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Mirena is an IUD made of soft, flexible plastic that’s placed into your uterus by a healthcare provider.

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Kim wanted birth control
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Important Safety Information | Full Prescribing Information

Kim’s Story

Kim wanted birth control with no daily routine.

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See for YourselfSee for Yourself

Effective birth control that lasts for as
long as Kim wants, for up to 5 years.

Important Safety Information | Full Prescribing Information

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A mother considers her reasons
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Frequently Asked Questions

What is Mirena? How does it work? Why should you consider it? These are examples of some common questions about Mirena. We hope that we can answer all of the questions you may have right here.

Choose a topic below to learn more about Mirena, but always remember that your healthcare provider is your best resource for any and all questions regarding Mirena and birth control in general.

Understanding Mirena

Click to expand What is Mirena (levonorgestrel-releasing intrauterine system)?

Mirena (levonorgestrel-releasing intrauterine system) is an intrauterine contraceptive that releases small amounts of the hormone levonorgestrel locally into your uterus. Made of soft, flexible plastic, Mirena is placed by your healthcare provider during an office visit. Mirena is recommended for women who have had a child. Plus:

Mirena offers contraception that's over 99% effective; in fact, it is one of the most effective methods of birth control

Mirena prevents pregnancy for as long as you want, for up to 5 years

You can try to become pregnant as soon as Mirena is removed by your healthcare provider

Click to expand

Click to expand Is Mirena FDA-approved?

Mirena (levonorgestrel-releasing intrauterine system) was approved by the FDA for use in the United States in 2000 for intrauterine contraception and in 2009 to treat heavy periods for women who choose intrauterine contraception. Discuss all safety considerations with your healthcare provider and use Mirena according to the Prescribing Information. No birth control is right for everyone and there are risks associated with Mirena that you should know about. Have a conversation with your healthcare provider to find out if Mirena is right for you.

Click to expand What is Mirena made of?

Mirena (levonorgestrel-releasing intrauterine system) is made of soft, flexible plastic and contains the hormone levonorgestrel.

See what Mirena looks like

Click to expand How does Mirena work to prevent pregnancy?

Mirena (levonorgestrel-releasing intrauterine system) prevents pregnancy, most likely in several ways:

Thickens cervical mucus to prevent sperm from entering your uterus

Inhibits sperm from reaching or fertilizing your egg

Makes the lining of your uterus thin

Click to expand

Mirena may stop the release of your egg from your ovary, but this is not the way it works in most cases. While there’s no single explanation for how Mirena works, most likely the above actions work together to prevent pregnancy for up to 5 years.

How Mirena may work

Click to expand What about hormones and Mirena?

Mirena (levonorgestrel-releasing intrauterine system) contains a progestin hormone called levonorgestrel that is often used in birth control pills. Mirena does not contain estrogen. Mirena releases the hormone into your uterus. Only small amounts of the hormone enter your blood.

More about how Mirena may work

Click to expand How effective is Mirena at preventing pregnancy?

Mirena (levonorgestrel-releasing intrauterine system) is one of the most effective forms of birth control. Unfortunately, no birth control method, including Mirena or tubal ligation (getting tubes tied), is 100% perfect. Once Mirena is placed by your healthcare provider, it is over 99% effective and works consistently to prevent pregnancy. So you don't have to think about taking birth control every day or even every year. Check the threads of Mirena once a month. Your healthcare provider can explain how. If you have trouble finding the threads, call your healthcare provider. And in the meantime, be sure to use a back-up form of birth control.

It is important to think about your daily, weekly and monthly routine and how that may affect which birth control method is best for you. The chart below shows the chance of becoming pregnant for women who use different methods of birth control. The most effective methods, including intrauterine devices such as Mirena, are found at the top of the chart. If you have any questions about this information, please ask your healthcare provider.

Click to expand

No birth control is right for everyone and there are risks associated with Mirena that you should know about. For detailed information about possible side effects, some potentially serious, please see Mirena Safety Considerations and the Patient Information.

Click to expand How can Mirena help with family planning decisions?

With Mirena (levonorgestrel-releasing intrauterine system), you get effective contraception for up to 5 years and flexibility because you can have it removed by your healthcare provider whenever you want to try to have another child. You can try to become pregnant as soon as Mirena is removed. In fact, within a year of having Mirena removed, approximately 8 out of 10 women succeed at becoming pregnant.

Click to expand What if I haven’t decided whether or not I want more children?

Then Mirena (levonorgestrel-releasing intrauterine system) may be a good choice because it prevents pregnancy for as long as you want, for up to 5 years. As far as family planning goes, this can be especially appealing if you are undecided whether you want more children. Should you decide you do want to try to become pregnant, Mirena can be removed at any time by your healthcare provider. Or, if at the end of the 5-year period you're still undecided, you can have another Mirena placed.

Click to expand What happens if I become pregnant while using Mirena?

Mirena is one of the most effective birth control options, however, over the course of 5 years, fewer than 8 in 1,000 women (0.8%) become pregnant while using Mirena. One risk of becoming pregnant while using Mirena is called ectopic pregnancy, when the pregnancy is not in the uterus. It may occur in the fallopian tubes. Signs of ectopic pregnancy may include unusual bleeding or abdominal pain. Ectopic pregnancy is an emergency that requires immediate medical attention and often surgery. Ectopic pregnancy can cause internal bleeding, infertility and even death. Call your healthcare provider right away if you think that you're pregnant.

There are also risks if you become pregnant while using Mirena and the pregnancy is in the uterus. Severe infection, miscarriage, premature delivery and even death can occur with pregnancies that continue with an intrauterine device (IUD). Because of this, your healthcare provider may try to remove Mirena, even though removing it may cause a miscarriage. If Mirena cannot be removed, talk with your healthcare provider about the benefits and risks of continuing the pregnancy.

Click to expand Can Mirena protect me from HIV or STDs (sexually transmitted diseases)?

No. Mirena (levonorgestrel-releasing intrauterine system) does not protect against HIV or STDs. So, if while using Mirena you think you or your partner might be at risk of getting an STD, use a condom and call your healthcare provider.

Click to expand Does Mirena contain any metal?

No, Mirena (levonorgestrel-releasing intrauterine system) does not contain any metal. It is made of soft, flexible plastic.

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Is Mirena Right for Me?

Click to expand Who is Mirena (levonorgestrel-releasing intrauterine system) right for?

Mirena (levonorgestrel-releasing intrauterine system) is a hormone-releasing system placed in your uterus to prevent pregnancy for as long as you want for up to 5 years. Mirena also treats heavy periods in women who choose intrauterine contraception.

Mirena is recommended for women who have had at least one child. This is because most of the medical research conducted on Mirena for FDA approval was among women who had at least one child. Only you and your healthcare provider can decide if Mirena is right for you. Please see Who should not use Mirena.

Mirena offers a flexible birth control option if:

You want birth control you don’t have to think about taking every day

You had a baby and want to explore your birth control options

You want to have more children in the future

You are happy with your family size the way it is

You are unsure if you want more children

You want birth control that is also approved to treat heavy periods

Start a conversation with your healthcare provider to find out if Mirena may be right for you.

Click to expand Not sure if Mirena is right for you?

Answer these questions and bring them with you to your healthcare provider.

Click to expand Who should not use Mirena?

Only you and your healthcare provider can decide if Mirena (levonorgestrel-releasing intrauterine system) is right for you. As the two of you discuss your options, there are a number of things you should share—like your general health, current or past health conditions, sexual history and whether you'd like to have more children in the future.

Mirena is not appropriate for women who:

Might be pregnant

Have had a serious pelvic infection called pelvic inflammatory disease (PID), unless you have had a normal pregnancy after the infection went away

Have an untreated pelvic infection now

Have had a serious pelvic infection in the past 3 months after a pregnancy

Can get infections easily. For example, if you have

More than one sexual partner or your partner has more than one partner

Problems with your immune system

Intravenous drug abuse

Have or suspect you might have cancer of the uterus or cervix

Have bleeding from the vagina that has not been explained

Have liver disease or a liver tumor

Have breast cancer now or in the past or suspect you have breast cancer

Have an intrauterine device in your uterus already

Have a condition of the uterus that changes the shape of the uterine cavity, such as large fibroid tumors

Are allergic to levonorgestrel, silicone or polyethylene

Additional information about Mirena is just a click away.

Click to expand What should I tell my healthcare provider when deciding if Mirena is right for me?

You should share any current or past health conditions that you have with your healthcare provider to help you both decide if Mirena (levonorgestrel-releasing intrauterine system) may be right for you.

Your healthcare provider needs to know if you:

Have had a heart attack

Have had a stroke

Were born with heart disease or have problems with your heart valves

Have problems with blood clotting or take medicine to reduce clotting

Have high blood pressure

Recently had a baby or if you are breastfeeding

Have diabetes (high blood sugar)

Use corticosteroid medications on a long-term basis

Have severe migraine headaches

What else should you discuss with your healthcare provider?

Click to expand How do I get Mirena?

Have a conversation with your healthcare provider to understand if Mirena (levonorgestrel-releasing intrauterine system) is a good option for you. If it is, then Mirena can usually be placed in your healthcare provider’s office at your next visit.

Click to expand Will Mirena be covered under my health plan?

Mirena (levonorgestrel-releasing intrauterine system) may be covered by your health insurance. To find out if Mirena is covered under your plan, call your healthcare insurance company directly.

Go to Getting Mirena for Free for more information about recent changes to healthcare and a list of insurance providers that may cover the cost of Mirena. If your health insurance provider does not cover the cost of Mirena, you may be able to get Mirena by using a health savings account (HSA) or by making a one-time payment.

Depending on your birth control needs and the help of your health plan, you may find that Mirena may be an affordable option for you. However, only you and your healthcare provider can decide if Mirena is right for you.

Click to expand Why would I consider Mirena?

Mirena is one of the most effective forms of birth control that lasts as long as you want, for up to 5 years. Because Mirena (levonorgestrel-releasing intrauterine system) can be removed at any time by your healthcare provider, it’s reversible and you’re free to keep your family planning options open. You can try to become pregnant as soon as Mirena is removed. Some methods, such as tubal ligation (getting your tubes tied) or your partner getting a vasectomy, should be considered as permanent.

No birth control is right for everyone and there are risks associated with Mirena that you should know about. For detailed information about possible side effects, some potentially serious, please see Mirena Patient Information.

Start a conversation to find out if Mirena may be right for you.

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How to Get Mirena

Click to expand When should Mirena (levonorgestrel-releasing intrauterine system) be placed?

Mirena (levonorgestrel-releasing intrauterine system) should be placed within 7 days of the start of your period. Once placed by your healthcare provider, Mirena prevents pregnancy for as long as you want, for up to 5 years.

Click to expand How is Mirena placed?

Your healthcare provider will place Mirena (levonorgestrel-releasing intrauterine system) into your uterus during an office visit. Placement typically takes only a few minutes.

He or she will:

Apply an antiseptic solution to your vagina and cervix

Pass 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

Ensure that the two threads attached to the stem of Mirena properly extend through the cervix, which help ensure that Mirena is properly placed. This will also help with the removal of Mirena by your healthcare provider when that time comes

Trim the threads to the appropriate length

Once Mirena is placed, check your threads once a month–your healthcare provider can explain how. If you have trouble finding the threads, call your healthcare provider right away, and use a back-up method of birth control.

If you think you may be pregnant and are considering Mirena, please tell your healthcare provider. Pregnant women should not use Mirena.

Click to expand Will placement hurt?

Some women may experience some discomfort while Mirena (levonorgestrel-releasing intrauterine system) is being placed. Side effects may include cramping or pain, bleeding and/or dizziness. This is common. To help minimize the cramps, ask your healthcare provider about medications that may be used before and after placement, such as over-the-counter pain medications. Let your healthcare provider know if the cramping is severe, or if these symptoms last for more than 30 minutes as Mirena may have not been properly placed and your healthcare provider should examine you.

Click to expand How long does it take to place Mirena in the uterus?

Your healthcare provider can generally place or remove Mirena (levonorgestrel-releasing intrauterine system) during an office visit. Placement of Mirena takes only a few minutes.

Click to expand Can I get Mirena if I have a vaginal infection?

Don’t use Mirena (levonorgestrel-releasing intrauterine system) if you have a vaginal or pelvic infection or get infections easily. Less than 1% of users get a serious infection called pelvic inflammatory disease. If you have persistent pelvic or abdominal pain, see your healthcare provider.

Click to expand How soon after I give birth can I get Mirena?

Mirena (levonorgestrel-releasing intrauterine system) should not be placed earlier than 6 weeks after you give birth or as directed by your healthcare provider. When you ask your healthcare provider about Mirena, be sure to tell him or her if you are breastfeeding and plan to continue breastfeeding after getting Mirena placed as there is an increased risk of perforation in women who are breastfeeding.

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After Mirena Placement

Click to expand What can I expect right after Mirena (levonorgestrel-releasing intrauterine system) is placed?

Some women may experience cramping or pain, bleeding and/or dizziness during and right after Mirena (levonorgestrel-releasing intrauterine system) is placed. Tell your healthcare provider if your cramps are severe. If these symptoms last for more than 30 minutes, let your healthcare provider know. Mirena may not have been properly placed and your healthcare provider should examine you.

Click to expand Will my periods change with Mirena?

For the first 3 to 6 months, your monthly period may become irregular and the number of bleeding days may increase. You may also have frequent spotting or light bleeding. A few women have heavy bleeding during this time. Call your healthcare provider if the bleeding remains heavier than usual. After your body adjusts, the number of bleeding days is likely to decrease, but may remain irregular, and you may even find that your periods stop altogether for as long as Mirena (levonorgestrel-releasing intrauterine system) is in place.

In some women with heavy bleeding, the total blood loss per cycle progressively decreases with continued use. The number of spotting and bleeding days may initially increase but then typically decreases in the months that follow. Call your healthcare provider if the bleeding becomes heavy after it has been light for a while.

By one year, about 1 out of 5 users may have no period at all. Your periods will return once Mirena is removed. If you do not have a period within 6 weeks of Mirena use, contact your healthcare provider to rule out pregnancy.

Track your periods right after you’ve had Mirena placed and share the results with your healthcare provider at your post-placement follow-up visit.

Click to expand How often should I see my healthcare provider once Mirena is placed?

As a follow-up, you should visit your healthcare provider once in the first 4 to 12 weeks after Mirena (levonorgestrel-releasing intrauterine system) 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. Call your healthcare provider if you have any questions or concerns.

Click to expand How can I be sure Mirena is properly in place?

Once Mirena (levonorgestrel-releasing intrauterine system) is placed, you should check the threads* once a month to make sure it is still positioned correctly. Your healthcare provider can explain how. If you have trouble finding the threads, call your healthcare provider. And in the meantime, be sure to use a back-up form of birth control.

*Two threads are attached to the stem of Mirena. These threads are the only part of Mirena you should be able to feel when Mirena is positioned correctly.

Click to expand What are my chances of getting an enlarged follicle, also known as an ovarian cyst?

About 12 out of 100 women using Mirena (levonorgestrel-releasing intrauterine system) develop a cyst on the ovary, sometimes known as an enlarged follicle. These cysts usually disappear on their own in a month or two. However, cysts can cause pain and sometimes need surgery.

Click to expand What if I decide I want to try to become pregnant?

When you decide you want to try to have another child, Mirena (levonorgestrel-releasing intrauterine system) can be removed by your healthcare provider at any time. It typically takes just a few minutes during an office visit. In fact, you can try to become pregnant as soon as Mirena is removed. Within a year of having Mirena removed, about 8 out of 10 women succeed at becoming pregnant.

Click to expand What if I need birth control for more than 5 years?

Mirena (levonorgestrel-releasing intrauterine system) must be removed after 5 years. If you want to continue using Mirena after those 5 years, you can choose to have another one placed. Talk with your healthcare provider about replacing your Mirena before your scheduled appointment to have your current Mirena removed. He or she can then place your new Mirena during the same office visit.

Click to expand Can I still use tampons?

Yes. However, if you use tampons you should change them with care so as not to pull the threads of Mirena (levonorgestrel-releasing intrauterine system) when removing the tampon.

Click to expand Why may my periods become lighter?

The reason many women may have lighter periods or stop having periods altogether with Mirena (levonorgestrel-releasing intrauterine system) is related to the uterine lining.

Typically, this is how your period works:

Every month, the lining of the uterus thickens during the first half of your menstrual cycle to prepare for ovulation

If ovulation takes place and the egg is not fertilized, the thickened uterine lining is shed as menstrual flow

On average, a woman's menstrual flow lasts 3 to 5 days. It may be shorter or longer, depending on the woman

Once Mirena is placed:

During the first 3 to 6 months your period may be heavier, irregular, your number of bleeding days may increase, and you may have frequent spotting or light bleeding

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

Click to expand

If you have not gotten your period or have other symptoms of pregnancy during the first 6 weeks of Mirena use, contact your healthcare provider to rule out pregnancy.

Track your periods right after you’ve had Mirena placed and share the results with your healthcare provider at your post-placement follow-up visit.

Click to expand Are there any potential serious complications with Mirena?

Some serious but uncommon side effects of Mirena (levonorgestrel-releasing intrauterine system) include:

Pelvic inflammatory disease (PID). Use of Mirena and other IUDs has been associated with an increased risk of PID. The percentage of women who develop PID while using Mirena is less than 1%. The risk is highest shortly after placement—especially within the first 20 days—and if you have a vaginal infection at the time of placement. After the first 20 days, the risk of PID is reduced.

PID is an infection of the uterus and other organs of the upper reproductive system. It is caused by bacterial infections that are usually sexually transmitted, such as gonorrhea or chlamydia, that travel beyond the vagina and cervix into the uterus and other organs in the reproductive system. The risk of PID is greater if you or your partner have sex with multiple partners. If not treated quickly and appropriately, PID can lead to serious problems, including infertility, ectopic pregnancy or constant pelvic pain. Serious cases of PID may require surgery. A hysterectomy (removal of the uterus) is sometimes needed. In rare cases, infections that start as PID can even cause death.

Before placement of Mirena, be sure to tell your healthcare provider if you have signs of a vaginal infection or PID. Signs of PID include long-lasting or heavy bleeding, unusual vaginal discharge, abdominal or pelvic pain or tenderness, or painful sex, chills or fever.

After placement, contact your healthcare provider if any of these symptoms listed above occur and persist.

A rare life-threatening infection called sepsis may occur within the first few days after Mirena is placed. As of September 2006, 9 cases of Group A streptococcal sepsis out of an estimated 9.9 million Mirena users had been reported. Call your healthcare provider immediately if you experience severe pain or unexplained fever after Mirena is placed.

Embedment is when Mirena attaches to the uterine wall. If embedment occurs, Mirena may no longer prevent pregnancy and you may need surgery to have it removed.

Perforation. Mirena may go through (perforate) the uterine wall. If your uterus is perforated, Mirena may no longer prevent pregnancy. It may move outside the uterus and can cause scarring, infection or damage to other organs. Surgery may be needed to have Mirena removed. The risk of perforation is increased in breastfeeding women.

Click to expand What are the more common side effects of Mirena?

Possible common side effects of Mirena (levonorgestrel-releasing intrauterine system) include:

Discomfort during placement. Pain, dizziness, bleeding or cramping may occur during placement. This is common. Let your healthcare provider know if the cramping is severe. If these symptoms do not stop 30 minutes after placement, Mirena may not have been placed correctly. Your healthcare provider will examine you to see if Mirena needs to be replaced or removed.

Expulsion. Mirena may come out by itself and no longer prevent pregnancy. Symptoms of partial or complete expulsion may include bleeding, pain and an increase in menstrual flow. If this occurs, Mirena may be replaced within 7 days of a menstrual period after pregnancy has been ruled out. If you notice Mirena has come out, use a back-up form of birth control like condoms and call your healthcare provider.

More than 10% of Mirena users may experience:

Missed menstrual periods. About 2 out of 10 women stop having periods after 1 year of Mirena use. Your periods come back when Mirena is removed. If you do not have a period for 6 weeks during Mirena use, contact your healthcare provider to rule out pregnancy.

Changes in bleeding. Your period may become irregular and you may have bleeding and spotting between menstrual periods, especially during the first 3 to 6 months. A few women have heavy bleeding during this time. After your body adjusts, periods usually get lighter and the number of bleeding days is likely to decrease, but may remain irregular. Or you may even find that your periods stop altogether—in which case, you should contact your healthcare provider to rule out pregnancy.

Call your healthcare provider if the bleeding remains heavier than usual or if the bleeding becomes heavy after it has been light for a while.

Pelvic and/or abdominal pain may occur. Talk to your healthcare provider if the pain is persistent.

Cyst on the ovary. About 12 out of 100 women using Mirena develop a cyst on the ovary. These cysts usually disappear on their own in a month or two. However, cysts can cause pain and may sometimes require surgery.

Between 5% and 10% of Mirena users may experience:

Headache/Migraine

Acne

Depressed mood

Heavy or prolonged menstrual bleeding

Less than 5% of Mirena users may experience:

Vaginal discharge

Breast pain or tenderness

Nausea

Nervousness

Inflammation of cervix, vulva or vagina

Pelvic pain during your period

Back pain

Weight increase

Decreased sex drive

High blood pressure

Pain during intercourse

Anemia

Unusual hair growth or loss

Skin irritations (such as hives, rash, eczema or itching)

Feeling bloated

Swelling of hands and/or feet

Expulsion

Every individual responds differently to medication, so talk to your healthcare provider about your individual risk factors and to see if Mirena is right for you.

Click to expand Will my partner be able to feel Mirena during intercourse?

You and your partner shouldn’t feel Mirena (levonorgestrel-releasing intrauterine system) during intercourse, because Mirena is placed in the uterus, not the vagina. Sometimes male partners feel the threads.

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