When menstruation comes when mirena is installed. Mirena coil and menstruation

Is it possible to use the Mirena coil for myoma to treat a tumor?

My periods completely stopped six months after the installation of the Mirena spiral. This is fine? Will I be able to get pregnant after the coil is removed?

Is there any pain, discharge or uterine bleeding after the installation of the Mirena coil?

Does Mirena affect weight? I really want to buy the Mirena intrauterine device, but I'm afraid to lose shape (there is a tendency to be overweight).

The site provides reference information for informational purposes only. Diagnosis and treatment of diseases should be carried out under the supervision of a specialist. All drugs have contraindications. Expert advice is required!

General characteristics

Therapeutic intrauterine system Mirena as an intrauterine contraceptive (IUD)

Therapeutic intrauterine system (hormonal intrauterine system, hormonal intrauterine device, Navy) Mirena refers to intrauterine hormonal contraceptives.

In the 1960s and 1970s, copper-containing IUDs appeared, the efficiency of which was even higher. However, the problem of metrorrhagia (uterine bleeding) was not solved by the second generation of intrauterine contraceptives.

And finally, in the second half of the 70s, the first hormone-containing intrauterine contraceptives appeared - a new, third generation of IUDs. These medical devices combine the positive aspects of the IUD and hormonal oral contraceptives.

Hormone-containing intrauterine contraceptives are more effective than others contraceptives this group. In addition, they do not lead to uterine bleeding. Against the background of the use of hormone-containing intrauterine contraceptives, menstrual bleeding becomes less abundant.

Description of the dosage form

The Mirena intrauterine hormonal system has a T-shaped body that provides a stable location in the uterine cavity. At one end, the body has a loop to which threads are attached to remove the system. On the body there is a hormonal-elastomer core, which is a substance of white or almost white color. The core is covered with a translucent membrane that regulates the flow of the active substance into the uterine cavity.

The active hormonal substance of the system - the progestogen drug levonorgestrel - is presented in an amount of 52 mg. Auxiliary substance - polydimethylsiloxane elastomer.

The Mirena intrauterine hormonal system is located in the cavity of the conductor tube. The conductor and body of the drug do not have impurities.

Each package of Mirena contains one intrauterine hormonal system, placed in a vacuum plastic-paper shell.

The acquired dosage form of Mirena before use should be kept in a place protected from sunlight, at room temperature (15-30 degrees). The shelf life is three years.

Metabolism of the active substance in the body

The hormonal IUD Mirena begins to secrete levonorgestrel immediately after being placed in the uterine cavity. The release rate of the active substance after administration is 20 µg/day, by the end of the fifth year it decreases to 10 µg/day.

The distribution of levonorgestrol characterizes Mirena as a drug of predominantly local action. The highest concentration of the substance is stored in the endometrium (the lining of the uterus). In the myometrium (in the muscular membrane), the concentration of levonorgestrel barely reaches 1% of the concentration in the endometrium. The concentration of levonorgestrel in blood plasma is 1000 times less than in the endometrium.

The active substance enters the bloodstream approximately one hour after the introduction of the system. The maximum concentration of levonorgestrel in the blood serum is reached after two weeks.

Body weight significantly affects the concentration of the active substance in the blood plasma. In women with reduced weight (37-54 kg), the concentration of levonorgestrol in the blood is on average one and a half times higher.

The active substance is almost completely metabolized (broken down) in the liver, and excreted through the kidneys and intestines.

Operating principle

The most important contraceptive effects of the Mirena intrauterine hormonal system are due to a weak local reaction to a foreign body in the uterine cavity, and mainly to the local influence of the progestogen drug levonorgestrol.

There is a suppression of the functional activity of the epithelium of the uterine cavity: the normal growth of the endometrium is inhibited, the activity of its glands decreases, transformations occur in the submucosa - all these changes ultimately prevent the implantation of a fertilized egg.

Another important contraceptive effect is the increase in the viscosity of the mucus secreted by the glands of the cervix, and the thickening of the mucous membrane of the cervical canal, which prevents the penetration of spermatozoa into the uterine cavity.

In addition, the Mirena drug inhibits sperm motility in the uterine cavity and in the fallopian tubes.

In the first months of use, due to the restructuring of the uterine mucosa, irregular spotting is possible. But in the future, inhibition of the proliferation of the endometrial epithelium leads to a pronounced decrease in the volume and duration of menstrual bleeding, up to amenorrhea (cessation of menstruation).

Indications for use

The Mirena intrauterine hormonal system is intended, first of all, to prevent unwanted pregnancy.

In addition, the drug is used for excessively heavy menstrual bleeding of unknown etiology (in cases where the possibility of oncological diseases of the female genital area is excluded).

As a local progestogen drug, the Mirena intrauterine device is used to prevent endometrial hyperplasia (growth) during estrogen replacement therapy (this kind of treatment is indicated after surgery to remove both ovaries, as well as with severe menopause).

Contraindications

Mirena is an intrauterine contraceptive, so it is categorically contraindicated in inflammatory diseases of the female genital area, such as:

• acute and chronic inflammatory diseases of the pelvic organs;
• infectious lesions of the lower urinary tract;
• postpartum endometritis;
• septic abortion that took place less than three months before installation.

Since the occurrence of an acute inflammatory disease of the pelvic organs, which is difficult to treat, will be an indication for the removal of the IUD, Mirena is contraindicated with an increased tendency to develop acute infectious diseases, including the female genital area (frequent change of sexual partners, a general decrease in body resistance, AIDS in the stage detailed clinical symptoms, etc.).

As an intrauterine contraceptive, Mirena is also contraindicated in cervical dysplasia, malignant neoplasms of the body and cervix, congenital or acquired changes in the configuration of the uterine cavity (including fibromyomas).

Since the active substance of the drug is metabolized in the liver, the Mirena intrauterine hormonal system is contraindicated in oncological pathology of this organ, as well as in acute hepatitis and cirrhosis. If jaundice of unknown origin has previously occurred, the drug should be used with great caution.

Since levonorgestrol is a gestagenic drug, Mirena is contraindicated in all gestagen-dependent oncological diseases (primarily in breast cancer).

The systemic effect of levonorgestrol on a woman's body is weak. Nevertheless, the Mirena intrauterine hormonal system should be used with extreme caution in cases where progestin preparations are contraindicated. This is especially true of severe circulatory disorders (heart attacks, strokes), severe migraine attacks in history (including those that may indicate severe disorders of cerebral circulation), arterial hypertension, severe forms of diabetes mellitus, thrombophlebitis and a tendency to thromboembolic complications.

In such cases, the degree of risk (the severity of the symptoms of the disease, which is a relative contraindication to prescribing the drug) and the benefits of its use should be correlated. The issue of using Mirena is decided in consultation with a professional, and during the application of the spiral, constant medical supervision and laboratory control are necessary.

Mirena is contraindicated in pregnancy (diagnosed or suspected) and in case of hypersensitivity to the components of the drug.

Side effects

Common Side Effects

Common side effects are commonly referred to as concomitant symptoms that appear at least in every hundredth, and no more than in every tenth patient using the spiral.

Women using Mirena most often experience unpleasant symptoms from the central nervous system, such as: nervousness, irritability, bad mood, decreased libido, headache.

On the part of the gastrointestinal tract, patients are often concerned about pain in the abdomen, nausea, and vomiting.

Among the adverse effects on appearance, acne and weight gain are most commonly observed.

Often, patients make many complaints about the state of the reproductive system and mammary glands: pain in the pelvic area, spotting, vulvovaginitis, tension and soreness of the mammary glands.

Back pain resembling sciatica is relatively common.

All the symptoms described above are most pronounced in the first months of using the Mirena IUD, then their intensity decreases, and in the vast majority of cases, unpleasant symptoms disappear completely.

Rare side effects

Rare side effects include concomitant signs of drug use that occur no more often than every hundredth patient, and no less than every thousandth.

Rare adverse side effects of Mirena include the following:

• emotional lability (frequent mood swings);
• the appearance of edema;
• alopecia (baldness);
• hirsutism (increased hairiness);
• skin itching;

These unpleasant symptoms are most pronounced in the first months of using Mirena. In cases where their intensity does not decrease, an additional examination is indicated to exclude concomitant diseases.

Very rare side effects

Very rare effects of the drug Mirena (less than one in a thousand) include allergic reactions in the form of a rash and urticaria. When such signs appear, other possible causes of skin allergies should be excluded and, if necessary, the use of the IUD should be discontinued.

Instructions for use

Insertion of the intrauterine device Mirena

Sterile vacuum packaging is opened immediately before the installation of the system. A prematurely opened system must be disposed of as medical waste.

Only a doctor with sufficient experience in carrying out such manipulations can install the Mirena intrauterine system.

Before installing the Mirena coil, it is necessary to consult a gynecologist and get information about all the risks and possible adverse side effects.

Having decided on the installation of the Mirena IUD, a woman must undergo an examination of the mammary glands and mammography, as well as a gynecological examination, including a study of the pelvic organs and colposcopy (or at least a cervical smear analysis).

It is necessary to exclude oncological pathology of the female genital organs, pregnancy and sexually transmitted infections. All inflammatory gynecological diseases should be completely cured by the time of installation.

It is extremely important before installing the Mirena coil to determine the location of the uterus in the small pelvis, as well as the size and configuration of the uterine cavity. The correct placement of the IUD in the uterine cavity guarantees the effectiveness of the Mirena system, and prevents its expulsion (expulsion).

For women of childbearing age, Mirena is placed in the first seven days of the menstrual cycle.

If there are no medical contraindications, the Mirena IUD can be installed immediately after an artificial or spontaneous abortion in the first trimester of pregnancy.

Surgical intervention is extremely rare.

Amenorrhea
Amenorrhea is a common complication of the Mirena IUD. As a rule, it develops gradually during the first six months of using a contraceptive.

With the disappearance of menstrual bleeding, pregnancy should be excluded (conduct a routine test). If the test is negative, you can not repeat it in the future. The normal menstrual cycle will resume after the removal of Mirena.

Spiral Removal

After 5 years of use, the Mirena coil should be removed. In cases where, after removing the IUD, a woman is going to continue contraceptive measures, the Mirena coil should be removed at the beginning of the menstrual cycle. If the IUD is removed in the middle of the cycle, and before that unprotected sexual intercourse took place, then the woman is at real risk of becoming pregnant.

If a woman wishes to continue using the IUD, a new IUD can be inserted immediately after removal. In cases where, after removing the IUD, a new intrauterine contraceptive is immediately installed, manipulations can be performed at any period of the cycle.

After removal of the Mirena IUD, the integrity of the spiral should be checked, since if it is difficult to remove the product, the substance sometimes slips into the uterine cavity.

Installation and removal of the Mirena coil may be accompanied by pain and bleeding of varying severity. In some cases, fainting is possible. In women with epilepsy, insertion or removal of a coil may cause a seizure.

Mirena intrauterine device and pregnancy

The drug has a very high efficiency. In cases where an unwanted pregnancy does occur, an ectopic pregnancy should be ruled out first. In uterine pregnancy, the question of its interruption is raised.

If the woman decides to keep the child, then the spiral is carefully removed from the uterine cavity. In cases where it is not possible to remove the intrauterine system, the woman is warned about the possible risks of pregnancy with an IUD in the uterine cavity (spontaneous premature termination of pregnancy).

The possible adverse effect of the drug on the development of the fetus should be taken into account. There are very few cases of bearing a child with the Mirena intrauterine system due to the high contraceptive properties of the drug. However, a woman is advised to report that there are no clinical data on the occurrence of fetal pathology under the influence of this drug.

Application for lactation

The active substance of the Navy Mirena in small concentrations penetrates the blood plasma, and can be excreted during lactation, so that the content of levonorgestrel in breast milk is about 0.1% of the daily dose of the substance secreted by the system.

It is unlikely that such a dose could affect the general condition of the infant. Experts say that the use of Mirena during lactation six weeks after birth is quite safe for a breastfed baby.

FAQ

The cost of Mirena is quite high. I have heard that the use of the helix comes with a lot of unpleasant side effects. Is there any positive effect of the drug on the body?

The Mirena intrauterine hormonal system has the following therapeutic (not contraceptive) effects:

• a decrease in the volume and duration of uterine bleeding (idiopathic - that is, not caused by any concomitant pathology);
• increased hemoglobin levels;
• normalization of iron metabolism in the body;
• general strengthening action);
• reduction of pain syndrome during painful menstruation;
• prevention of endometriosis and uterine fibroids;
• prevention of hyperplasia and endometrial cancer.

In addition, Mirena is widely used to normalize the state of the endometrium during estrogen replacement therapy (such treatment is usually carried out with pathological menopause, or after bilateral ovary removal).

Is it possible to use the Mirena coil for myoma to treat a tumor?

The Mirena therapeutic system inhibits the growth of the fibroid tumor node. However, additional examination and consultation with a doctor is necessary. Much depends on the size of the nodes and their location. For example, submucosal fibroid nodes that change the configuration of the uterine cavity are an absolute contraindication for the use of the Mirena IUD.

Does Mirena help with endometriosis?

The intrauterine system releases a hormone into the uterine cavity that inhibits endometrial proliferation - this is the basis for the ability of the Mirena spiral to prevent the development of endometriosis.

In recent years, works have appeared that testify to the therapeutic effect of the Mirena spiral in endometriosis. Clinical data are rather contradictory. In addition, it should be noted that the treatment of endometriosis with hormonal IUDs is not used in all countries.

From the standpoint of evidence-based medicine, the Mirena spiral for endometriosis, like any other hormonal therapy, can only give a temporary result. The National Guidelines of the Russian Federation on gynecology recommends starting with surgical treatment, as the most radical one.

However, in each case, a thorough examination and consultation of doctors is necessary - a gynecologist, surgeon and endocrinologist.

My periods completely stopped six months after the installation of the Mirena spiral. This is fine? Will I be able to get pregnant after the coil is removed?

Amenorrhea (cessation of menstruation) is a normal reaction of the body to the action of the Mirena hormonal system, which occurs in every fifth woman using the spiral. As a rule, this condition develops gradually.

At the first disappearance of menstrual bleeding, pregnancy should be excluded. The effectiveness of the drug is very high, but experts still recommend taking the test. If the test result is negative, then you don't have to worry. After the removal of the Mirena spiral, menstruation will be restored, and a normal pregnancy can be expected.

Is there any pain, discharge or uterine bleeding after the installation of the Mirena coil?

Immediately after the installation of Mirena, a slight pain syndrome and spotting are possible. Severe pain and bleeding may indicate that the IUD has not been inserted correctly. In this case, the Mirena coil must be removed.

Pain, discharge or uterine bleeding a considerable time after the installation of the Mirena coil may indicate the onset of expulsion (expulsion of the drug from the uterine cavity) or an ectopic pregnancy. Therefore, if such symptoms appear, you should immediately consult a doctor.

Does Mirena affect weight? I really want to buy the Mirena intrauterine device, but I'm afraid to lose shape (there is a tendency to be overweight).

Weight gain is a fairly common unpleasant side effect of the Mirena spiral. However, it should be noted that not everyone is getting fat. According to clinical data, at least nine out of ten women do not even notice a slight increase in weight after the insertion of an IUD.

In addition, weight gain is one of the side effects of Mirena, most pronounced in the first months after installation. As a rule, in the future, the tendency to be overweight, caused by a hormonal drug, disappears.

According to the existing tendency to be overweight, it is impossible to judge the possibility of weight gain after installing the Mirena spiral, since the appearance of this side effect and the degree of its severity depends on the individual response to the hormonal drug.

I was protected by hormonal preparations. There are no side effects, but I often forget to take pills. What is the best way for me to switch from pills to Mirena?

If you took the pills irregularly, then there is a risk of pregnancy, which should be excluded when prescribing the Mirena spiral.

In addition, it is necessary to undergo a complete gynecological examination (examination of the pelvic organs, colposcopy) and check the condition of the mammary glands.

If there are no contraindications to the use of the IUD, it is best to insert the spiral on the fourth or sixth day of the menstrual cycle. On the day of installation of the Mirena spiral, contraceptive pills are canceled.

When does pregnancy occur after Mirena removal?

Clinical data indicate that 80% of women who want to have a baby become pregnant in the first year after the removal of the Mirena coil. This is even slightly above the usual level of fertility (fertility).

Of course, it takes some time to restore the normal state of the reproductive system, which is individual for each woman.

For patients for whom pregnancy is undesirable, doctors advise immediately after removing the Mirena coil to take measures to prevent conception, since in many women the likelihood of pregnancy appears immediately after the system is terminated.

Where to buy a Mirena coil?

The Mirena intrauterine device can be bought at a pharmacy. The drug is dispensed by prescription.

Mirena spiral with menopause - consequences, reviews, cost, rules of use, you need to find out in advance. The contraceptive is different from the usual spiral, which prevents pregnancy. It contains a synthetic hormone - progesterone. Mirena normalizes hormonal levels, protects against unwanted pregnancy.

The action of the Mirena coil

T-shaped device with 2 antennae. In the body of the Mirena spiral there is a cavity filled with hormones. The body receives an equal amount of progesterone daily in the form of levonorgestrel - 20 mcg each. The hormone belongs to the group of gestagens. Prevents the formation of the endometrium, the growth of cancer cells. The Mirena coil balances progestins and estrogens. Does not interfere with ovarian function. Prevents the development of pathological processes in the pelvic organs, reduces the manifestation of menopause. Used as a means of contraception. Its action is especially useful at the initial stage of menopause, when it is still possible to become pregnant. The spiral thickens the discharge, prevents sperm from entering the uterine cavity. Prevents the development of hyperplasia, endometriosis.

Mirena and uterine fibroids

One of the reasons for the development of fibroids is hormonal disorders. The likelihood of a tumor appearing in the process of menopause is high. Uterine fibroids provoke painful, heavy periods, bleeding during menopause. The Mirena spiral evens out the hormonal background, prevents the development of a neoplasm or helps to reduce it. While the conventional coil is contraindicated, Mirena is recommended by doctors for the prevention of many diseases. The tool regulates estrogens, prevents the development of the endometrium. Menstruation scanty may be present in the first months of treatment, then disappears altogether.

An increased amount of estrogen provokes the growth of fibroids. In the process of fading reproductive functions, the amount of estrogens in a woman's body decreases, but they replenish it with drugs containing a synthetic hormone. As a result, there is a situation with a high rate of estrogen. The spiral allows you to balance this level. Since it contains progesterone, it is possible to use drugs with estradiol. But the treatment regimen should be selected by the doctor, taking into account the individual characteristics of the organism. According to women, Mirena copes quite well with fibroids. It either stays the same or disappears completely.

Abundant discharge after the installation of the spiral

When using this remedy, spotting may be present for the first 4 months, which is the norm for menopause. So the body adapts to the new conditions of existence, the hormonal background stabilizes. At the same time, the risk of developing inflammation is high. Often, pathology is the cause of bleeding after the installation of the spiral. Firstly, the body is trying to get rid of a foreign object, and secondly, the hormonal background is changing. If bleeding occurs, consult a specialist. Even if there are no other warning signs.

How long does the bleeding last

With menopause, the Mirena spiral helps to avoid spotting, spotting. For the first 2 months, there may be abundant spotting if the spiral was placed at the beginning of menopause. But after 4 months everything returns to normal - there are no discharges or they come too scarce. The bleeding lasts from 5 to 7 days. After installing the Mirena spiral, the doctor should advise the woman. Tell what consequences await her. In what cases to seek help from gynecologists. In general, you should visit a doctor 2 times a year. And also 1-2 months after the installation of the spiral.

Contraindications

The tool is not suitable for everyone. Before installing the Mirena spiral, it is necessary to undergo an examination of the whole body. Contraindications are:

The consequences of installing a spiral

Side effects may appear at first. If they are not significant, continue to use the remedy. Otherwise, you will have to refuse it. What could be?

If the body has taken the remedy without side effects, the disappearance of menopause symptoms can be felt immediately. Headache, excessive sweating, hot flashes, irritability, and other unpleasant manifestations of menopause pass.

However, there is another side of the coin. Progesterone promotes fluid retention, possibly swelling of the legs, weight gain. An allergic rash, acne appears on the skin. There is constant nausea, an incomprehensible state, a clouded state, laziness, apathy appear. Hair on the face may grow, fall out in bunches on the head. Doctors usually say that the condition of the hair and skin improves from the system, fewer wrinkles appear. If the above symptoms are present, you need to double-check the hormonal background, consult with specialists. You may have to take it out. Hormone deficiency and excess negatively affects the body. Doctors allow such a negative impact of the system for 3 months. Then the body adapts to the new conditions of existence, excess weight goes away, and the woman feels healthy again, without side effects, symptoms of menopause.

Mirena use for menopause

The doctor installs the remedy after a preliminary examination of the woman's body. The procedure itself does not take much time. Immediately after installation, a woman can leave the gynecologist's office. Within 2 weeks it is forbidden to lift weights. In the future, when using the spiral, heavy physical exertion should be avoided. There are no discharges during menopause. The use of Mirena provides for constant monitoring by the gynecologist, the woman herself. If pink, bloody discharge appears, you should consult your doctor. The rest of the woman leads a full life.

The use of Mirena prevents unwanted pregnancy. In the first years of the extinction of reproductive functions, conception is quite possible. However, it is almost impossible to determine pregnancy by your own feelings - they resemble the manifestations of menopause. Menstruation may be absent due to menopause. The pregnancy test is also not as accurate as before. Since the level of hCG during menopause in women is increased. Corresponds to the first weeks of pregnancy. Thus, a negative test result can mean pregnancy, and a positive one can deny it. Using Mirena allows a woman to have sex without the threat of conception.

The intrauterine therapeutic system Mirena is a white or almost white hormonal-elastomer core located on a T-shaped body and covered with an opaque membrane, which serves as a kind of regulator for the release of the active active ingredient. The T-body is provided with a loop at one end with an attached thread to remove the helix and two shoulders. The Mirena system is placed in a conductor tube and is free from visible impurities. The drug is supplied in sterile blisters made of polyester or TYVEK material in the amount of 1 piece.

pharmachologic effect

The intrauterine system or simply the IUD Mirena is a pharmaceutical preparation based on levonorgestrel , which, gradually released into the uterine cavity, has local gestagenic action . Due to the active component of the therapeutic agent, the sensitivity of the estrogen and progesterone receptors of the endometrium decreases, which manifests itself in a strong antiproliferative effect.

There are morphological changes in the inner lining of the uterus and a weak local reaction to a foreign body in its cavity. The mucous membrane of the cervical canal thickens to a large extent, which prevents the penetration of sperm into the uterus and inhibits the motor abilities of individual spermatozoa. In some cases, ovulation is also inhibited.

The use of the drug Mirena gradually changes the nature menstrual bleeding . In the first months of using the intrauterine device, due to the inhibition of endometrial proliferation, there may be an increase in bloody spotting from the vagina. As the pharmacological effect of the therapeutic agent develops, when the pronounced suppression of proliferative processes reaches a maximum, a period of scanty bleeding begins, which often transforms into oligo- And amenorrhea .

3 months after the start of using Mirena, the menstrual blood loss of women is reduced by 62-94%, and after 6 months - by 71-95%. This pharmacological ability to change the nature of uterine bleeding is used to treat idiopathic menorrhagia in the absence of hyperplastic processes in the membranes of the female genital organs or extragenital conditions, an integral part of the pathogenesis of which is a pronounced hypocoagulation , since the effectiveness of the drug is comparable to surgical methods of treatment.

Pharmacodynamics and pharmacokinetics

After the intrauterine system is established, the pharmaceutical drug begins to act immediately, which is manifested in the gradual release levonorgestrel and its active absorption, which can be judged by the change in its concentration in blood plasma. Speed the release of the active ingredient is initially 20 mcg per day and gradually decreases, reaching 10 mcg per day after 5 years. Hormonal coil Mirena sets high local exposure , which provides a concentration gradient of the active substance in the direction from the endometrium to the myometrium (the concentration in the walls of the uterus varies by more than 100 times).

Entering the systemic circulation levonorgestrel contacts whey proteins blood: 40-60% of the active ingredient non-specifically combines with , and 42-62% of the active component - specifically with selective carrier of sex hormones SHBG . About 1-2% of the dosage is present in the circulating blood as the free steroid. During the use of a therapeutic agent, the concentration of SHBG decreases, and the free fraction increases, which indicates the non-linearity of the pharmacokinetic ability of the drug.

After the introduction of the Mirena IUD into the uterine cavity, levonorgestrel in the blood plasma is found after 1 hour, and the maximum concentration is reached after 2 weeks. In the course of clinical studies, it has been proven that the concentration of the active component depends on the woman's body weight - with low weight and / or with a high concentration of SHBG, the amount of the main component in the plasma is higher.

Levonorgestrel metabolized with isoenzyme CYP3A4 to the end products of metabolism in the form of conjugated and unconjugated 3-alpha and 5-beta tetrahydrolevonorgestrel , after which it is excreted through the intestines and through the kidneys with an excretion coefficient of 1.77. In an unchanged form, the active component is eliminated only in trace amounts. The total clearance of the biological substance Mirena from blood plasma is 1 ml per minute per kilogram of weight. The half-life is about 1 day.

Indications for use

• contraception;
• idiopathic menorrhagia;
• preventive treatment endometrial hyperplasia during hormone replacement therapy.

Mirena spiral - contraindications

Absolute contraindications for the use of a hormonal spiral:

• pregnancy ;
• inflammatory diseases of the pelvic organs;
• postpartum ;
• infectious process in the lower parts of the genitourinary system;
• history of septic abortion within the last three months;
• malignant neoplasms uterus or cervix;
• female reproductive system;
• uterine bleeding of unknown origin;
• hormone-dependent tumor neoplasms;
• congenital or acquired anomalies of the anatomical and histological structure of the uterus;
• acute liver disease;
• increased sensitivity to the pharmacological components of the intrauterine device.

Pathological conditions that may complicate the use of an intrauterine device with levonorgestrel :

• postpartum period from 48 hours to 4 weeks;
• deep vein thrombosis;
• benign trophoblastic disease ;
• breast cancer present or in history within the last 5 years;
• high risk of sexually transmitted infections;
• active liver disease (eg. spicy , decompensated and so on).

Side effects of Mirena

Changes in the menstrual cycle

IUD side effects should start with changes in the nature and cyclicity of menstrual bleeding , because they appear much more often than other adverse effects of therapeutic measures. Thus, the duration of bleeding increases in 22% of women, and irregular uterine hemorrhages observed in 67%, when considering the first 90 days after the installation of Mirena. The frequency of these phenomena gradually decreases, since the hormonal coil releases less biologically active substance over time and by the end of the first year, respectively, is 3% and 19%. However, the number of manifestations of other menstrual irregularities increases - by the end of the first year develops in 16%, and rare bleeding in 57% of patients.

Other side effects

• From the side immune system: skin rash and , , .
• From the side nervous system: headache, , depressed mood up to .
• Side effects from the reproductive system and mammary glands: vulvovaginitis , discharge from the genital tract, infections of the pelvic organs, , breast pain, expulsion intrauterine device, , perforation of the uterus.
• From the side gastrointestinal tract: abdominal pain, nausea.
• Dermatological disorders: , , .
• From the side of cardio-vascular system: increased blood pressure.

Mirena intrauterine device: instructions for use (Method and dosage)

General provisions for the use of the drug

The Mirena contraceptive is injected directly into the uterine cavity, where it exerts its pharmacological effects for 5 years. Release rate the active hormonal component is 20 mcg per day at the beginning of the use of the intrauterine device and gradually decreases to a level of 10 mcg per day after 5 years. Average elimination rate levonorgestrel throughout the therapeutic course is about 14 mcg per day.

There is a special contraceptive effectiveness rate , which reflects the number of pregnancies in 100 women during the use of contraception. With proper installation and compliance with all the rules for using the intrauterine device, pearl index for mirena is about 0.2% for 1 year, and the same figure for 5 years - 0.7%, which expresses the incredibly high efficiency of using this method of contraception (for comparison: for condoms, the Pearl index ranges from 3.5% to 11 %, and for chemicals such as spermicides - from 5% to 11%).

Installation and removal of the intrauterine system may be accompanied by pain in the lower abdomen, moderate bleeding. Also, manipulation can cause fainting due to a vascular-vagal reaction or a seizure in patients. therefore, the use of local anesthesia of the female genital organs may be required.

Before installing the drug

It is recommended that an intrauterine device be installed only doctor who has experience with this type of contraception, as mandatory aseptic conditions and appropriate medical knowledge of female anatomy and the operation of a pharmaceutical preparation are required. Immediately prior to installation, it is necessary to carry out general and gynecological examination in order to eliminate the risks of further use of a contraceptive, the presence pregnancy and diseases that act as contraindications.

The doctor must determine the position of the uterus and the size of its cavity, since the correct location of the Mirena system ensures a uniform effect of the active ingredient on endometrium which creates the conditions for its maximum efficiency.

Instructions for Mirena for medical personnel

Visualize the cervix with the help of gynecological mirrors, treat it and the vagina with antiseptic solutions. Grab the upper lip of the cervix with forceps and straighten the cervical canal with gentle traction, fix this position of the medical instruments until the end of the manipulation to install the intrauterine device. Slowly moving the uterine probe through the organ cavity to the bottom of the uterus, determine the direction of the cervical canal and the exact depth of the cavity, in parallel, excluding possible anatomical septa, synechia, submucosal fibroma or other obstacles. If the cervical canal is narrow, it is recommended to use a local or conductive type of anesthesia to widen it.

Check the sterile packaging with the drug for integrity, then open it and remove the intrauterine device. Move the slider to the farthest position so that the system is drawn into the conductor tube and takes the form of a small stick. While holding the slider in the same position, set the upper edge of the index ring in accordance with the previously measured distance to the fundus of the uterus. Carefully advance the conductor through the cervical canal until the ring is about 1.5-2 cm from the cervix.

After reaching the desired position of the spiral, slowly move the slider to the mark of full disclosure of the horizontal hangers and wait 5-10 seconds until the system acquires a T-shape. Advance the conductor to the fundal position, as evidenced by the full contact of the index ring with the cervix. While holding the conductor in this position, release the drug using the lowest possible position of the slider. Carefully remove the conductor. Cut the threads to a length of 2-3 cm, starting from the external os of the uterus.

It is recommended to confirm the correct position of the intrauterine device using ultrasound immediately after the manipulation to install the Mirena preparation. Re-examination is performed after 4-12 weeks, and then 1 time per year. In the presence of clinical indications, gynecological examination and verification of the correct position of the spiral by functional methods of laboratory diagnostics should be carried out regularly.

Removal of the intrauterine device

Mirena must be removed after 5 years after installation, since the effectiveness of the therapeutic agent is significantly reduced after this period. The medical literature even describes cases of the adverse effects of an intrauterine device not removed in a timely manner with the development of inflammatory diseases of the pelvic organs and some other pathological conditions.

To extract the drug requires strict adherence to aseptic conditions. Removal of Mirena is a gentle pulling of the threads captured by special gynecological forceps. If the threads are not visible, and the intrauterine device is deep in the organ cavity, then a traction hook can be used. It may also be necessary to dilate the cervical canal.

After removal the Mirena drug, the system should be examined for its integrity, since in some situations separation of the hormonal-elastomer core or its slipping onto the shoulders of the T-shaped body can be observed. Pathological cases are described when such complications of the removal of the intrauterine device required additional gynecological intervention.

Overdose

With proper use and compliance with all the rules for setting up an intrauterine device, an overdose of a pharmaceutical drug impossible .

Interaction

Pharmaceutical enzyme inducers, especially biological catalysts from the system cytochrome P 450 , which are involved in the metabolic degeneration of drugs such as anticonvulsants ( , Phenytoin , ) And ( and others), enhance the biochemical transformation gestagens . However, their influence on the effectiveness of Mirena is insignificant, since the main point of application of the therapeutic abilities of the intrauterine device is a local effect on the endometrium.

Terms of sale

It is released in pharmacy kiosks by prescription.

Storage conditions

The intrauterine hormonal coil should be stored in a sterile package out of the reach of young children, which is protected from direct sunlight. Proper temperature conditions should not exceed 30 degrees Celsius.

Best before date

special instructions

Hormonal spiral Mirena with uterine myoma

(other names are fibromyoma or leiomyoma ) is a benign tumor that grows from the muscular layer of the uterus (myometrium) and is one of the most common gynecological diseases. Pathological focus is a knot of randomly woven smooth muscle fibers from a few millimeters to several centimeters. For the treatment of this nosological unit, as a rule, surgical intervention is used, however, a conservative therapy scheme has now been developed.

The drug of choice is hormonal agents with a preferred local type of interaction, therefore the Mirena intrauterine device is a kind of gold standard for the sanitation of uterine fibroids.

Antiestrogenic effect It is implemented in reducing the size of pathological nodes, preventing possible complications and reducing the volume of surgical intervention in order to preserve the most physiological structure of the uterus and make future pregnancies possible.

Mirena coil for endometriosis

- a pathological condition when the cells of the inner layer of the uterus grow outside of it. Histological structures have receptors for female sex hormones, which causes the same changes as in normal endometrium, manifested by monthly bleeding, in response to which an inflammatory reaction develops.

A gynecological disease is inherent in women of reproductive age and, in addition to pain, can lead to a frequent complication of endometriosis, which is why it is so important to diagnose and treat the pathological condition in a timely manner. Of course, endometriosis therapy can be a surgical intervention with a minimally invasive approach and a small number of side effects, but it is much preferable to choose conservative methods of treatment.

The Mirena intrauterine device is an effective tool for the elimination of endometriosis for several reasons:

• proven by practical studies, the effect of the drug, manifested by inhibition of the growth of pathological foci, a decrease in their size and gradual resorption;
• fewer side effects compared to other pharmaceuticals;
• relief of the pain syndrome inherent in the problem of endometriosis;
• there is no need for daily oral tablets or injections;
• normalization of the menstrual cycle;
• there is no need for contraception.

Intrauterine device for endometrial hyperplasia

endometrial hyperplasia - this pathological condition is extremely similar to endometriosis, as it is an excessive growth and thickening of the mucous membrane of the female genital organs. The difference lies in the correct anatomical location of the histological structures, which only changes the symptoms and possible complications, but does not eliminate them.

Recognize the nosological unit allow abundant and prolonged spotting during menstruation or uterine hemorrhages not related to the cycle, the absence of ovulation and the impossibility of implanting the embryo into the altered endometrium, which is a manifestation of an increased level of estrogens in the body. The etiological treatment of this problem, aimed at eliminating the immediate cause, is a hormonal agent with a pronounced anti-estrogenic effect.

Most gynecologists prefer to use the Mirena intrauterine system because of the reliability of its pharmacological action, the convenience of everyday use, which does not require additional medical knowledge and relative cheapness compared to other therapeutic agents, because the use of Mirena does not involve daily spending on oral tablets or injections.

Pregnancy after using the Mirena intrauterine device

Since the contraceptive has predominantly local pharmacological effects, the complete restoration of all physiological parameters after removal of the drug comes quickly enough. Within a year after the evacuation of the system, the frequency of planned pregnancies reaches 79.1-96.4%. The histological state of the endometrium is restored after 1-3 months, and the menstrual cycle is completely rebuilt and normalized within 30 days.

Analogues

There are several pharmaceutical preparations with the same ATC code and a similar composition of active ingredients: Jaydes , , Evadir , however, only Jaydes can rightly be called an analogue, since the drug is represented by an intrauterine system based on levonorgestrel with a lower dosage, and therefore designed for only three years of continuous use.

With alcohol

The pharmaceutical preparation has a pronounced local therapeutic effect and enters the systemic circulation of the female body in small quantities, therefore it does not interact with the components of alcoholic beverages, however, it is recommended to use them in doses so as not to cause other side effects or adverse effects.

During pregnancy and lactation

The use of the Mirena intrauterine device is contraindicated in pregnancy or suspicion of it, since any intrauterine contraceptive increases the risk spontaneous abortion And premature birth. Removal or probing of the system can also lead to unplanned evacuation of the fetus from the uterine cavity. If careful removal of the contraceptive is not possible, medical abortion should be discussed if indicated.

If a woman wants to keep the pregnancy, then, first of all, the patient should be fully informed about the possible risks and adverse consequences, both for her body and for the child. In the future, it is necessary to carefully monitor the course of pregnancy and be sure to exclude ectopic implantation by reliable diagnostic methods.

Due to the topical use of a hormonal contraceptive, there is a possibility virilizing effect on the fetus However, due to the high efficacy of Mirena, clinical experience with pregnancy outcomes while using an intrauterine device is very limited. The woman who wishes to continue the pregnancy should also be informed of this.

Breast-feeding is not a contraindication for the use of the intrauterine system, although small amounts of the active ingredient (about 0.1% of the dose) can enter the milk during lactation. It is unlikely that such meager amounts of levonorgestrel have any pharmacological effects on the child. The medical community overwhelmingly agrees that the use of the drug after 6 weeks after childbirth does not have adverse effects on the growth and development of a young organism.

Every year, intrauterine contraceptives are gaining more and more popularity among women around the world. And the Mirena spiral, reviews, the consequences of which will be discussed below, deservedly takes first place among the Navy.

Why is this tool so good? To begin with, it should be clarified that there are 2 types of spirals: ordinary, containing silver or copper, and hormonal. Copper coils are very popular in many countries due to their low cost, but their only purpose is to protect a woman from unwanted pregnancy. Their method of exposure is based on the spermicidal activity of copper and the reaction of the internal mucous membrane of the uterine body to the appearance of a foreign body. Hormonal IUDs, which include the Mirena spiral, have not only a contraceptive, but also a therapeutic effect. This intrauterine levonorgestrel releasing system is a T-shaped frame with a plastic container that contains the hormone levonorgestrel.

Immediately after installation, the contents of the container gradually begin to penetrate the woman's body. The movement occurs at a minimum speed - at first, the amount of the hormone is 20 mg / day, by the end of 5 years - no more than 10 mg / day. The microdose "works" only in the area of ​​the uterus, absorption into the blood is practically excluded. As an alternative to surgery for uterine fibroids, doctors often recommend installing the Mirena coil. Reviews and consequences of this step in women range from enthusiastically positive to sharply negative.

All this is purely individual, the body of each person is unique and can both accept a foreign body and react inadequately to it. For any complaints that occur after the insertion of the IUD, you should consult a doctor and report the problems. However, with myoma, the Mirena coil acts as a remedy. It is especially effective in the presence of small formations. Of course, they will not completely disappear, but under the influence of a hormone-containing spiral, their growth will slow down significantly or completely stop. In large tumors, its presence prevents recurrence of growth.

In addition, it provides a standard duration and volume of menstrual flow after medical or organ-preserving surgical treatment of uterine fibroids has been carried out. In addition, indications for the use of the Mirena coil are the prevention of endometriosis and idiopathic menorrhagia. Spirals have their own uses. Most doctors agree that only women who have given birth should have an IUD inserted. Few experts will dare to allow nulliparous patients under 25 years of age to use this method as a contraceptive.

Before installing the spiral, it is necessary to pass tests:

• A smear on the flora and cytology will show if there are inflammation or precancerous changes in the uterus. With the existing pathology, it will be necessary to first carry out the treatment, and only after its completion, carry out the installation procedure.
• An ultrasound of the ovaries and uterus is done to make sure there are no abnormalities. The operation will be safe when the uterus has a normal shape. If a bicornuate uterus, septa or other pathologies of the organ are found, the procedure is not performed.
• A pregnancy test proves to the doctor that the woman is not in an "interesting position" - it is clear that when carrying a child, placing a spiral is not only pointless, but also unsafe.
• Blood test for RW and HIV.

In addition, an examination of the mammary glands and pelvic organs is carried out. After the introduction of the Mirena spiral, reviews, the consequences are often diametrically opposed. In almost all women who use such methods of protection, menstruation becomes less plentiful and painful. For someone, they completely stop and are restored only after the removal of the spiral.

The hormonal spiral may have the following side effects:

• allergic rashes and itching;
• hair loss and alopecia;
• migraine, headaches;
• irritability, fatigue;
• irregularity of menstruation;
• the appearance of excess weight;
• pain in the abdomen and back;
• change in the appearance of the skin (it becomes oily).

In 0.1% of women, the use of the spiral caused swelling, bloating, skin rash, hirsutism (excessive growth of male-type hair - dark and hard). The undesirable consequences of the use of the IUD include ectopic pregnancy, ovarian cysts, amenorrhea (absence of menstruation for several cycles), ingrowth of the device into the uterus or damage to its walls, infection and the development of pelvic inflammatory disease.

Mirena: reviews of women after 40 years

There are many benefits to using the Mirena coil. Reviews of women after 40 years of age testify to this.

1. The hormone-containing spiral is installed for a long period of 5-6 years. During this period, you do not need to buy and use other contraceptives - condoms and expensive oral contraceptives.
2. In addition, a pill not taken on time greatly increases the risk of unwanted pregnancy. With the spiral installed, you can not worry about this for several years.
3. The presence of the IUD is not felt by any of the partners, which provides a full sensation during intimacy. Unfortunately, the same cannot be said for a condom.
4. The Mirena spiral reviews of women after 40 years of age are characterized as a remedy for uterine myoma and endometriosis.

Of course, such devices have some disadvantages. For example, they will not protect against sexually transmitted diseases. Therefore, this method of protection will not be convenient for women who often change partners for love pleasures.

The gynecologist installs the IUD in his office. It is desirable that the operation was carried out in the first days of the menstrual cycle. If this happens on the 1-7th day from the start of the discharge, then this month you can no longer be protected. If the installation was carried out on the 8th day of the cycle and later, then within 30 days you should resort to additional contraceptives. Insertion of an intrauterine device is a bit of an inconvenience, but generally a painless procedure. Women with a low threshold of sensitivity may ask a specialist to apply local anesthesia.

After using the IUD, a control visit to the gynecologist should take place after 30 days, then another one after 2 months. Further, it is enough to visit a specialist once a year. The spiral is not installed immediately after childbirth. The reason for this is simple - during this period, it is not able to properly gain a foothold in the uterus, there is a high probability of its imperceptible loss.

This can lead to an unplanned pregnancy. The procedure is best done after the uterus acquires its usual dimensions. Usually this process takes about 2 months, but sometimes it can stretch up to 3-4 months.

After an abortion, you can install a spiral on the same day. The procedure for placing an IUD is as follows: first, the doctor treats the vagina and cervix with an antiseptic solution, and then grabs her front lip with forceps. Using a special tool, it straightens the cervical canal and injects a contraceptive into the uterine cavity.

According to the instructions, contraindications for installing a spiral are:

• cervicitis;
• pregnancy or suspicion of it;
• cervical dysplasia;
• malignant formations of the uterus or its cervix;
• postpartum endometritis;
• uterine anomalies, both congenital and acquired;
• acute diseases and tumors of the liver;
• infections and inflammation of the lower urinary tract and pelvic organs;
• intolerance to the components of the drug;
• bleeding of unknown origin;
• septic abortion within the last 3 months;
• age over 65 years - studies have not been conducted in this category of patients, so the effect of the spiral on the body has not been studied.

The most popular intrauterine hormonal contraceptive is the Mirena coil (IUD). Intrauterine contraceptives (IUDs) have been used since the middle of the last century. They quickly fell in love with women due to many positive qualities: the absence of a systemic effect on the female body, high performance, ease of use.
The spiral does not affect the quality of sexual contact, it is installed for a long period, practically does not require control. But the IUD has a very significant disadvantage: many patients develop a tendency to metrorrhagia, as a result of which they have to give up this type of contraception.

In the 60s, intrauterine systems containing copper were created. Their contraceptive effect was even higher, but the problem of bleeding from the uterus was not solved. And as a result, in the 70s, the 3rd generation of the VMC was developed. These medical systems combine the best qualities of oral contraceptives and IUDs.

Description of the intrauterine device Mirena

Mirena has a T-shape, which helps to securely fix in the uterus. One of the edges is equipped with a loop of threads designed to remove the system. In the center of the spiral is a whitish hormone. It slowly enters the uterus through a special membrane.

The hormonal component of the helix is ​​levonorgestrel (gestagen). One system contains 52 mg of this substance. An additional component is a polydimethylsiloxane elastomer. The Mirena IUD is inside the tube. The spiral has an individual vacuum plastic-paper packaging. You need to store it in a dark place, at a temperature of 15-30 C. The shelf life from the date of manufacture is 3 years.

The effect of Mirena on the body

The Mirena contraceptive system begins to “release” levonorgestrel into the uterus immediately after installation. The hormone enters the cavity at a rate of 20 mcg / day, after 5 years this figure drops to 10 mcg per day. The spiral has a local effect, almost all of levonorgestrel is concentrated in the endometrium. And already in the muscular layer of the uterus, the concentration is no more than 1%. In the blood, the hormone is contained in microdoses.

After the introduction of the spiral, the active ingredient enters the bloodstream in about an hour. There, its highest concentration is reached after 2 weeks. This indicator can vary significantly depending on the body weight of a woman. With a weight of up to 54 kg, the content of levonorgestrel in the blood is approximately 1.5 times higher. The active substance is almost completely cleaved in the liver, and evacuated by the intestines and kidneys.

How Mirena works

The contraceptive effect of the drug Mirena does not depend on a weak local reaction to a foreign body, but is mainly associated with the effect of levonorgestrel. The introduction of a fertilized egg is not carried out by silencing the activity of the uterine epithelium. At the same time, the natural growth of the endometrium is suspended and the functioning of its glands decreases.

Also, the Mirena spiral makes it difficult for sperm to move in the uterus and its tubes. The contraceptive effect of the drug increases the high viscosity of the cervical mucus and the thickening of the mucous layer of the cervical canal, which complicates the penetration of spermatozoa into the uterine cavity.

After setting up the system, a restructuring of the endometrium is noted for several months, manifested by irregular spotting. But after a short time, the proliferation of the uterine mucosa provokes a significant decrease in the duration and volume of menstrual bleeding, up to their complete cessation.

Indications for use

The IUD is installed primarily to prevent unwanted pregnancy. In addition, the system is used for very heavy menstrual bleeding for an unknown reason. The probability of malignant neoplasms of the female reproductive system is preliminarily excluded. As a local progestogen, the intrauterine device is used to prevent endometrial hyperplasia, for example, in severe menopause or after bilateral oophorectomy.

Mirena is sometimes used in the treatment of menorrhagia, if there are no hyperplastic processes in the uterine mucosa or extragenital pathologies with severe hypocoagulation (thrombocytopenia, von Willebrand disease).

Contraindications for use

The Mirena spiral belongs to internal contraceptives, therefore, it cannot be used for inflammatory diseases of the genital organs:

• endometritis after childbirth;
• inflammation in the pelvis and cervix;
• septic abortion performed 3 months before the system was installed;
• infection localized in the lower part of the genitourinary system.

The development of acute inflammatory pathology of the pelvic organs, which is practically not amenable to therapy, is an indication for the removal of the coil. Therefore, internal contraceptives are not installed with a predisposition to infectious diseases (constant change of sexual partners, a strong decrease in immunity, AIDS, etc.). To protect against unwanted pregnancy, Mirena is not suitable for cancer, dysplasia, fibroids of the body and cervix, changes in their anatomical structure.

Since levonorgestrel is cleaved in the liver, the spiral is not installed in a malignant neoplasm of this organ, as well as in cirrhosis and acute hepatitis.

Although the systemic effect of levonorgestrel on the body is insignificant, this progestogen is still contraindicated in all progestogen-dependent cancers, such as breast cancer and other conditions. Also, this hormone is contraindicated in stroke, migraine, severe forms of diabetes, thrombophlebitis, heart attack, arterial hypertension. These diseases are a relative contraindication. In such a situation, the question of using Mirena is decided by the doctor after laboratory diagnostics. The spiral can not be installed if pregnancy is suspected and hypersensitivity to the components of the drug.

Side effects

Common side effects

There are several side effects of Mirena, which occur in almost every tenth woman who has installed a spiral. These include:

• disruption of the central nervous system: irascibility, headache, nervousness, bad mood, decreased sexual desire;
• weight gain and acne;
• gastrointestinal dysfunction: nausea, abdominal pain, vomiting;
• vulvovaginitis, pelvic pain, spotting;
• tension and soreness of the chest;
• back pain, as in osteochondrosis.

All of the above signs are most pronounced in the first months of using Mirena. Then their intensity decreases, and, as a rule, unpleasant symptoms pass without a trace.

Rare side effects

Such side effects are noted in one patient out of a thousand. They are also usually expressed only in the first months after the installation of the IUD. If the intensity of manifestations does not decrease with time, the necessary diagnostics are prescribed. Rare complications include bloating, mood swings, itchy skin, swelling, hirsutism, eczema, baldness, and rashes.

Allergic reactions are very rare side effects. With their development, it is necessary to exclude another source of urticaria, rash, etc.

Instructions for use

Installation of the Mirena coil

The intrauterine system is packed in a sterile vacuum bag, which is opened before insertion of the coil. A previously opened system must be disposed of.

Only a qualified person can install the Mirena contraceptive. Before this, the doctor must conduct an examination and prescribe the necessary examination:

• gynecological and breast examination;
• analysis of a smear from the cervix;
• mammography;
• colposcopy and pelvic examination.

You need to make sure that there is no pregnancy, malignant neoplasms and STIs. If inflammatory diseases are detected, they are treated before Mirena is placed. You should also determine the size, location and shape of the uterus. The correct position of the helix provides a contraceptive effect and protects against system expulsion.

For women of childbearing age, IUDs are inserted in the first days of menstruation. In the absence of contraindications, the system can be installed immediately after the abortion. With normal contraction of the uterus after childbirth, Mirena can be used after 6 weeks. You can replace the coil on any day, regardless of the cycle. To prevent excessive growth of the endometrium, the intrauterine system should be introduced at the end of the menstrual cycle.

Precautionary measures

After installing the IUD, you need to see a gynecologist after 9-12 weeks. Then you can visit the doctor once a year, with the appearance of complaints more often. So far, there are no clinical data proving a predisposition to the development of varicose veins and thrombosis of the veins of the legs when using a spiral. But when signs of these diseases appear, you need to consult a doctor.

The action of levonorgestrel negatively affects glucose tolerance, as a result, patients with diabetes need to systematically monitor blood glucose levels. With the threat of septic endocarditis in women with valvular heart disease, the introduction and removal of the system should be performed with the use of antibacterial agents.

Possible side effects of Mirena

1. Ectopic pregnancy - develops extremely rarely and requires emergency surgical intervention. This complication can be suspected if symptoms of pregnancy occur (long delay in menstruation, dizziness, nausea, etc.) together with severe pain in the lower abdomen and signs of internal bleeding (severe weakness, pale skin, tachycardia). There is a higher probability of “earning” such a complication after suffering severe inflammatory or infectious pathologies of the pelvis or a history of ectopic pregnancy.
2. Penetration (growing into the wall) and perforation (perforation) of the uterus usually develop with the introduction of a spiral. These complications may be accompanied by lactation, recent childbirth, unnatural location of the uterus.
3. Expulsion of the system from the uterus occurs quite often. For its early detection, patients are recommended to check the presence of threads in the vagina after every menstruation. Simply, as a rule, it is during menstruation that the probability of the IUD falling out is high. This process goes unnoticed by the woman. Accordingly, when Mirena is expelled, the contraceptive action ends. In order to avoid misunderstandings, it is recommended to inspect used tampons and pads for loss. Bleeding and pain can be a manifestation of the beginning of the spiral loss in the middle of the cycle. If an incomplete expulsion of an intrauterine hormonal agent has occurred, then the doctor must remove it and install a new one.
4. Inflammatory and infectious diseases of the pelvic organs usually develop in the first month of using the Mirena system. The risk of complications increases with frequent changes in sexual partners. The indication for the removal of the spiral in this case is a recurrent or severe pathology and the absence of a result from the treatment.
5. Amenorrhea develops in many women against the background of the use of the IUD. The complication does not occur immediately, but somewhere in 6 months after the installation of Mirena. When menstruation stops, pregnancy must first be ruled out. After removing the spiral, the menstrual cycle is restored.
6. Approximately 12% of patients develop functional ovarian cysts. Most often, they do not manifest themselves in any way, and only occasionally can there be pain during sex and a feeling of heaviness in the lower abdomen. Enlarged follicles usually return to normal after 2-3 months on their own.

IUD removal

The coil must be removed 5 years after installation. If further the patient does not plan pregnancy, then the manipulation is carried out at the beginning of menstruation. By removing the system in the middle of the cycle, there is a possibility of conception. If desired, you can immediately change one intrauterine contraceptive with a new one. The day of the cycle does not matter. After removing the product, the system should be carefully examined, since if Mirena is difficult to remove, the substance may slip into the uterine cavity. Both insertion and removal of the system may be accompanied by bleeding and pain. Sometimes there is a fainting state or a seizure in patients with epilepsy.

Pregnancy and Mirena

The spiral has a strong contraceptive effect, but not 100%. If pregnancy does develop, then first of all it is necessary to exclude its ectopic form. In a normal pregnancy, the coil is carefully removed or a medical abortion is performed. Not in all cases, it turns out to remove the Mirena system from the uterus, then the likelihood of premature increases. It is also necessary to take into account the likely adverse effects of the hormone on the formation of the fetus.

Application for lactation

Levonorgestrel IUD in a small dosage enters the bloodstream and can be excreted in milk when breastfeeding a baby. The content of the hormone is about 0.1%. Doctors say that at such a concentration it is impossible that such a dose can affect the general condition of the crumbs.

FAQ

The price of Mirena is quite high, and the use of a contraceptive can provoke many side effects. Does the remedy have any positive effect on the female body?

Mirena is often used to restore the state of the endometrium after bilateral removal of the ovaries or with pathological menopause. Also intrauterine device:

• increases the level of hemoglobin;
• performs the prevention of cancer and endometrial hyperplasia;
• reduces the duration and volume of idiopathic bleeding;
• restores iron metabolism in the body;
• reduces pain in algomenorrhea;
• carries out the prevention of fibromyoma and endometriosis of the uterus;
• has a general strengthening effect.

Is Mirena used to treat fibroids?

The spiral stops the growth of the myomatous node. But additional diagnostics and consultation of the gynecologist are necessary. It is necessary to take into account the volume and localization of the nodes, for example, with submucosal fibroid formations that change the shape of the uterus, the installation of the Mirena system is contraindicated.

Is the Mirena intrauterine drug used for endometriosis?

The coil is used to prevent endometriosis because it stops the growth of the endometrium. Recently, the results of studies proving the effectiveness of the treatment of the disease have been presented. But the system provides only a temporary effect and each case must be considered separately.

Six months after the introduction of Mirena, I developed amenorrhea. Is that how it should be? Will I be able to get pregnant in the future?

The absence of menstruation is a natural reaction to the influence of the hormone. It gradually develops in every 5 patients. Take a pregnancy test just in case. If it is negative, then you should not worry, after the removal of the system, menstruation resumes, and you can plan a pregnancy.

After installing the Mirena contraceptive, can there be discharge, pain or uterine bleeding?

Usually these symptoms appear in a mild form, immediately after the introduction of Mirena. Severe bleeding and pain are often indications for coil removal. The cause may be an ectopic pregnancy, improper installation of the system, or expulsion. Urgently address to the gynecologist.

Can Mirena coil affect weight?

Weight gain is one of the side effects of the drug. But you need to consider that it occurs in 1 out of 10 women and, as a rule, this effect is short-lived, after a few months it disappears. It all depends on the individual characteristics of the organism.

I protected myself from unwanted pregnancy with hormonal pills, but often forgot to take them. How can I change the drug to the Mirena coil?

Irregular oral hormone intake cannot completely protect against pregnancy, so it is better to switch to intrauterine contraception. Before that, you need to consult a doctor and pass the necessary tests. It is better to install the system on the 4th-6th day of the menstrual cycle.

When can I get pregnant after taking Mirena?

According to statistics, 80% of women become pregnant, unless of course they want it, in the very first year after the extraction of the spiral. Due to hormonal action, it even slightly increases the level of fertility (fertility).

Where can I buy the Mirena coil? And what is its price?

The IUD is released only by prescription and is sold in a pharmacy. Its price is determined by the manufacturer, and varies from 9 to 13 thousand rubles.