Mirena® is an intrauterine contraceptive (IUC) used to provide long-term birth control. It is a small, flexible polyethylene (plastic) device that contains levonorgestrel, a progesterone hormone. It is designed for women who have had at least one child, who desire long-term birth control, and who are in a mutually monogamous relationship (neither you nor your partner currently have other sexual partners).
(Click Mirena Uses for more information on what Mirena is used for, including possible off-label uses.)
Mirena is made by Bayer HealthCare Pharmaceuticals, Inc.
There are two types of intrauterine contraceptives (IUC), non-hormonal copper devices (known as intrauterine devices, or IUDs) and hormonal devices (known as intrauterine systems, or IUSs). Mirena is an IUS, meaning that it contains a hormone and relies on the hormone for preventing pregnancy. Your healthcare provider inserts the device into the uterus, where it can remain for up to five years.
Mirena slowly releases a low level of levonorgestrel (a progesterone hormone). In some women (less than half), Mirena works by stopping ovulation (the maturation and release of eggs from the ovaries). However, for most women, Mirena works in other ways (and ovulation continues as usual). In these women, Mirena alters the cervical mucus (the fluid of the cervix, which is the lower, narrow part of the uterus that is connected to the vagina), making it more difficult for sperm to enter the uterus. Mirena also decreases the ability of sperm to survive in the uterus. Lastly, Mirena alters the lining of the uterus (called the endometrium), making it less receptive to an embryo.
When and How to Use Mirena
Some general considerations for when and how to use Mirena include the following:
- Your healthcare provider will carefully insert Mirena into the uterus within seven days after your period starts (or immediately after a first trimester abortion or miscarriage).
- Mirena is inserted using a small tube (known as a catheter). Once Mirena is in place, the catheter is removed. Some women have cramps and dizziness while Mirena is being inserted.
- Although Mirena can be left in place for up to five years, your healthcare provider can remove it any time before that. After five years (if you still want to use Mirena), your healthcare provider can remove the old Mirena and replace it with a new one.
- You will not feel the device in your body (it will be placed safely in your uterus). However, you will be able to feel the removal threads at your cervix (the top of your vagina). Don't pull on the threads, as this could displace the device.
- After each menstrual period, it is a good idea to make sure Mirena is still in place. After washing your hands, feel to make sure the threads are still there. Make sure you don't feel any other part of the device. If you can't feel the threads (or if you feel other parts of the device), let your healthcare provider know right away and use a backup method of birth control (such as condoms) until your healthcare provider gives you further instructions.
Mirena Dosing Information
There is only one standard Mirena dose, regardless of age, weight, or medical conditions. As always, do not adjust your dose unless your healthcare provider specifically instructs you to do so.
Side effects are possible with Mirena. However, not every woman who uses the contraceptive will experience side effects. In fact, most women tolerate it quite well. If side effects do occur, in most cases, they are minor and either require no treatment or are easily treated by you or your healthcare provider. Serious side effects are less common.
Common side effects of Mirena include, but are not limited to:
(Click Mirena Side Effects to learn more, including potentially serious side effects that you should report immediately to your healthcare provider.)
Drug Interactions With Mirena
Mirena: What Should I Tell My Healthcare Provider?
You should talk with your healthcare provider prior to using Mirena if you have:
- A history of pelvic inflammatory disease (PID)
- Had a serious pelvic infection
- More than one current sexual partner (or if your partner has more than one sexual partner)
- A weakened immune system due to HIV or AIDS, cancer, or IV drug abuse
- Uterine cancer or cervical cancer
- Unexplained vaginal bleeding
- Liver disease, such as liver failure, cirrhosis, hepatitis, or liver tumors
- Breast cancer (or a history of breast cancer)
- Had an ectopic pregnancy (a "tubal" pregnancy) or are at high risk for an ectopic pregnancy
- An intrauterine device (IUD) still in place
- An abnormally shaped uterus or uterine fibroids
- Diabetes
- Had a blood clot or a clotting disorder
- Heart disease or problems with your heart valves
- Any allergies, including allergies to medications, foods, dyes, or preservatives.
Also, let your healthcare provider know if you:
Make sure to tell your healthcare provider about any other medications you are taking, including prescription and non-prescription medicines, vitamins, and herbal supplements.
Is There a Generic Version of Mirena?
Currently, there is no generic version of Mirena licensed for sale
(see Generic Mirena).
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