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   Mirena – Summary


  1. Mirena is one of the best contraceptives available.

  2. It’s also a good choice to reduce heavy periods.

  3. Mirena can often be placed in the office with or without using local anaesthesia or Green Whistle Analgesic.

  4. It lasts at least 5 years.

  5. 3-6 months of “settling in” with spotting is common.

  6. Significant complications are rare.

  7. Overall 80% satisfaction rates with Mirena.

  Mirena – What is it?

Mirena is a soft, flexible plastic device that releases tiny amounts of hormone only locally into your womb. Most of the time, placing a Mirena is a straightforward procedure for your gynaecologist. Some women benefit from a local anaesthetic in the cervix or breathing on a Green Whistle analgesic.


A Mirena gives you birth control you can count on, for up to 5 years and even beyond. Mirena is more than 99% effective at preventing pregnancy and as effective as a tubal ligation. You can try to become pregnant as soon as it is removed, as your body return to normal fertility the quickest of all the contraception options.

 Heavy, painful periods

A Mirena is also highly effective at treating heavy painful periods with a good satisfaction rate in women who choose it. It does take a few months to work, and during that time you will likely have some irregular spotting.

 Pelvic pain

Mirena is increasingly being used for pelvic pain, especially in women with endometriosis or adenomyosis. The device either treats these conditions or to prevents them generally. It can also be used after surgery for endometriosis to prevent it’s return.

 Hormone Replacement Therapy (HRT)

Mirena is used as one of the components in HRT in menopausal women who haven’t had a hysterectomy. Using an oestrogen patch with a Mirena is very safe HRT and has important benefits.


 Having a Mirena placed

The Mirena is usually inserted by Dr Swanepoel during an office visit.

After written consent is given, Ami will perform a urine test to exclude pregnancy.

Dr Swanepoel will perform a trans-vaginal ultrasound to asses your uterus position

and to exclude any pathology. The majority of patients elect to place the Mirena

"in the chair" without any anaesthetic and most patients tolerate placement well

and compare it to period pains.

We have lots of experience at placing them. You do not need to have had a baby

before, and it is suitable for all age groups. If you are concern about discomfort or pain, we can use a local anaesthetic injection into your cervix, that helps a bit, or you can elect to try the Green Whistle analgesic inhaler.

Alternatively, you could have a quick general anaesthetic in Hospital.

The choice is yours. Slight cramps are common afterwards but usually settle very quickly with a few minutes rest. Bleeding can occur after the fitting – this is usually very mild and settles quickly.

We recommend ibuprofen 400mg (2 tablets) an hour before your appointment (as long as you’re OK with this medicine) to prevent cramps.


 After your Mirena placement

There may be some mild cramping pain for an hour or two, or occasionally a day or two after placement. This settles with some ibuprofen or similar. We like you to rest in our  offices for 15 minutes after placement, and if all is OK (highly likely) you’ll be able to drive home without a problem. You can go back to work if all is well if you wish.

Some patients can experience a transient dizziness or fainting (a vaso-vagal attack) and it is usually in patients that had similar experiences when donating blood or getting blood test done. A short rest period with your feet up and head down is usually all that is required to recover.

If you’re using the Mirena for contraception, you should continue your current method until you have a period.

Your period may be less predictable than usual for a few months, especially if the Mirena is not fitted during or just after your period. Irregular bleeding and spotting may increase in the first few months and continue to be irregular. Periods over time may become shorter, lighter or even stop. Your periods may stop altogether for as long as you have a Mirena. This is not a problem – there is nothing building up inside. Your periods will return once the Mirena is removed.


Important information

Mirena is not used if you have a pelvic infection, or have certain cancers. It is very rare to get a serious infection after insertion called pelvic inflammatory disease.

If you have persistent pelvic or abdominal pain, or notice a foul smelling vaginal discharge after a Mirena has been placed, call us or see your GP.

Perforation of the uterus during placement is possible but very rare. By performing an ultrasound pre and post placement this complication has not been seen in our practice.

Mirena can be expelled. Use back-up birth control if this happens, if you have the Mirena in for contraception.

Ovarian cysts can still form and ovulation continue unhindered with the Mirena in situ.

Irregular bleeding and spotting may occur in the first few months. Periods over time may become shorter, lighter or even stop. Nothing is building up inside – this is a benefit of the Mirena.

Hormonal side effects, if they do occur, most often are mild and only last up to 4-6 weeks. Side effects include headache, water retention, breast tenderness or acne.


Mirena is 99.8% effective as a contraceptive

Green Whistle Analgesic

Green Whistle Analgesic Inhaler

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