Modern methods contraception allows a woman to prevent the onset of an unplanned pregnancy and thereby avoid problems associated with it. From the variety of modern contraceptives, the Mirena intrauterine hormonal coil can be distinguished. In addition to its main purpose, the Mirena spiral can be prescribed as a treatment for some diseases of the female genital area.
The Mirena intrauterine device has the form of a T-shaped frame, from which (after its introduction into the uterine cavity) a certain amount of the hormone levonorgestrel, the main component of any new generation contraceptive, enters the woman's blood every day. This tool intrauterine contraception has a predominantly local effect. The Mirena spiral is put on for five years, after which it is replaced with a new one.
Mechanism of action.
The principle of operation of the hormonal coil is similar to the action of combined oral contraceptives, hormonal implants and contraceptive injections. The action is aimed at blocking the ovulation process (the release of the egg from the ovary) and delaying the development of the uterine mucosa, thereby making it difficult to implant the ovum.
The effectiveness of the method.
Spiral Mirena - reliable and effective remedy protection against unwanted pregnancy, with a long period of use. For every thousand women who started using this hormonal coil, there are only two cases of unplanned pregnancy during the first year.
Fertility is restored literally immediately after the coil is removed. Very rarely, the opportunity to become pregnant is restored in women in a longer period after the cancellation of the use of the drug (within three to six months).
It should be noted that, like any other means of hormonal contraception, the Mirena spiral is not able to protect a woman from sexually transmitted diseases (STDs).
Side effects.
Usually side effects hormonal spiral Mirena appear in the first months after its implementation. Gradually they all disappear and do not require complementary treatment... Most often, after starting to use it, women notice the following side effects:
- a reduction in the duration of menstrual bleeding (it may not be at all), as well as a decrease in its intensity;
- the occurrence of acne;
- headaches;
- nausea;
- increase in body weight;
- dizziness;
- frequent mood swings;
- ovarian cysts;
- increased sensitivity of the mammary glands.
The impact of the intrauterine system on a woman's health.
Spiral Mirena is excellent remedy prevention of diseases of the small pelvis, wearing inflammatory nature, iron deficiency anemia, in addition, its use significantly reduces the risk of developing endometriosis, relieves painful menstruation (algomenorrhea), and can also reduce the size of myomatous nodes.
The cost of the Mirena hormonal coil varies between nine and eleven thousand rubles, depending on the region. Compared to birth control pills, on which monthly (within five years) will have to spend an average of seven hundred to a thousand rubles, then its use is more profitable from an economic point of view.
Contraindications.
In the presence of severe diseases, chronic infections or malignant neoplasms, the use of the Mirena intrauterine device should be agreed with specialists.
Other contraindications to the use of this method of contraception are:
- hypersensitivity to the components of the drug;
- the presence in the past of deep vein thrombosis of the lower extremities;
- malignant neoplasms of the uterus or cervix;
- previous treatment for breast cancer;
- diseases that occur with increased susceptibility to infections;
- the presence of diseases of the pelvic organs of an inflammatory nature;
- anomalies of the uterus (congenital and acquired);
- pregnancy or suspicion of it;
- the presence of urinary tract infections;
- postpartum endometritis;
- dysplasia of the cervix;
- a septic abortion within the last three months (a serious uterine infection during or shortly before or after an abortion);
- uterine bleeding of unknown cause;
- cervicitis;
- acute liver disease (severe cirrhosis, jaundice, hepatitis) and liver tumors.
The installation of intrauterine devices should only be experienced doctor, which has repeatedly carried out this procedure... For women of childbearing age, the Mirena spiral as a means of contraception is introduced into the uterine cavity no later than seven days from the beginning menstrual cycle... The introduction of the contraceptive at a later date is carried out only after confirmation that the woman is not in position, while during the week she is recommended to additionally use barrier methods of contraception (condom). After the expiration of the term of use, the spiral can be replaced with another one on any day of the cycle.
The installation of the intrauterine device after childbirth is carried out no earlier than six weeks later, this is how much time is required for the involution of the uterus. If there is a decrease in the rate of contraction of the uterus after childbirth or subinvolution, it is necessary to exclude the development of postpartum endometritis and postpone the introduction of the spiral until the complete recovery of the uterus.
It is recommended to install the spiral into the uterine cavity after an artificial or spontaneous abortion in the first and second trimester after seven days, if there are no signs of infection.
If the installation of an intrauterine device is difficult, or there is very severe pain or bleeding during or after the procedure, then in in this case necessary physical and ultrasound procedure in order to exclude perforation (mechanical damage) of the uterus.
Removal of Mirena.
The specialist removes the intrauterine device from the uterine cavity (after the expiration date) on any day of menstruation (provided regular cycle) by grabbing the threads with forceps and pulling gently. If further contraception is necessary, a new spiral is placed on the woman on the same day, and there is no need to use additional contraceptives. If the spiral is not removed during menstruation, then a week before this procedure, the woman should use additional funds contraception. In the case of amenorrhea, a woman should use barrier contraception a week before removing the intrauterine device and before the onset of menstruation.
After removal of the Mirena intrauterine system, the doctor must make sure of its integrity, because if difficulties arise during its extraction, there have been cases of the hormonal-elastomeric core slipping onto the horizontal shoulders of the T-shaped body, as a result of which they "sank" inside the core. After confirming the integrity of the spiral, additional examinations and interventions are not required. The restraints located on the horizontal arms, as a rule, prevent the complete separation of the core from the T-shaped body.
To date, it has been scientifically proven that it is possible to safely use two or more intrauterine systems in a row.
Use of Mirena during pregnancy and lactation.
Hormonal contraceptives, including the Mirena intrauterine device, should not be used during pregnancy or if it is suspected. If pregnancy occurs during the use of the intrauterine system (which is possible when the sirali falls out), then the system should be removed, since it significantly increases the risk of spontaneous abortion and premature birth.
Careless removal of the coil or probing of the uterus can also provoke a spontaneous abortion. If it is not possible to remove the contraceptive carefully, the question arises about the advisability of artificial termination of pregnancy. If a woman does not want to have an abortion in this case, she is informed about the risks and likely consequences of premature birth for the child. In the future, such a pregnancy will need to be closely monitored. Also, the patient will need to be sure to inform the doctors in case of symptoms that may complicate the pregnancy (including colic-like abdominal pain, combined with fever).
It is believed that the use of Mirena, six weeks after childbirth, does not affect the growth and development of the baby. Monotherapy with gestagens does not affect the quality and quantity of breast milk.
Complications.
The use of this intrauterine contraceptive very rarely leads to problems and complications. If any unusual symptoms it is important to see a doctor right away to avoid further complications.
When using the Mirena hormonal coil, complications may occur in the form of prolapse of the intrauterine system, perforation of the uterus, infection, ectopic pregnancy.
Prolapse (expulsion).
The spiral can partially or completely fall out of the uterine cavity. The risk of this phenomenon is very high in nulliparous womenusing this method of contraception during the first few months of use. However, there are cases of rejection of the system and for more late date application. In order to notice the loss in time, it is necessary to check them every menstruation when changing pads or tampons.
If you notice a loss, you must additionally use a condom and immediately contact your gynecologist. In the event of a partial prolapse, the intrauterine system is completely removed.
Perforation.
It is very rare, but still there are cases when the spiral pierces the wall of the uterus during the introduction. Usually this fact is identified immediately and corrected. If this was not noticed, the spiral can fall into other parts of the pelvis and damage internal organs... In this case, surgical intervention is required to remove it.
Infection.
The use of intrauterine contraceptives is accompanied by some risk of infection of the pelvic organs, but the risk of this is significantly reduced twenty days after its introduction into the uterine cavity. Infections pelvic organs can be triggered by bacteria that enter the uterus during the installation of the spiral. Infection usually develops within three weeks after insertion. If infection is observed after the specified time, then infection is more likely to occur through contact with a sick partner.
Scientific studies have proven that the Mirena spiral does not contribute to the development of the pelvic organs or infertility.
The issue of contraception is relevant for every woman of childbearing age. There are many effective ways avoid unwanted pregnancy, especially popular among which are intrauterine contraceptives. When a spiral is put, before or after menstruation - many girls turn to doctors with this question.
Intrauterine contraceptives have been in use since the mid-1920s. Then they were a ring made of an alloy of brass and bronze, to which a small amount of copper was added. In 1960, more safe remedymade of elastic material.
Modern spirals have different shape, some of them contain hormonal drugs... The contraceptive effect is achieved by releasing a small amount of them into the cavity of the genital organ. In addition, the coil has a mechanical effect on the inner lining of the uterus, preventing the attachment of the egg after fertilization.
The spiral significantly complicates the advancement of male germ cells and weakens them, which prevents pregnancy.
During this time, the cervix is \u200b\u200bslightly open so that the procedure for introducing a contraceptive is the least traumatic and easy to carry out. The onset of menstruation is one of the signs that a woman has excluded pregnancy, so it is at such a time that it is preferable to install a spiral.
Before installing the intrauterine device, an examination should be scheduled to exclude the presence of infections and pathologies associated with the reproductive organs. The standard list of diagnostic procedures looks like this:
- cervical and vaginal smears;
- tests for syphilis, hepatitis and HIV;
- general urine analysis;
- tests that detect genital infections;
- ultrasound examination of the uterus.
Ultrasound is prescribed not only to make sure that the woman has no changes that prevent the use of an intrauterine contraceptive. Its purpose is also to make sure that the woman is not pregnant when the coil is installed. To do this, you will have to do a test that determines the level of hCG.
The installation procedure is carried out exclusively in a gynecological office under sterile conditions. The woman sits in a chair with her feet on the holders. Before the introduction of the spiral, the doctor processes disinfectant cervix and vagina. Additionally, local anesthesia is performed. Usually, a special gel is used for anesthesia, sometimes injections. 
Only after that, the doctor, with the help of special tools, opens the cervix, measures the depth, and then introduces the contraceptive into the uterine cavity. The doctor brings the so-called "antennae" up to 2 cm long out into the vagina. This is done so that the spiral can be removed. During the hygiene procedures a woman should check from time to time whether these "antennae" are in place.
The installation procedure is practically painless. Only sometimes do women feel pain that goes away quickly. Some ladies have bouts of dizziness and fainting. But this is an extremely rare occurrence that disappears after a few minutes.
With a spiral, you can have sex after a few days. In the first month while the immune system does not adapt to the presence of a foreign body, it is better for a woman to refrain from visiting a bath, a swimming pool. Strong physical exertion should also be avoided.
Contraindications to the installation of an IUD
Intrauterine device - comfortable and relatively inexpensive remedy contraception. But like many medical drugs, it has contraindications in which it is impossible to use it to prevent unwanted pregnancy. The main ones are listed below:
- dysplasia of the cervix;
- malignant and benign neoplasms in the reproductive organs;
- a woman's previous ectopic pregnancy;
- severe trauma to the cervix during childbirth;
- blood diseases.
For girls who have never given birth, doctors usually do not recommend a spiral. They are individually selected for other contraceptives.
Spiral after childbirth or abortion
After the appearance of the baby, women try to take a "pause" before planning new pregnancy... And this is understandable - the body needs to get stronger after pregnancy and childbirth, and the family needs to get used to the new rules and routine.
It is believed that in the first months, while there are no periods and a young mother is breastfeeding, she cannot get pregnant. However, this is not so, and very often a woman learns that a man has again settled in her womb, when all the signs of pregnancy have become apparent. 
That is why it is very important for women who have recently given birth to properly protect themselves. And the optimal choice during this period is Mirena or another spiral.
You can install it when the uterus acquires normal sizes... This occurs approximately 6-12 weeks after the birth of the baby, although it is also practiced to install the coil immediately after natural childbirth... In the event that the delivery took place by caesarean section, the intrauterine device can be installed after 6 months.
According to many medical practitioners, with which US researchers also agree, positive results gives the introduction of a spiral into the uterus immediately after an abortion, regardless of whether it was caused by natural causes (miscarriage) or performed by surgery.
If the contraceptive is injected into the uterus 15-20 minutes after surgery, this minimizes the possibility of an unwanted pregnancy. In addition, there is no need to reuse anesthetics and dilate the cervix.
Advantages and disadvantages of an intrauterine device
The spiral is considered a reliable method of protection: its efficiency reaches 95%. Many women mark as positive factor the fact that one and the same spiral can live up to 5 years, and in some cases even longer. This saves time and money that would have to be spent on purchasing other contraceptives. In addition, intrauterine devices have other advantages:
- you do not need to strictly follow the schedule of taking, unlike contraceptive pills;
- allowed for use by women who breastfeed;
- after removal from the uterus, you can quickly become pregnant.
Hormone-containing spirals, for example, Mirena, not only prevent pregnancy, but also have an anti-inflammatory effect on reproductive organs, prevent endometriosis. In addition, after the installation of the Mirena spiral, menstruation becomes practically painless and less prolonged. 
With all positive aspects using a spiral can sometimes have negative consequences. First of all, this is a restriction that applies to nulliparous girls. It is due to the fact that they have a small uterine cavity, as well as too narrow. This makes the placement of the contraceptive more complicated and painful. IN rare cases it ends with perforation of the genital wall.
The spiral is suitable for women who have a long-term sexual partner, as the risk increases infectious diseases, especially in the first month after the installation of the contraceptive. A foreign body inside the uterus contributes to rapid spread infections. In case of untimely treatment, infertility becomes a consequence of inflammation.
IUD use is associated with regular visits gynecologist. First in order to install it, and then preferably every six months. In addition, a woman has to independently control the antennae, the ends of which are in the vagina. This is to make sure the spiral does not fall out. To remove the contraceptive, you will have to go to the doctor again.
Is it possible to remove the IUD myself
Some women are interested in whether it is possible to remove a spiral without menstruation or on their own? Experts categorically do not recommend conducting experiments at home. To do this, you need to contact a gynecologist. The extraction procedure should be carried out when menstruation has come (in the first days) under sterile conditions.
With self-removal of the spiral, there is a high risk of damaging the genital mucosa and causing an infection.
Removing the IUD by a gynecologist is practically painless procedure if there are no inflammatory processes. In front of her, the doctor examines. If the spiral is intact, then pulls it out by pulling the antennae. If there are no threads in the vagina or the contraceptive has collapsed, microsurgical intervention is used - hysteroscopy.
After removing the spiral from the uterus, the doctor takes a smear from it, which is sent to the laboratory for cytological examination... This procedure is followed in most cases, but it is not required. 
IUD types
If there are no contraindications, then, after consulting with your doctor, almost every woman can pick up a spiral. Among the devices available on the market today are those that are shaped like an umbrella or a spiral, an egg and a ring. The materials from which they are made are also different.
Taking into account the peculiarities of the location and structure of the uterus, the doctor will recommend a woman certain type spirals. First-generation S-shaped contraceptives made of polyethylene are practically not used anymore. This is due to their low efficiency and frequent cases of arbitrary prolapse from the uterus.
The relatively inexpensive modern copper-based IUDs are highly effective. They oxidize the environment in the uterus, so the sperm, getting into it, become less active. Since copper is released quickly, such a coil is replaced every 3-5 years.
There are not only copper spirals, but also those that contain silver, platinum and gold. Particularly effective are medicated intrauterine systems containing levonorgesterol or progesterone in the leg. A small dose of the hormone is released into the uterus every day.
The most popular among such spirals are Mirena, Levonova and others. They improve the condition of the endometrium and fallopian tubes, provide positive influenceif the period is too profuse and painful. The disadvantages include the appearance of intermenstrual discharge. You can install a Mirena spiral or another containing a hormone for up to 5 years.
The choice of a contraceptive should be done with a doctor. He, focusing on whether menstruation is regular, evaluating the condition of the genitals, will determine which type of spiral will be optimal.
Good day!
Due to the myomatous nodes formed during pregnancy, the gynecologist recommended installing the Mirena intrauterine hormonal system. We got it in Ukraine. The discounted price was UAH 2365.50.
The packaging was sealed tightly to keep the contents sterile.
You won't even be able to read the instructions until you open the box.
Initially, I wanted to attach instructions to the review, but after seeing its scale, I realized that it was pointless. You can see for yourself:
Installation.
It took : Mirena spiral, gynecological examination set with mirror.
I was seated on a chair, installed a mirror, blotted excess bleeding with cotton swabs, disinfected alcohol solution, opened the cervical canal with long forceps, set the spiral, cut off the excess part of the thread and removed the mirror. All! It took no more than 5 minutes. But if you take into account the time when they went to get sterile forceps and scissors, filled out the map, etc. Then everything lasted 20-25 minutes.
As such, there was no pain. It was a little scorching with alcohol, and it was unpleasant when opening the cervical canal with forceps (but this is because I could not relax in any way).
It was a little scary to go to the toilet for the first time. But inside myself I feel absolutely nothing foreign.
Don't have sex for 10 days;
Do not lift weights, including a child, for at least 10 days (later it turned out that it is better not to lift anything at all ...);
Do not swim in the bath for 10 days;
After 10 days, come for an inspection to check the correct installation.
Feelings after installing Mirena.
Self-hypnosis is a terrible thing! I constantly thought about the possible displacement of the spiral, it constantly seemed to me that I could feel it touching the walls ... until I was distracted. My daughter got sick and there was no time for that. By chance, I remembered the intrauterine system (the child cannot be lifted). Then I realized that while I don't think about a foreign body, I don't feel it. At all.
I also noticed that a day after the installation, the pigmentation on the nipples increased slightly, they became darker and stretched out like after feeding a child (although I turned my guards more than 4 months ago). Then it passed.
The bloody discharge at the time of installation was very profuse. Immediately after the procedure, they became scarce.
Throughout all 10 days, scanty smears bloody issues continued.
Re-examination after 10 days.
This was a routine examination with a gynecological speculum. The doctor checked the presence of threads and the location of the coil itself, asked about the sensations and discomfort. I had no complaints, so the next examination is scheduled in three months.
The discharge did not stop. The instructions indicate that the norm is up to three months. I also want to note that spotting does not constantly go, but periodically throughout the day. Two or three drops of pads are enough.
After 22 days from the beginning of the cycle, the discharge intensified and acquired a more familiar color for menstrual periods. This continued for five days, then the intensity decreased again. I don't know what it was. Maybe my period is going like this now, maybe something else. It will be seen further.
First sex after installing Mirena.
Naturally, no one was going to wait for three months. Therefore, we decided to test the system on the 13th day. Nobody felt any foreign body. So you shouldn't worry about this. But it is better to underlay the diaper ...
Impressions and observations after the installation of the Mirena spiral.
Now let's talk about the specific cons for me, for which I was not ready. This is a ban on weight lifting. Complete ban. And how is it even possible, having one year old child??? And someone has two children ... As I was told, with muscle tension, the system can be pushed out of the uterus. Great! Nothing to say...
Of course, the first week I was completely replaced by my husband (motion sickness, bathing the child, walking, shopping, throwing out garbage, etc.), but then I had to distribute responsibilities. After all, he needs to go to work sometime ... after a month I have already entered my usual routine. Of course, I try not to lift the winter stroller with my child, but otherwise everything is the same.
Also sexual attraction disappeared altogether. After giving birth, I’ve already got used to the fact that “the appetite comes with eating,” but then something is generally hard to sway ... Well, okay, there will be another reason to somehow diversify the sex life.
It's too early to talk about the weight, only half a month has passed. Appetite has not increased, but soon new year holidays, birthday ... I will try to control myself.
A month later and New Year's holidays - minus a pound. This makes me happy!))))
!!! UPDATE (04/16/2018)
Days 10 were scanty spotting. For a week there was no discharge at all. Then they began again: two days, barely noticeable, smearing, 9 moderate days, typical for menstruation, and again slightly smearing, residual.
In total, the periodic discharge took about 70 days.
After 3 months.
For two days there was a barely noticeable daub. After 10 days, bloody discharge began, which lasted a little over a week. At this time, I was doing ultrasound. It turned out that it was already the middle of the cycle, and those two days earlier were monthly ...
The next menstrual period began on a day-to-day schedule. Discharge lasted 5 days. Not profuse, not painful (although there were tingling sensations in the area of \u200b\u200bthe "active" ovary, but quickly passed). Pulling pains there was no more cycle on the first day. I'll save on spazmalgon))).
The myoma has noticeably decreased (almost by half), and the forming node has generally resolved. The gynecologist said that while it was necessary to spend money on pads, and when the fibroid disappeared, the spiral could be removed.
Attraction returned a month and a half after installation.
Spiral FEELS partner in some positions. I don’t know how, but we have it. Unpleasant sensations it does not deliver, according to her husband. And, to be completely frank, the male genital organ feels movement along some foreign tube. P.S .: only the first months are felt)))
The weight is in place. I’m thinking of losing weight by summer… someone)).
9 months later !!!
The fourth month after installing the coil was perfect! The cycle was clear, the discharge lasted 6 days (as before the spiral), painful sensations did not have.
BUT! Before starting the next cycle chest pain appeared, the mammary gland has noticeably increased and a painful nodule appeared on the left... I started googling (not destined to go to the doctor right away). According to the description, it looked like a cyst and it was said that there was nothing terrible, they themselves dissolve after the release of the egg, there was not a word about their connection with Mirena).
I'm waiting for the next cycle .. A few days earlier, the discharge began, 10 days passed. The soreness in the chest was gone, but the lump remained. I called the gynecologist. She said that prolactin increased, it happens after childbirth. Drink the Mastodinon.
I bought Mastodinon, but decided to wait until the start of the next cycle to get tested for prolactin levels. I waited ... I waited ... I waited ... But there was no period ... I started buying all the pregnancy tests that I came across in stores - everything was negative.
The next step is pelvic ultrasound. Result - OVARIAN CYST... I'm shocked. For some reason, I decided that the hormonal coil would protect against such formations ... Where I got this from - I don't know. I started googling again ... turn off someone's internet! There is no mention of that intrauterine device Mirena causes the formation of cysts in the ovaries, I have not found.
The results of tests for progesterone showed a good level of the hormone, TSH is also normal.
I went to the gynecologist. She canceled Mastodinon (which I never started taking) and prescribed Distreptase suppositories (for resorption of cysts), Amelotex suppositories (analgesic and anti-inflammatory) and Tazalok drops (to normalize hormonal levels). After the first menstruation, make a control ultrasound.
A month and a half passed. The cycle never started. Again, very painful lumps appeared in BOTH breasts... I - again to the gynecologist. She sent for ultrasound of the pelvis and mammary glands.
It's summer now, vacation season. I found a mammologist in the regional oncology, and there I decided to do an ultrasound scan. And ... not in vain. Painful lumps in the chest is overgrowth of glandular tissue, it is treated with the same Tazalok at long-term use... But they accidentally found a painless lump in the left breast, made a puncture and - TUMOR!
Conclusion: A proliferative form of mastopathy with foci of pronounced proliferation of the epithelium and stroma of the mammary gland.
Surgery soon ... And treatment.
Pelvic ultrasound was done in private clinic... The cyst did not disappear after the treatment, new ones also did not form. There the doctor told me that the Mirena intrauterine device very often leads to the formation of cysts in the ovaries! This is due to the fact that the progesterone hormone contained in it is released in a large number and predominates over estrogen. The brain perceives this signal as if ovulation has already occurred and does not give the command to release an egg from the ovary. It remains there and grows into a cyst. Usually, these cysts are small in size and dissolve themselves, and later reappear. It's not scary, but you have to watch. that is why menstruation may not go with the Mirena spiral at all.
Regarding the main reason why I installed the spiral - UTERINE MYOMA:
- A small (9.0x0.8 mm) incipient subserous-interstitial myomatous node disappeared.
- A large (30, x25.0 mm) subserous-interstitial myomatous node decreased in 9 months to 21, x19.0 mm, the walls thickened and it is considered "old", not dangerous for the body.
Thus, the spiral fulfills its main task. But according to the result - one heals, the other cripples!
I won't extract it yet, I'll see if Tazalok will help normalize hormonal levels. For my age, such a reaction to Mirena is rare. But I want you to be also aware of the possible consequences.
That's all for me. The post will be supplemented with the passage of time of use. Bookmark so you don't get lost 😉
The most popular intrauterine device hormonal contraceptive is the Mirena spiral (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: no systemic effects on the female body, high efficiency, ease of use.
The spiral does not affect the quality sexual contact, is established 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 refuse this type of contraception.
In the 1960s, copper-containing intrauterine systems were developed. 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 IUD was developed. These medical systems combine the best qualities oral contraceptives and IUD.
Description of the Mirena intrauterine device
Mirena has T-shape, which helps to securely fix in the uterus. One of the edges is equipped with a loop of threads for removing 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 coil is levonorgestrel (gestagen). One system contains 52 mg of this substance. An additional component is a polydimethylsiloxane elastomer. The Mirena Navy is located inside the tube. The spiral has an individual vacuum plastic-paper packaging. It should be stored in a dark place at a temperature of 15-30 C. Shelf life from the date of manufacture is 3 years.
Mirena's action on the body
The Mirena contraceptive system begins to "release" levonorgestrel into the uterus immediately after installation. The hormone is released into the cavity at a rate of 20 μg / day, after 5 years this figure drops to 10 μg per day. The spiral has a local effect, almost all 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 micro doses.
After the introduction of the spiral, the active ingredient enters the bloodstream after about an hour. There him highest concentration achieved after 2 weeks. This indicator can vary significantly depending on the woman's body weight. With a weight of up to 54 kg, the level of levonorgestrel in the blood is about 1.5 times higher. Active substance almost completely broken down in the liver and evacuated by the intestines and kidneys.
The principle of action of Mirena
The contraceptive effect of Mirena does not depend on a weak local reaction to foreign bodybut is mainly associated with levonorgestrel exposure. The introduction of a fertilized egg is not carried out due to muffling of 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 hinders the mobility of sperm in the uterus and its tubes. The contraceptive effect of the drug increases the high viscosity of cervical mucus and thickening of the mucous layer of the cervical canal, which complicates the penetration of sperm into the uterine cavity.
After the installation of the system, for several months, there is a restructuring of the endometrium, manifested by irregular spotting. But after a long 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 strong menstrual bleeding for an unclear reason. The probability of malignant neoplasms of the female reproductive system is preliminarily excluded. As a local progestogenic agent, 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
Spiral Mirena refers to internal contraceptives, therefore, it cannot be used for inflammatory diseases of the genital organs:
- endometritis after childbirth;
- inflammation in the small pelvis and cervix;
- septic abortion performed 3 months before the installation of the system;
- an infection located in the lower part of the genitourinary system.
Development of acute inflammatory pathology organs of the pelvis, which is practically not amenable to therapy, is an indication for the removal of the spiral. Therefore, internal contraceptives are not established 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 broken down in the liver, the spiral is not installed in malignant neoplasms of this organ, as well as in cirrhosis and acute hepatitis.
Although the systemic effect of levonorgestrel on the body is insignificant, nevertheless, this gestagenic substance is contraindicated in all gestagen-dependent cancers, for example, breast cancer and other conditions. Also, this hormone is contraindicated in stroke, migraine, severe forms diabetes mellitus, thrombophlebitis, heart attack, arterial hypertension... These diseases are relative contraindication... In such a situation, the question of using Mirena is decided by the doctor after laboratory diagnostics... The spiral should not be installed if pregnancy is suspected and hypersensitivity to the drug components.
Side effects
Frequent side effects
There are several side effects Mirens, which are found in almost every tenth woman who installed a spiral. These include:
- disorder of the central nervous system: irascibility, headache, nervousness, bad mood, decreased sex drive;
- weight gain and the appearance of acne;
- dysfunction of the gastrointestinal tract: nausea, pain in the abdomen, vomiting;
- vulvovaginitis, pain in the small pelvis, spotting;
- chest tension and soreness;
- back pain, as in osteochondrosis.
All of the above signs are most pronounced in the first months of using the Mirena drug. 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 in 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 over time, necessary diagnostics... Rare complications include bloating, frequent mood swings, itchy skin, the appearance of edema, hirsutism, eczema, baldness and rash.
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 spiral
The intrauterine system is packed in a sterile vacuum bag, which is opened before installing the spiral. A system that has been opened beforehand must be disposed of.
Only a qualified gynecologist can install the Mirena contraceptive. Before this, the doctor must conduct an examination and prescribe the necessary examination:
- gynecological examination and breast examination;
- analysis of a smear from the cervix;
- mammography;
- colposcopy and examination of the small pelvis.
You need to make sure that there is no pregnancy, malignant neoplasms and STIs. Upon detection inflammatory diseases, before Mirena is staged, they are treated. You should also determine the size, location and shape of the uterus. The correct position of the coil ensures contraceptive action and protects the system from expulsion.
For patients of fertile age, the IUD is injected in the first days of menstruation. In the absence of contraindications, the system can be installed immediately after the abortion. When normal contraction uterus after childbirth, you can use Mirena after 6 weeks. The coil can be changed on any day, regardless of the cycle. To prevent excessive growth of the endometrium, the intrauterine system should be inserted at the end of the menstrual cycle.
Precautions
After the installation of the IUD, it is necessary to see a gynecologist after 9-12 weeks. Then you can visit the doctor once a year, if complaints appear more often. So far, clinical data proving a predisposition to development varicose and thrombosis of the veins of the legs when using the spiral are absent. But when signs of these diseases appear, you need to consult a doctor.
The action of levonorgestrel negatively affects glucose tolerance, as a result of this, patients with diabetes mellitus you 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 undesirable consequences of mirena
Removal of the IUD
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 you wish, you can intrauterine contraceptive replace immediately with a new one. The day of the cycle does not matter. After removing the product, you need to carefully inspect the system, since if it is difficult to remove Mirena, the substance may slip into the uterine cavity. Both insertion and withdrawal of the system can be accompanied by bleeding and pain. Sometimes fainting or seizure occurs in patients with epilepsy.
Pregnancy and Mirena
The spiral has a strong contraceptive effect, but not 100%. If pregnancy nevertheless develops, then first of all it is necessary to exclude its ectopic form. When normal pregnancy the coil is carefully removed or a medical abortion is performed. Not in all cases, it turns out to extract the Mirena system from the uterus, then the likelihood of premature termination of pregnancy increases. You also need 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. In this case, the content of the hormone is about 0.1%. Doctors say that at such a concentration, it is excluded that such a dose can affect general state crumbs.
Frequently asked Questions
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 ovarian removal or with pathological menopause. Also, the 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 fibroids and endometriosis of the uterus;
- has a tonic effect.
Is Mirena used to treat fibroids?
The spiral stops the growth of the myomatous node. But you need additional diagnostics and consultation with a gynecologist. It is necessary to take into account the volume and localization of the nodes, for example, with submucous fibroids that change the shape of the uterus, the installation of the Mirena system is contraindicated.
Is the intrauterine drug Mirena used for endometriosis?
The coil is used to prevent endometriosis because it stops the proliferation of the endometrium. Recently, the results of studies were presented, proving the effectiveness of treatment of the disease. 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?
Lack 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 contraceptive Mirena, can you experience discharge, pain or uterine bleeding?
Usually, these symptoms appear in a mild form, immediately after the introduction of Mirena. Heavy bleeding and pain is often an indication for the extraction of the coil. The cause may be an ectopic pregnancy, improper installation of the system, or expulsion. See your gynecologist urgently.
Can the Mirena spiral affect weight?
Weight gain is one of the side effects of the drug. But it must be taken into account that it occurs in 1 woman in 10 and, as a rule, this effect is short-lived, after a few months it disappears. It all depends on individual characteristics organism.
I protected myself from unwanted pregnancy with hormonal pills, but I often forgot to drink them. How can I change the drug to the Mirena spiral?
Irregular oral hormone intake cannot completely protect against pregnancy, so it is better to switch to intrauterine protection. Before that, you need to consult a doctor and pass required analyzes... It is better to install the system on days 4-6 of the menstrual cycle.
When can I get pregnant after removing Mirena?
According to statistics, 80% of women become pregnant, if of course they want to, in the very first year after removing the spiral. Thanks to its hormonal action, it even slightly increases the level of fertility (fertility).
Where can you buy the Mirena spiral? And what is its price?
The IUD is dispensed only by prescription and is sold at the pharmacy. Its price is determined by the manufacturer, and varies from 9 to 13 thousand rubles.
Endometriosis often occurs as a result of abortion, so after that the woman needs best practices protection against unwanted pregnancy. Mirena spiral renders apart from therapeutic effect and contraceptive. Moreover, it is valid for up to five years, showing the same degree of effectiveness. Its benefits have been repeatedly confirmed by gynecologists, since the installation inhibits the growth of endometrial foci and myomatous nodes. Reviews of the Mirena intrauterine device are positive, women like the ease of administration and high degree efficiency. The method has a number of nuances, you need to familiarize yourself with them before starting the procedure.
Composition and form of release
Spirals Mirena are produced in Finland and Germany. The main active substance is levonorgestrel. It is contained in one coil of 52 mg. The quality of the additional substance includes polydimethylsiloxane elastomer in the same volume.
The release form of the medication is a spiral. It has a white core of the main substance and is located in the body. The base is in the form of the letter T. Covered with a membrane, almost ghostly. Membrane protection is needed in order to regulate the supply of the active ingredient. A loop with a thread for removal is fixed on the body at the bottom.
Delivery is carried out in sterile blisters. One package contains one spiral.
Mechanism of action
The main active ingredient has a progesterone effect. As a result of the fact that only a certain part of the substance is released, it comes in small doses. The drug is gradually released and at the same time has permanent action on the body.
Contraceptive in medicinal purposes contains small doses of the active ingredient, its action is local, that is, it does not enter the systemic beds. Spiral for endometriosis painlessly inserted into the uterus. Moreover, in addition to the obvious contraceptive effect, it affects pathologies. In particular:
- a decrease in the rate of release of follicles;
- a change in the hormonal balance towards a decrease in the activity of the hormone progesterone;
- a decrease in the size of the walls of the uterus, which affects the frequency of menstruation and volume;
- a decrease in the speed of movement of spermatozoa that enter the vagina.
The Mirena spiral with endometriosis protects against conception for five years. In addition, it also has a number of therapeutic effects, which are described above. Hormonal system also allows you to establish the regularity of the discharge. During its use, the periods are not so abundant, there is less pain.
Indications for use
Mirena spiral protects against unwanted conception for five years. However, this is not the only property. Helps to cure such diseases:
- uterine fibroids;
- endometriosis;
- uterine leiomyoma;
- disruption of the female organ after removal;
- endometrial hyperplasia;
- polyp of the uterus;
- bleeding of the uterus during premenopause;
- painful critical days;
- profuse menstruation;
- duration critical days more than 5, with the formation of anemia.
Indications are not always a guarantee that the spiral will be able to cope with these diseases. Hormonal coils do not help everyone; consultation of a gynecologist is required before using them. Only a specialist will be able to understand how suitable they are for a particular patient, calculate the risk of complications and decide on the effectiveness and safety of using a medical device.
Contraindications
Mirena spirals are not always used. There are a number of contraindications that reduce its effectiveness. It should also be remembered that hormone therapy, even in small doses, can cause harm not only female organs, but the whole body as a whole. So, the spiral cannot be used when:
- the likelihood of pregnancy (the active ingredient can cause a miscarriage);
- acute viral and infectious diseases in active stage (it is not clear how hormones can affect the course of the disease and the body's ability to resist viruses and infections);
- malignant neoplasms in the body (while they can be localized in any part of the body, on any organ);
- inflammations of a gynecological nature;
- genital infections (this includes any infections of this type);
- frequent uterine bleedingthe cause of which has not been identified;
- deformities of the genetic or obtained uterine cavity.
Only a gynecologist can identify the risk during examination. It is imperative to coordinate your decision with him on how to use the spiral as a contraceptive and therapeutic agent.
Preparatory conditions
In order to determine whether the remedy will be effective, whether its use will cause side effects, a woman needs to undergo a thorough examination by a doctor. The intrauterine device is placed only if, after the test result, no viral, sexual diseases are found. The following research is required:
- transvaginal ultrasound;
- taking smears for the presence or absence of infectious diseases;
- examination for chronic diseases (gynecological);
- bacterial culture.
Research methods allow you to identify whether a woman has contraindications. If they are present, then the treatment takes place first, and only then you can put a candle. But this is not the case in all cases. For example, if genetic pathologies of the development of the uterine cavity are detected, then the tool cannot be used.
Therapeutic action
Spiral Mirena has a number of healing effects. The package contains an attached instruction for use, which indicates the indications. But there are actually more effects. The use of the drug for myoma and endometriosis provides therapy for a number of diseases and conditions:
- prevention of pregnancy;
- removal of pain during menstruation and intercourse;
- suspension of the progress of endometriosis and uterine fibroids;
- creating an enabling environment for intimacy (eliminates the risk of penetration of some infection);
- decrease in blood loss during critical days (even if it is associated with anemia that occurs);
- restoration of hormonal balance in female body (due to the regulation of progesterone levels);
- therapy of anemia (as a result of less blood loss, the disease becomes less obvious).
Also, suppositories cope with adenomyosis, which is characterized by private pain symptoms, violations in the frequency and abundance of menstruation. Also, candles control the psycho-emotional state. A woman who is used to them experiences less stress if she does not want to given time conceive a child.
Main advantages of using
The advantages of using a spiral against endometriosis have been confirmed by gynecologists. If there are no contraindications, then this method of contraception becomes the best choice for protection against unwanted pregnancy and treatment gynecological diseases... The main advantages of the technique:
- therapeutic effect against endometriosis and fibroids;
- a high degree of effectiveness against unwanted pregnancy (up to 98-99 percent);
- reduction of blood loss during heavy periods;
- loss fertility for a while (after removing the spiral, the ability to conceive a child is restored on average from three to six months).
In addition, the obvious fact of the convenience of using the spiral should be noted. You will not need to perform any manipulations other than the installation itself, constantly monitor how it works, and the like. Combination of high contraceptive efficacy and proven healing effect make such coils an obvious choice for women with some gynecological diseases... Reviews of the Mirena intrauterine device in this regard are positive. The remedy is called one of the most effective.
Disadvantages of the technique
Despite the ease of installation, the Mirena spiral has a lot of positive properties and disadvantages. Among them, the main one is the high cost. According to women, the price is quite high. But it is important to understand that this is a one-time investment for five years. On average, the purchase of contraceptives and pills for the treatment of fibroids, endometriosis is more expensive. There are also such disadvantages of protection with a spiral:
- changes in the menstrual cycle in the first months of use;
- some side effects, such as dizziness, changes in taste.
Side effects and adverse effects of use are observed only during the adaptation period of the organism to the spiral. The time of adaptation is different for women, but, as a rule, it is from three months to six months.
Side effects
Side effects occur in the first months of use, their manifestations bother women for no more than six months. During this time, it is important to be observed by a gynecologist, who will note whether the treatment is effective. If the side effects are minor, but have been bothering for more than six months, then this is a reason for cancellation.
Adverse reactions of the body occur mainly due to hormonal changes in the body. Despite the fact that the dose of the active ingredient is small, this can cause discomfort. At first, such reactions from the body are possible:
- nausea and change in taste preferences;
- headaches, up to severe migraines;
- impaired concentration ability;
- emergence of scarce bleeding at a time when menstruation should not be;
- violation of the cyclicity, frequency of menstruation;
- change in the abundance of secretions during critical days;
- the appearance of rough areas in the mammary glands (can be single or strongly pronounced);
- change skin (the appearance of acne, rashes, blackheads, blackheads);
- increased oiliness of the epidermis and hairline on the head.
There are other negative reactions, but they are extremely rare. These include disorders of the psychoemotional background, in particular, frequent mood swings, the occurrence of depressive and unconditioned states. It is also possible formation in the ovaries of small sizes of the cystic type. If adverse reactions are found, a woman should immediately contact a gynecologist. In this case, the coil should be removed and another method of treatment chosen, for example, hormonal tablets with a lower concentration of the active substance.
There are many negative reactions, but in 98 percent of cases they all go away after several months of use. Hormonal background women are stabilized and the body begins to work in the same mode. After six months, the patients forget about the gynecological problems that bother them and get used to the established contraceptive-therapeutic Mirena spiral.
Examinations while using the spiral
A woman needs examinations by a gynecologist at a certain time after installation. This is necessary in order to understand how the spiral works effectively, will allow to identify the risk of adverse reactions. Visits are preventive, in the absence of pathologies, it is not necessary to take tests or undergo a thorough examination.
After the gynecologist conducts the necessary tests and understands that there are no risks that the spiral will be ineffective, the installation takes place. You will need to make visits to a specialist three times during the first year of use (or more often, if adverse reactions). Usually it is necessary to visit a gynecologist:
- seven days after installing the spiral;
- one month after continuous wearing;
- six months after installation.
It is worth remembering that the period of use should not exceed five years. After this term, the active active ingredient remains very little or it exhausts itself completely. In this case, the already expired spiral will not have a therapeutic gynecological effect, in addition, the chances of conceiving a child are greatly increased. After a period of five years, it is removed or replaced with a new one.