Frequently Asked Questions

Mirena^® (levonorgestrel-releasing intrauterine system) is an estrogen-free intrauterine contraceptive that delivers small amounts of hormone directly to the uterus. Mirena^® virtually eliminates the worry of unplanned pregnancy.

• 99.8% effective in preventing pregnancy for up to 5 years (or less, if you choose)¹
• Provides lower and steadier hormones than the Pill
• Won't cause significant weight gain²
• Easily removed with quick return to fertility¹
• May also help shorten, lighten, or even eliminate periods³

There is no single explanation of how Mirena^® works. Mirena^® may:

• Block sperm from reaching or fertilizing your egg
• Make the lining of your uterus thin (this may also result in benefits like less menstrual bleeding over time)
• Stop the release of your egg from your ovary (but this may not be the way it works in most cases)

It is believed that all 3 of these actions may work together to prevent pregnancy.

Mirena^® does not require any daily maintenance, allowing you to simplify your life and live hassle-free without the hassles of birth control.¹

• No pill to take every day or worry about forgetting
• No fumbling with condoms
• No rings to remember to change
• No peeling patches

Mirena^® is small and comfortable; most likely you and your partner will never know it's there.¹

Over the past 16 years, more than 8 million women worldwide have used Mirena^® successfully. It is 99.8% effective and has been approved by the FDA for use in the United States since 2001. As a result of their personal experiences, 9 out of 10 women who use Mirena^® would recommend it to their friends.

Mirena^® is one of the most reliable methods of birth control. Only about 1 in 1,000 women who use Mirena^® will experience an unintended pregnancy during the first year of use. Mirena^® doesn't rely on your using it regularly and properly to be effective.

Adapted from Trussel J. The essentials of contraception: efficacy, safety, and personal consideration, and Trussell J. Contraceptive efficacy. In: Hatcher RA, Trussel J, Stewart F, et al. Contraceptive Technology, 18th ed. New York, NY: Ardent Media; 2004:773-845. Slight adaptations from CT table.

Click here to download the Birth Control Efficacy sheet

Mirena^® is recommended for women who have had at least one child and are in a mutually monogamous relationship. It is an option at every stage of your reproductive life:

• If you are currently pregnant or just had a baby and want to explore birth control options for new moms
• If you are still planning your family and are unsure if you want more children, but are seeking hassle-free birth control
• If you are still planning your family and are unsure if you want more children, but are seeking hassle-free birth control

IUC stands for intrauterine contraceptive and is a delivery method for birth control. There are two forms available, the copper IUD (intrauterine device) and Mirena^® (levonorgestrel releasing intrauterine system).

Mirena^® is safe and effective:

• 99.8% effective in preventing pregnancy¹
• FDA-approved
• Used successfully over the past 16 years by over 8 million women around the world, and available in the United States since 2001
• 9 out of 10 women who use Mirena^® would recommend it to their friends

Some women decide to have their tubes tied thinking they can reverse the surgery if they change their minds. The truth is, tubal ligations are not easily reversed, and reversing a male vasectomy is not easy, either. Up to 25% of women regret their decision, and approximately 25% of reversal attempts for surgery are unsuccessful. Mirena^® lets you keep your family-planning options open. Mirena^®'s long-term contraception provides 5 years of pregnancy prevention (or less, if you choose)¹ that's just as effective as surgery but easily reversible.

Large studies have shown that Mirena^® has no effect on weight gain.¹

Although Mirena^® lasts up to 5 years, you are not committed to the full 5 years.¹ When you decide you want to try to have another child, Mirena^® is easily removable at any time. It takes just a few minutes during a visit to your healthcare professional. After that, there is a quick return to fertility, and you can begin trying to get pregnant right away.²

Mirena^® should not be placed until 6 weeks postpartum. If you are breast-feeding, please talk to your healthcare professional to see if Mirena^® is the right contraceptive option for you.

No problem. Mirena^® must be removed after 5 years, but your healthcare professional can place a new Mirena^® immediately during the same visit if you want to continue using Mirena^®. Soon after the second device is put in place, many women have said that their periods stop.

Yes. Tampons will not change the position or effectiveness of Mirena^®. However, care must be observed when removing or pulling out the tampon.

Your healthcare professional will place Mirena^® into your uterus during an office visit. He or she will:

• Clean your vagina and cervix with an antiseptic solution
• Insert a thin tube of flexible plastic (the inserter) containing Mirena^® into your vagina and then into your uterus
• Check to make sure Mirena^® is positioned correctly
• Withdraw the plastic inserter, leaving Mirena^® in your uterus
• Trim the removal threads to the proper length

If you think you may be pregnant and are considering getting a Mirena^®, please tell your healthcare professional before you have Mirena^® placed. Pregnant women should not use Mirena^®.

Some women may experience some discomfort while Mirena^® is being placed. Uterine cramps, which feel like menstrual cramps, and dizziness may also occur, but typically disappear within a day or two. Notify your healthcare professional if pain and other symptoms persist.

The procedure for placing Mirena^® into your uterus takes only a few minutes during an office visit.

You should visit your healthcare professional 3 months after Mirena^® is placed to make sure it is in the right position. After that, Mirena^® can be checked once a year as part of your routine exam.

After Mirena^® is placed, you may experience heavier periods over the first 3 to 6 months because the lining of your uterus is shedding. This may also result in irregular periods and irregularities such as "spotting" (a small amount of blood loss) or light bleeding outside of your monthly period. During this time, you may need sanitary protection, like you do during your period.

Remember, these menstrual benefits are not harmful. The reason you may eventually have a shorter period, or one with little or no menstrual flow, is because of the thinning of your uterine lining. When Mirena^® is removed, your uterine lining and menstrual cycle will return to the way they were before you used Mirena^®.

Not having your period while you are using Mirena^® is not abnormal. Nor is it harmful or anything to worry about. The following charts show the difference in your uterine lining with and without Mirena^®.

• Every month, the lining of the uterus thickens during the first half of your menstrual cycle
• The lining is shed as menstrual flow
• On average, a woman's menstrual flow lasts 3 to 4 days. It may last shorter or longer, depending on the woman

• The levonorgestrel in Mirena^® reduces the monthly thickening of the lining of your uterus
• Less thickening means less menstrual flow
• Eventually your menstrual flow may stop completely
• Once Mirena^® is removed, your menstrual cycle will return to the way it was before you used Mirena^®

During the first 6 weeks of use, you should contact your healthcare professional to rule out pregnancy if you do not get your period or if you have other symptoms of pregnancy.

In clinical studies, the most common side effects with Mirena^® included:

• Menstrual changes
• Lower abdominal pain (cramps)
• Acne or other skin problems
• Back pain
• Breast tenderness
• Headache
• Mood changes
• Nausea
• Ovarian cysts have been diagnosed in about 12% of Mirena^® users. In most cases, the enlarged follicles disappeared spontaneously during two to three months of observation.

Side effects with Mirena^® are most common during the first three months after insertion and decrease over time.

Percentage of women reporting side effects during the first 3 months and fifth year of use.

Serious complications with Mirena^® are uncommon but may include:

• Mirena^® going through (perforating) the uterus, which may require surgery
• Mirena^® coming out by itself (expulsion), which can lead to unwanted pregnancy; if this happens, use back-up birth control, such as a condom, and call your healthcare professional

Research has shown that although there is some risk of PID associated with this type of birth control (intrauterine contraceptive), the risk is small after the first 20 days following insertion. Generally PID is sexually transmitted. You have a higher risk of getting PID if you or your partner have sex with multiple partners.

The risk of PID in women who use Mirena^® is similar to the risk in women of childbearing age (i.e. 18 to 44 years of age). Women using Mirena^® do not have an increased risk of acquiring chlamydia or gonorrhea; however, women with these conditions who do not have symptoms may have a higher risk of PID once an intrauterine contraceptive is placed. If you've had or think you may currently have either PID or a pelvic infection, talk to your healthcare professional. Mirena^® should not be used by women who have had PID or a serious pelvic infection in the past.

Mirena^® contains levonorgestrel, a hormone commonly used in birth control pills. Mirena^® does not contain estrogen, so you can be hassle-free from estrogen-related side effects. The low level of hormones in Mirena^® is safe and effective and a good option for women who are sensitive to hormones or are seeking a long-term contraceptive option.

Women who have, or have had, breast cancer should not use hormonal therapy.

Mirena^® is appropriate for women who:

• Have had at least one child
• Are looking for an effective, reversible form of birth control that's easy to use
• Are in a mutually monogamous relationship

Choosing the right birth control method is a personal decision that should be made by a woman in partnership with her healthcare professional. It's important that you share any current or past health conditions like diabetes, heart disease or pelvic inflammatory disease (PID) with your healthcare professional so together you can decide whether Mirena^® is the right choice for you.

Women should not use Mirena^® if they:

• Think they may be pregnant
• Have ever had pelvic inflammatory disease (PID)
• Have had a serious pelvic infection in the past three months following pregnancy
• Currently have an untreated pelvic infection
• Have more than one sexual partner, or a sexual partner who has more than one sexual partner
• Get infections easily, including women with immune-system problems, leukemia, AIDS, or who abuse intravenous drugs
• Might have cancer of the uterus or cervix
• Have unexplained bleeding from the uterus
• Have liver disease or a liver tumor
• Have or have ever had breast cancer
• Have had, or are at risk of having, an ectopic pregnancy (pregnancy occurring elsewhere other than the womb)
• Are already using an intrauterine device
• Have a condition that changes the shape of the uterus, such as large fibroid or tumor
• Are allergic to levonorgestrel, silicone or polyethylene

Mirena^® may be covered under your employer's healthcare plan. To find out if it is, simply talk to your company's human resources manager or contact your healthcare plan. To find out more, click here.

After just one year, Mirena^® is cost-effective. The one-time cost of Mirena^®, in comparison to other birth control methods, could save you hundreds of dollars or more over time. Your savings could be even greater with the help of your health plan.