What You Can Expect When Using the Mirena IUD

Insertion of the Mirena IUD

Because of negative stories from other women, many women fear the actual insertion of the IUD. They have heard it is extremely painful, or that it causes heavy bleeding immediately following insertion. While it can be very painful for some women, many sail through the procedure with no trouble at all. Once you have made the decision to have your health care provider insert an IUD as your form of birth control, you will probably have two appointments. During the first, your doctor will give you information regarding the IUD, such as how it will be inserted, the pros and cons, as well as what you can expect following insertion. On your second appointment, the doctor will insert the IUD. Most all women agree that the procedure is much easier if you take Motrin or some other pain medication prior to insertion of the IUD. If you are able to relax your body during the procedure it will likely be less painful, although this can be easier said than done.

During the procedure, the doctor will insert a speculum into your vagina, washing the vagina and cervix area with antiseptic. Another tool will be used to align the cervical canal and uterine cavity. Finally, a third tool will be inserted to measure the uterine cavity's depth. The doctor will next fold the IUD's horizontal arms, and place it inside a special tool designed to insert the IUD. The insertion tube is placed into the cervical canal, and once the tube is removed, the Mirena stays in place. After the Mirena is successfully inserted, the doctor will cut the strings to prevent them from protruding very far into the vagina. He or she may record the actual length of the strings as well. While very occasionally the IUD may perforate the uterine wall or cervix during insertion, this is relatively rare. Besides the pain and cramping, many women experience a slower than normal heart rate during insertion, as well as fainting, dizziness, and low blood pressure. Your doctor will likely have you remain where you are for at least thirty minutes to ensure there are no problems and the IUD is properly inserted. Should you continue to have severe pain or bleeding, the doctor will re-check the IUD.

Following the Procedure

Your doctor will instruct you to check the strings of the Mirena after every period to ensure they are still protruding from your cervix, however you are only checking, not pulling on them. You will likely be asked to return for a follow-up visit from four to six weeks following the initial insertion of Mirena so your physician can re-examine you and make sure the IUD has not moved. He will also check for signs of pelvic inflammatory disease as something like that could cause tubal damage or infertility.

What if Mirena Moves or Dislodges?

If you believe the Mirena has moved or is no longer in place, contact your doctor immediately. If having sex with your partner is suddenly painful, the Mirena may be partially or completely expelled. If the strings are suddenly longer than normal, or you cannot locate the strings at all, it's very possible the IUD has moved or dislodged completely. If you can feel the hard plastic in your vagina, then the Mirena is not where it should be. If your periods suddenly return to the "normal" they were prior to the insertion of Mirena, then it may have become dislodged. Your doctor will check the location, removing it if necessary. The doctor may be able to remove the IUD by hand, or may need a thin tube equipped with camera lens and light to remove it. If the doctor can neither see nor feel the Mirena, he may send you for an ultrasound and X-ray to ensure the Mirena is not in the pelvis or abdomen, and will require a pregnancy test prior to reinserting another IUD.