If you have a pelvic 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 or if Mirena comes out, tell your healthcare provider (HCP)... Continue below
When you start Mirena, you may notice the following.
In the first 3 to 6 months:
Your period may be irregular
Your period may be heavier at first and the number of bleeding days may increase
You may have frequent spotting or light bleeding
A few women may find that their periods are heavier than normal. Some women have heavy bleeding during this time. Call your healthcare provider 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. However, your period is likely to return once Mirena is removed. If you haven't gotten your period for 6 weeks or more during Mirena use, or you feel like you may be pregnant, call your healthcare provider to rule out pregnancy.
Mirena may also affect heavy periods in other ways. The number of spotting and bleeding days may initially increase but then typically decreases in the months that follow. Bleeding may also continue to be irregular. Call your healthcare provider if bleeding becomes heavy after it has been light for a while.
With Mirena, there’s no daily routine. However, you will need to do a self-check of the threads of your Mirena once 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.
At the end of 5 years with Mirena, it's up to you whether to remove or replace it. Remember, Mirena can be removed at any time by your healthcare provider 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 provider choose to replace Mirena with a new one after 5 years, be sure to:
Let your healthcare provider know in advance so he or she can remove your current Mirena and replace it during the same visit—removal, like placement, takes only a few minutes
Schedule a follow-up visit 4 to 6 weeks after your new Mirena is placed to check that it's in the right position