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What to Expect When Getting a Mirena IUD

Understanding what happens before, during, and after placement

Once you and your healthcare provider decide that Mirena® is right for you, they’ll schedule an appointment for it to be placed. Sometimes this can be done during the same office visit. If not, you’ll make another appointment to come back. 


There are options to help you pay for Mirena.

Before having Mirena placed, tell your healthcare provider 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 are breastfeeding 
  • have severe headaches or migraine headaches 
  • have AIDS, HIV, or any other sexually transmitted infection


Tell your healthcare provider about all of the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements.

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Taking the mystery out of Mirena placement

Many women have concerns about the placement of Mirena. Often, learning all you can about what to expect can help:


    Getting Mirena does not involve surgery and is done by your healthcare provider during an in-office visit or immediately after giving birth. 

    • First, your healthcare provider will examine your pelvis to find the exact position of your uterus.
    • They will then clean your vagina and cervix with an antiseptic solution and slide a slim plastic tube containing Mirena through the cervix into your uterus.
    • Your healthcare provider will then remove the plastic tube and leave Mirena in your uterus.
    • Following placement, your healthcare provider will then cut the threads to the right length.


    You may experience pain, bleeding or dizziness during and after placement. If your symptoms do not pass within 30 minutes after placement, Mirena may not have been placed correctly. Your healthcare provider will examine you to see if Mirena needs to be removed or replaced.

    You may experience pain, bleeding, or dizziness during and after placement. If your symptoms do not pass within 30 minutes after placement, Mirena may not have been placed correctly. Your healthcare provider will examine you to see if Mirena needs to be removed or replaced.


    If you are concerned about pain, ask your healthcare provider about taking over-the-counter pain medication before the procedure.

    Your healthcare provider should teach you how to check that Mirena is in the proper position by feeling for the removal threads. It is a good habit to do this 1 time a month.

    • First, wash your hands with soap and water.
    • Then, check for the threads by reaching up to the top of your vagina with clean fingers to feel the removal threads. Do not pull on the threads.
    • If you feel more than just the threads or if you cannot feel the threads, Mirena may not be in the right position and may not prevent pregnancy. Avoid intercourse or use non-hormonal back-up birth control (such as condoms or spermicide) and ask your healthcare provider to check that Mirena is still in the right place.

    Call your healthcare provider if you have any questions or concerns (see "When should I call my healthcare provider?"). Otherwise, you should return to your healthcare provider for a follow-up visit 4 to 6 weeks after Mirena is placed to make sure that it is in the right position. 

    Call your healthcare provider if you have any concerns about Mirena. Be sure to call if you:

    • think you are pregnant 
    • have pelvic pain, abdominal pain or pain during sex 
    • have unusual vaginal discharge or genital sores 
    • have unexplained fever, flu-like symptoms or chills 
    • might be exposed to sexually transmitted infections (STIs) 
    • are concerned that Mirena may have been expelled (came out)
    • cannot feel Mirena's threads 
    • develop very severe or migraine headaches 
    • have yellowing of the skin or whites of the eyes. These may be signs of liver problems. 
    • have had a stroke or heart attack 
    • become HIV positive or your partner becomes HIV positive 
    • have severe vaginal bleeding or bleeding that lasts a long time or concerns you

    How Mirena may affect your period

    3-6 months

    What will my period be like after starting Mirena?

    For the first 3 to 6 months, your period may become irregular and the number of bleeding days may increase. You may also have frequent spotting or light bleeding, and some women have heavy bleeding during this time. You may also have cramping during the first few weeks. Call your healthcare provider (HCP) if the bleeding remains heavier than usual or increases after it has been light for a while.

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    How will my period change after I've already been on Mirena for a while?

    After you have used Mirena for a while, the number of bleeding and spotting days is likely to lessen. For some women, periods will stop altogether. This is because the hormone in Mirena reduces the monthly thickening of your uterus lining. 

    Changes with duration in time

    What will the long-term changes in my period be like?

    By the end of year one, about 20% of users have no period at all. If you have any concerns that you may be pregnant while using Mirena, or if you do not have a period for 6 weeks during Mirena use, do a urine pregnancy test and call your HCP. When Mirena is removed, your menstrual periods should return.

    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 decrease in the months that follow. 



    Your Mirena IUD can be removed at any time by your
    healthcare provider.

    Mirena and sex

    Because Mirena sits in your uterus and not your vagina, you should not be able to feel it after it has been placed. You and your partner should not be able to feel Mirena during sex. Sometimes, your partner may feel the threads. If this happens, or if you or your partner experience pain during sex, talk with your healthcare provider. 

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    Mirena® (levonorgestrel-releasing intrauterine system) is a hormone-releasing IUD that prevents pregnancy for up to 8 years. Mirena also treats heavy periods for up to 5 years in women who choose intrauterine contraception.



    • If you have a pelvic or 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, or excessive bleeding after placement, tell your healthcare provider (HCP). If Mirena comes out, call your HCP and avoid intercourse or use non-hormonal back-up birth control (such as condoms or spermicide). Mirena may go into or through the wall of the uterus and cause other problems.
    • Pregnancy while using Mirena is uncommon but can be life threatening and may result in loss of pregnancy or fertility.

    • Ovarian cysts may occur but usually disappear.
    • Bleeding and spotting may increase in the first 3 to 6 months and remain irregular. Periods over time usually become shorter, lighter, or may stop.


    Mirena does not protect against HIV or STIs.


    Only you and your HCP can decide if Mirena is right for you. Mirena is available by prescription only.


    For important risk and use information about Mirena, please see Full Prescribing Information.