Mirena installation. Bloody discharge that appears after the installation of an intrauterine device. What is the Mirena Navy

The active components of the Mirena spiral are the hormones gestagen and levonorgestrel. The spiral is inserted directly into the uterine cavity. For the purposes of contraception, the IUD is installed in women of childbearing age within 7 days. from start . After an abortion in the 1st trimester of pregnancy, Mirena should be installed immediately. After childbirth, the spiral is used when the uterus is restored, but not earlier than after 6 weeks.

In order to protect the endometrium during estrogen replacement therapy in women with amenorrhea, Mirena can be used at any time; in women with saved, the procedure is performed, according to the cycle schedule, on the last days of menstruation or immediately after the end of bleeding. Before installing the spiral, it is necessary to undergo examinations of both the mammary glands and the pelvic organs, to pass an analysis of a smear from the cervix. It is also necessary to exclude pregnancy and - without fail - the presence of sexually transmitted diseases. Existing genital infections should be treated.

How to install the intrauterine device "Mirena"

"Mirena" is sold in a sterile package, which must be opened directly at the moment before installing the spiral. When handling an opened system, asepsis must be observed. If the sterility of the packaging is violated, the IUD is destroyed as medical waste. Mirena should be installed by a doctor who already has sufficient experience with this IUD. Before the procedure, the doctor determines the position of the uterus and the size of its cavity. Important is the correct location of the IUD in the fundus of the uterus, which creates the necessary conditions for maximum efficiency. Mirena is installed using sterile instruments - mirrors and forceps.

After 4-12 weeks, it is necessary to undergo an examination, then it is carried out once a year or more often if indicated. In case of difficulty in installing Mirena, in case of severe pain or in case of bleeding during the procedure or after it, ultrasound is performed immediately to exclude perforation (perforation) of the uterus. The spiral is removed after 5 years, it can be replaced with a new one any day.

Side effects of Mirena

Mirena may have the following side effects: nausea, discomfort and bloating, headache, nervousness, mood depression, decreased libido, breast engorgement, urticaria, menstrual dysfunction, acne, itching, eczema, back pain and pain in the small area. pelvis, dysmenorrhea, vaginal discharge and bleeding, spotting, endometritis, cervicitis, inflammatory diseases, benign ovarian cysts.

Modern methods of contraception allow a woman to prevent an unplanned pregnancy and thereby avoid the 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 certain 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 means of intrauterine contraception has a predominantly local effect. The Mirena spiral is placed 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 process of ovulation (the release of an egg from the ovary) and delaying the development of the uterine mucosa, thereby making it difficult for the implantation of the fetal egg.

The effectiveness of the method.
Mirena spiral is a reliable and effective means of protection against unwanted pregnancy, which has a long period of use. For every 1,000 women who start using this hormonal coil, there are only two cases of unplanned pregnancy during the first year.

Fertility is restored literally immediately after the extraction of the spiral. Very rarely, the ability to become pregnant is restored in women in a longer period after the abolition of the use of the remedy (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, the side effects of the Mirena hormonal coil appear in the first months after its introduction. Gradually, they all disappear and do not require additional treatment. Most often, after the start of its use, women note the following side effects:

• reduction in the duration of menstrual bleeding (may be completely absent), as well as a decrease in its intensity;
• the occurrence of acne;
• headache;
• nausea;
• weight gain;
• dizziness;
• frequent mood swings;
• ovarian cysts;
• increased sensitivity of the mammary glands.

Regarding the duration of menstruation, it should be noted that everything will fall into place after the termination of the use of this contraceptive.

The impact of the intrauterine system on women's health.
The Mirena spiral is an excellent means of preventing inflammatory diseases of the small pelvis, iron deficiency anemia, in addition, its use significantly reduces the risk of developing endometriosis, alleviates the condition with painful menstruation (algodysmenorrhea), and can also reduce the size of myomatous nodes.

The cost of the Mirena hormonal spiral varies between nine and eleven thousand rubles, depending on the region. Compared with contraceptive pills, for which you will have to spend an average of seven hundred to a thousand rubles a month (for five years), 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;
• uterine anomalies (congenital and acquired);
• pregnancy or suspicion of it;
• the presence of urinary tract infections;
• postpartum endometritis;
• cervical dysplasia;
• septic abortion within the last three months (serious uterine infection during or shortly before or after the abortion);
• uterine bleeding of unknown cause;
• cervicitis;
• acute liver disease (severe cirrhosis, jaundice, hepatitis) and liver tumors.

Conditions for the introduction of a hormonal coil into the uterine cavity.
Only an experienced doctor who has performed this procedure more than once should be engaged in the installation of intrauterine devices. For women of childbearing age, the Mirena spiral as a means of contraception is introduced into the uterine cavity no later than within seven days from the start of the menstrual cycle. The introduction of a contraceptive at a later date is carried out only after confirming 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 date, the spiral can be replaced with another one on any day of the cycle.

The installation of an 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 uterine contraction after childbirth or subinvolution, it is necessary to exclude the development of postpartum endometritis and transfer the introduction of the spiral until the uterus is completely restored.

It is recommended to install a spiral in 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 contraceptive is difficult, or there is very severe pain or bleeding during or after the procedure, then in this case a physical and ultrasound examination is necessary in order to exclude perforation (mechanical damage) of the uterus.

Mirena removal.
The specialist removes the intrauterine device from the uterine cavity (after the expiration date) on any day of menstruation (subject to a regular cycle), by grabbing its threads with forceps and carefully pulling it out. If further contraception is necessary, a woman is put on a new spiral on the same day, 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 contraceptives. 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 removing the Mirena intrauterine system, the doctor must verify its integrity, because if there were difficulties in removing it, there were cases of the hormonal-elastomer core slipping onto the horizontal arms of the T-shaped body, as a result of which they "drowned" inside the core. After confirming the integrity of the spiral, additional examinations and interventions are not required. Limiters 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.

Mirena use 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 an intrauterine system (which is possible with a prolapse of sirali), then the system should be removed, since it significantly increases the risk of spontaneous abortion and preterm birth.

Careless removal of the coil or probing of the uterus can also provoke spontaneous abortion. If it is not possible to carefully remove the contraceptive, the question arises of 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 preterm birth for the child. In the future, such a pregnancy will need to be carefully monitored. Also, the patient will need to be sure to inform the doctors in case of symptoms that may complicate pregnancy (including colic-like pain in the abdomen, combined with fever).

It is believed that the use of Mirena, six weeks after childbirth, does not affect the growth and development of the child. Monotherapy with gestagens does not affect the quality and quantity of breast milk.

Complications.
The use of this intrauterine device very rarely leads to problems and complications. If any unusual symptoms occur, 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.

Fallout (expulsion).
The spiral may partially or completely fall out of the uterine cavity. The risk of this phenomenon is very high in nulliparous women who use this method of contraception during the first few months of use. However, there are cases of rejection of the system and at a later date of 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 prolapse, you must additionally use a condom and immediately contact a gynecologist. In case of partial prolapse, the intrauterine system is completely removed.

Perforation.
Very rarely, but still there are cases when the spiral pierces the wall of the uterus during insertion. Usually this fact is detected immediately and corrected. If this was not noticed, the spiral can get into other parts of the pelvis and damage the internal organs. In this case, surgery 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 of the pelvic organs can be triggered by bacteria that enter the uterus during the installation of the coil. The development of infection usually occurs within three weeks after installation. If infection is observed after the specified time, then infection is more likely to have occurred through contact with a sick partner.

Scientific studies have proven that the Mirena coil does not contribute to the development of pelvic organs or infertility.

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 the removal of 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 spiral 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.

Married or out of wedlock, but a man and woman living together have to think about protection from "unwanted pregnancy" - no matter how this phrase itself scratches the ear. And a woman has to think about such protection more, as a person more responsible in matters of the birth and upbringing of a child. In the article, we will describe in detail the Mirena intrauterine device, the features of its use and possible contraindications.

Here is just a partial list of ways to prevent unwanted pregnancy:

1. barrier method
   • Local chemical reagents in the form of pastes, gels, capsules introduced into the vagina before coitus
   • Mechanical barriers to sperm entering the uterus (female condoms, cervical caps, vaginal diaphragms)
2. Hormonal contraception (mainly taking drugs orally, less often - intramuscular injections)
3. Surgical methods of contraception
   • Fallopian tube ligation by laparoscopy
   • Minilaparotomy
   • Sterilization with the possibility of colpotomy access
4. Intrauterine devices

The use of unwanted pregnancies is rightfully considered one of the most effective methods of protection. True, due to female anatomical features and the complexity of the installation, the IUD can only be inserted into the uterus by a gynecologist and only if there are indications for such an installation.

5 benefits of spiral contraception:

1. Greater efficiency of the method. No more than 0.01% cases of pregnancy with a correctly installed spiral
2. Rapid return of the ability to conceive after removal of the IUD.
3. Does not need to be combined with another contraceptive (with the exception of condoms used as a means of protection against STDs)
4. After fixing the uterine coil in place, only one follow-up visit to the gynecologist is required to make sure that the coil is correctly installed and not rejected by the body.
5. When installing a progestin-containing intrauterine device, pain during menstruation is guaranteed to disappear.

The Mirena hormonal coil is easy to install, inexpensive and always in stock.

Mirena intrauterine device

Mirena belongs to the third generation of spirals, where a membrane container is used, from which, after installation in the uterus, levonorgestrel begins to be released in microdoses - a hormone that prevents both the attachment of the egg to the walls of the uterus in the field of fertilization, and the fertilization of the egg itself by suppressing the vital activity of the spermatozoa that managed to do it get.

The Mirena intrauterine therapeutic system is a T-shaped hormonal-elastomer core with an outer membrane that releases a microdose of levonorgestrel into the bloodstream of the uterine mucosa. The membrane was developed using nanotechnology, and its thickness is calculated in such a way as to release a strictly metered amount of the drug from the contents of the spiral. The spiral is in a collapsed state in the tube of the conductor, from which, during installation into the uterus, it is pushed out by a special pusher, the T-shaped outgrowths at this moment straighten out and block the possible passage of seminal fluid and spermatozoa into the uterus.

The amount of hormone-containing agent in the coil container is about 52 mg. It is released into the uterus at an average rate of 20 mcg per day. With normal functioning, by the end of the 5th year, the release of the hormone decreases to 10 mcg per day, then the effectiveness of the Mirena spiral decreases, the barrier functions remain mainly mechanical, that is, its presence in the uterus in the form of an obstacle.

The hormone secreted through the membrane acts locally and progestogenally. The mechanism of its antiproliferative action is that the accumulation of levonorgestrel in the epithelium of the uterine walls helps to reduce the sensitivity of its progesterone and estrogen receptor cells, so the endometrium stops responding to estradiol, causing the uterus to become indifferent to the very process of possible conception. In addition to the suppression of spermatozoa that have entered the uterus in about half of women, the suppression of the production of the eggs themselves from the uterine follicles is also added.

The Mirena spiral does not affect female fertility.

Therapeutic action

The proliferation (division) of the mucous layer, or the endometrium, lining the uterus from the inside, is inhibited by the drug in the first months of use, therefore it is more actively rejected, and during this period an increase in spotting discharges in the intermenstrual periods is possible. Then, in women using Mirena, a well-marked suppression of endometrial proliferation occurs, and the time of release and the amount of menstrual bleeding are already reduced. But the work of the ovaries and the content of estradiol in the blood do not fall, remain normal.

A good therapeutic effect of using the spiral in the diagnosis of "idiopathic menorargia" has also been proven, that is, there were abundant, possibly even with bloody clots, menstruation. Unless, of course, hyperplastic phenomena in the mucosa are noted, such as submucosal or large interstitial fibroid nodes, which caused a change in the configuration of the shape of the uterus, or identified oncology of the mucus-producing layer, as well as any other conditions in which there is severe hypocoagulation, the symptoms of which are often and there is menorrhagia.

During the first three months of using the drug contained in the spiral, blood loss from menstruation is reduced by 60-90%. And after 6 months - already by 70-95%. If the duration of the stay in the uterus of the Mirena spiral was up to two years, the effect of this can be compared with a radical surgical intervention. As if a complete removal of the endometrium were performed. But with submucosal fibroids unnoticed in time, when the installation of the Mirena spiral has already taken place, the effectiveness of the drugs will no longer be so good. In most cases, reducing blood loss during menstruation will have a positive effect on reducing the symptoms of iron deficiency anemia, if they have already occurred.

Levonorgestrel in a coil

The levonorgestrel secreted by the spiral has a purely local effect on the uterus. This means that the concentration of the hormone in her muscles compared to the adjacent layer that produces mucus is 100 times less. And in the blood of the hormone is so vanishingly small that it can only be detected by using special methods of blood testing, similar to the methods for detecting doping in athletes, when they try to find hundred-thousandths of a percent of substances. Naturally, such shares do not have any noticeable effect on the vital activity of the organism.

The concentration of the drug in the endometrium is directly dependent on the woman's body weight. Those 52 mg of the drug that are in the coil reservoir are designed for an average weight of about 65 kg. In women of a slender physique with a lower body weight, the concentration of the hormone in the endometrium may be increased. Accordingly, in overweight women, the stated 20 mcg / day may also be unattainable. When choosing this particular spiral model, this dependence must be borne in mind.

The main effect of the hormones contained in the system is that the contraceptive effect is achieved mainly not from the fact that the active component gets inside, but due to its reaction to the presence of a foreign object in it. This means that the inserted coil causes local inflammation of the endometrium, and such inflammation makes it impossible for the egg to attach to the uterine walls. This is achieved through

• Inhibition of standard processes of endometrial formation
• Active change in the submucosal layers
• Decreased glandular function of the uterus

The direct effect of levonorgestrel will be expressed in

1. Significant narrowing of the lumen of the uterine canal on its side (internal cervical canal)
2. The viscosity of the mucus in it and in the fallopian tubes will become higher.

These factors become an almost insurmountable barrier to spermatozoa. The most active individual specimens of them will be suppressed by the direct action of the hormone, and they will lose the rest of their mobility.

Indications for installation

1. The desire of a woman not to become a mother with a long-term (up to 5 years) perspective.
2. Unreliability of other types of contraception, whatever the reasons.
3. Desire to protect yourself while breastfeeding your baby (fatigue from childbirth, lack of sleep, and other factors)
4. Considerations of economy and convenience: the installation of a spiral is done for several years, while you can forget about other types of contraception.
5. Abundant spotting during menstruation is not pathogenic.
6. Prevention of uncontrolled growth of the uterine mucosa during treatment with estrogens.
7. without pronounced pathology

Based on many years of clinical practice, doctors are inclined to install the Mirena IUD not only for contraception, but also to normalize pathogenic processes like menorrhagia, exhausting the woman's body with heavy bleeding, which can lead to anemia - unless, of course, this happens against the background of excessive growth of the endometrium.

The effectiveness of the hormones contained in the preparation is such that already six months after the installation of the system, the intensity of bleeding drops by half, and by the end of the five-year period of using the spiral, with a favorable course of processes, the effect of the action is comparable in efficiency to uterine resection.

Non-standard situations

Most often, women are concerned about the fact of a sharp decrease or even sometimes a complete cessation of menstruation after they put the spiral. An additional disturbing factor is that in the first two or three months the bleeding, on the contrary, was stronger. But after all, both the first and the second are the result of a restructuring of the endometrial metabolism, when its proliferation is suppressed by the introduced hormone.

Installation of the Mirena coil

Only a specialist gynecologist can put a Mirena intrauterine device into the uterus, a woman should go through some procedures in front of her.

1. Analyzes
   • Blood and urine (general)
   • HCG level to exclude pregnancy
   • Confirmation of the absence of sexually transmitted infections
2. Examination by a gynecologist with a two-hand examination
3. Diagnosis of precancerous pathologies
4. Ultrasound of the reproductive organs

In order to have an idea about the manipulations performed by a doctor and not worry about the process, it is useful for women to know how the process of inserting an IUD takes place.

After inserting a gynecological speculum into the uterus, its neck is treated with a disinfectant solution. Controlling the process with a mirror, the doctor inserts the conductor with the IUD contained inside in a folded (folded) state. Correctly, in accordance with the location of the fallopian tubes, the system is installed and the conductor is removed from the uterine cavity, leaving the spiral in a straightened form. After that, the woman is given the opportunity to rest and recover for 25-30 minutes.

The installation of Mirena is done in the first week of the cycle. True, this recommendation is not valid if a spiral is installed not only for contraceptive, but also for therapeutic purposes, if the effect of levonorgestrel is indicated. It is also possible to install an IUD after an artificial termination of pregnancy made in its first trimester, if inflammation of the uterine mucosa was not observed after the abortion procedure itself.

Possible Complications

Hormonal regulation of life processes is one of the most subtle and delicate. Even microscopic portions of substances entering the bloodstream in people who are especially sensitive to this can cause malfunctions in the central nervous system. A possible expression of this is irritability, headaches, depression. It is up to the patient to keep the IUD with such symptoms: if such side effects do not disappear after 2-4 months after installation, the gynecologist who installed the helix may also recommend removing the helix.

Another disturbing factor that serves as the reason and reason for the removal of the delivered intrauterine device is severe bleeding during the same 2-3 months from the start of the installation. The effect of the hormone on the central nervous system and on the intensity of secretions can have a direct relationship, so it always makes sense to wait a bit - with a decrease in blood loss due to thinning of the endometrium, other unpleasant consequences of the initial action of the spiral also disappear.

In addition to the listed signs, in the first days of the IUD, there are also violations of the digestive and gastrointestinal tract: nausea and even vomiting, abdominal pain, loss of appetite.

If there is hypersensitivity to levonorgestrel, then some weight gain and acne are possible.

Expulsion

Complications include expulsion - loss of the spiral during menstruation or even in the intermenstrual period.

Inconspicuous expulsion occurs during heavy discharge, so women with an installed spiral should carefully examine hygiene products to control possible loss. In the intermenstrual period, you can verify the integrity of the IUD by feeling its threads. With espulsion, if it happened in the middle of the cycle, extracurricular bleeding begins, so that even at this time the loss of the spiral cannot go unnoticed.

Perforation

Even more dangerous is perforation - perforation of the uterine wall, which usually occurs during the installation of an intrauterine device. It occurs as a complication due to difficult childbirth, in the midst of breastfeeding, and with an atypical location of the uterus. But usually the cause of perforation is the inexperience of the gynecologist installing the spiral.

When to See a Doctor

There are situations when contacting a gynecological office with an already installed spiral is not only desirable, but also necessary:

• Delay of menstruation for one and a half to two months, while pregnancy is excluded
• Prolonged, for more than a month, pain in the lower abdomen
• Discomfort during sex, anorgasmia
• Feverish with chilliness, profuse perspiration at night
• Significant increase in menstrual flow
• Change in color, smell, consistency of menstruation, in general, any of its unusual appearance.

Contraindications

Like any effective medical device, IUDs also have contraindications.

1. The onset of pregnancy
2. Sexual infections, cystitis
3. Suspicion of oncology of the reproductive system
4. Bleeding of unknown etiology
5. The uterus is deformed due to the presence of a large myoma node or a tumor of a different (non-cancer) origin
6. Severe liver damage
7. Allergic incompatibility with the composition of the contraceptive
8. Old age (over 65)
9. Thromboembolism, thrombophlebitis, other vascular pathologies
10. Severe forms of migraine with temporary asymmetric vision loss

In addition, there is a list of diseases in which the installation of an intrauterine system is problematic:

• Diabetes mellitus of any type.
• A heart attack recorded in a personal medical record, regardless of its statute of limitations.
• severe hypertension.
• Migraine, headaches of unknown etiology.
• Cardiac ischemia.
• Pathology of the heart valves.

Women from this list, if they decide to install an intrauterine device, and the doctor has not found obvious reasons for refusing this procedure, you need to carefully monitor all sudden changes in your well-being.

The duration of the spiral

The Mirena hormonal coil is designed for five years of continuous work as a contraceptive. The coil is removed in the gynecologist's office. The doctor pulls the contraceptive from the installation site by the threads coming out of the spiral into the vagina. When extracting, women often feel discomfort, up to severe pain - the spiral, as it were, grows into the flesh, it is not so easy to extract it.

If pregnancy occurs with the installed spiral (and such cases, although rare, are not excluded), its removal is necessarily indicated - an unremoved spiral can cause a miscarriage or childbirth ahead of schedule.

Conclusion

The Mirena Navy is a good solution if you intend to purchase a reliable remedy that protects against unwanted pregnancy, despite its high cost (about 12,000 rubles).

Mirena is indicated for women with good compatibility with gestogenic drugs. It will be especially useful for those who, in the normal state, have abundant and painful periods. But, bearing in mind the possibility of incompatibility of the body with the drug, it is better to discuss the acquisition and installation of the Mirena spiral with a doctor who will offer a different model with possible installation risks.

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.