If you have an untreated genital infection, get infections easily, or have certain cancers, don't use Mirena. Less than 1% of users get a serious pelvic infection called pelvic inflammatory disease (PID). If you have persistent pelvic or stomach pain, excessive bleeding after placement, or if Mirena comes out, tell your healthcare professional (HCP)... Continue below
When you start Mirena, you may notice the following.
In the first 3 to 6 months:
Your period may be irregular and the number of bleeding days may increase
You may have frequent spotting or light bleeding and cramping
Some women have heavy bleeding during this time. Call your healthcare professional if your period continues to be heavier than usual
After you have used Mirena for a while:
The number of bleeding and spotting days is likely to lessen
There is a small chance that your period will stop altogether
These effects may continue for as long as you have Mirena. About 2 out of 10 women stop having periods after 1 year of Mirena use. If you have any concerns that you may be pregnant while using Mirena, do a urine pregnancy test and call your healthcare professional. If you do not have a period for 6 weeks during Mirena use, call your healthcare professional. When Mirena is removed, your menstrual periods will come back.
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.
With Mirena, there’s no daily routine. However, you will need to do a self-check of the threads of your Mirena 1 time a month to make sure it’s in place. Ask your healthcare provider to explain how.
If you ever have trouble finding the threads or feel more than just the threads, Mirena may not be in the right position and may not prevent pregnancy.
Use nonhormonal back-up birth control (such as condoms and spermicide) and ask your healthcare provider to check that Mirena is still in the right place.
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.
Mirena lasts for as long as you want, for up to 6 years for pregnancy prevention and up to 5 for heavy menstrual bleeding.
If you choose to continue to use Mirena for birth control beyond 6 years, your healthcare professional can remove and replace it with a new one during the same office visit. In women who choose intrauterine contraception and need treatment for heavy menstrual bleeding for more than 5 years, your healthcare professional can remove Mirena and replace it with a new one within that same office visit as well.
Remember, Mirena can be removed at any time by your healthcare professional and you can try to get pregnant right away. About 8 out of 10 women who try to become pregnant after removal of Mirena will become pregnant within one year.
If you and your healthcare professional choose to replace Mirena with a new one, be sure to:
Let your healthcare professional know in advance so he or she can remove your current Mirena and replace it during the same visit.
Schedule a follow-up visit 4 to 6 weeks after your new Mirena is placed to check that it's in the right position