be increased if Mirena is administered shortly after childbirth.
Ectopic pregnancy
Pregnancy when using Mirena is extremely rare. The frequency of ectopic pregnancy with Mirena is approximately 0.1% per year. If you become pregnant while using Mirena, the fetus may be outside the uterus (ectopic pregnancy). Ectopic pregnancy - severe pathological condition requiring immediate medical attention. The risk of ectopic pregnancy is increased in women who have had an ectopic pregnancy in the past and who have had surgical intervention on fallopian tubes or pelvic infections. The following symptoms may indicate that you have an ectopic pregnancy and need to see a doctor immediately.
Disappearance of menstrual cycles, after which appears constant bleeding or pain.
Wandering or very severe pain in the lower abdomen.
Signs of a normal pregnancy combined with bleeding and feeling dizzy.
Weakness
Some women feel dizzy after insertion of Mirena. This is a normal physiological reaction. Doctors offer women to rest for some time after the introduction of Mirena.
ovarian cysts
Since the contraceptive effect of Mirena is due to the main action, women of childbearing age usually experience ovulatory cycles with rupture of the follicles. Sometimes the atresia of the follicles is delayed, and their development can continue. These enlarged follicles are clinically indistinguishable from ovarian cysts. About ovarian cysts as adverse reaction reported in approximately 7% of women using Mirena. In most cases, these follicles do not cause any symptoms, although sometimes they are accompanied by pain in the lower abdomen or pain during intercourse.
In most cases, ovarian cysts disappear on their own within two to three months of observation. If this does not happen, it is recommended to continue monitoring with ultrasound, as well as conducting therapeutic and diagnostic measures. In rare cases, it is necessary to resort to surgical intervention.
By fates of the heart
Mirena should be used with caution in women with congenital or acquired heart disease due to the risk infectious inflammation heart muscle. Such patients should be treated prophylactically with antibiotics when installing or removing Mirena.
Diabetes
Women with diabetes and using Mirena, it is necessary to regularly determine the content of glucose in the blood. However, as a rule, there is no need to change therapeutic prescriptions in women with diabetes using Mirena.
Mirena is not used for postcoital contraception.
Available data suggest that Mirena does not increase the risk of developing breast cancer in postmenopausal women under the age of 50 years. Due to the limited data obtained during the Mirena study for the indication "prevention of endometrial hyperplasia during estrogen replacement therapy", the risk of breast cancer when using Mirena according to this indication cannot be confirmed or denied.
Excipients contained in Mirena
Mirena's T-shaped base contains barium sulfate, which becomes visible on x-ray.
Precautionary measures
Influence on the ability to drive a car and work with mechanisms
Not observed.
Release form
Self-medication can be harmful to your health.
It is necessary to consult a doctor, and also read the instructions before use.
