1. Health
You can opt-out at any time. Please refer to our privacy policy for contact information.

Mirena Intrauterine Device

The Levonorgestrel IUD


Updated July 28, 2014


Mirena IUD

Photo © 2014 Dawn Stacey


Photo © 2014 Dawn Stacey

The Mirena intrauterine device (IUD) is a small, "T-shaped" contraceptive device made of flexible plastic and must be inserted by a qualified health-care professional (such as an ob/gyn or nurse practitioner). Mirena releases a low amount of progestin levonorgestrel continuously over a 5-year period as a way to prevent pregnancy.

How Mirena Works:

The Mirena IUD helps prevent sperm from joining with an egg by affecting how the sperm move. Basically, it interferes with the movement of the sperm toward the egg. The hormonal component in Mirena makes it more effective than the ParaGard IUD.

Mirena is effective immediately if inserted within 7 days after the start of your period. If you have Mirena inserted at any other time during your menstrual cycle, use another method of birth control during the first week after insertion. Pregnancy protection will begin after 7 days.

Advantages of Mirena:

  • It can provide continuous pregnancy prevention for 5 years and can be removed anytime within that 5-year period.
  • Convenient and hassle-free – once inserted, you don’t have to do anything.
  • An IUD is the most inexpensive long-term reversible method of contraception.
  • Mirena can help protect against pelvic inflammatory disease (PID) because it thickens cervical mucus and decreases menstrual flow.
  • IUDs can improve a woman's sex life by allowing for spontaneity.
  • Eco-friendly birth control method.
  • A good alternative option for women who cannot tolerate estrogen-based or combination contraceptives.
  • After removing the IUD, a woman’s ability to become pregnant returns quickly.
  • It is an extremely private and discreet birth control method. Nobody can tell if you are using it, and there is no packaging or other evidence of use that may embarrass some women.
  • The Mirena IUD can reduce menstrual cramps and the amount of bleeding that accompanies a woman’s period. Typically, women using Mirena may see that their menstrual flow is reduced by 90 percent. In approximately 20 percent of Mirena users, their flow stops altogether within one year. This could lower one’s risk for anemia.
  • For women who choose Mirena for contraception, it is the only FDA-approved contraceptive to treat heavy menstrual bleeding.

Mirena Disadvantages:

Although most women do not experience any trouble adjusting to an IUD, some women may have heavy bleeding and cramping during the first few weeks or months after insertion. But doctors can prescribe medication that can lessen cramps and bleeding during menstruation.

Mirena Side Effects:

Women may experience side effects, but in most cases, they will go away after the first few weeks to months. These include:

Mirena Risks and Complications:

Serious problems with Mirena are rare. Make sure to tell your doctor right away if any problems occur.

Who Should Use Mirena:

According to Bayer HealthCare Pharmaceuticals, the manufacturer of Mirena, this IUD is appropriate for women who have had at least 1 child, who are in a stable, mutually monogamous relationship, and have no risk or history of ectopic pregnancy or pelvic inflammatory disease.

It should be noted, however, that the manufacturer also says that this is because most of the research on Mirena for FDA approval was conducted on women who had at least one child. The American College of Obstetricians and Gynecologists (ACOG) recommends that both women who have not given birth as well as teenagers could benefit from IUD use (either Mirena or ParaGard). And, despite the manufacturer’s guidelines, many doctors have been inserting Mirena in these populations for years.

Removal of the Mirena IUD:

  • After 5 years are up, you must have the Mirena IUD removed. You can choose to have another one inserted during the same visit. Do not try to take it out yourself. Mirena should be removed by a medical professional.
  • You can also have Mirena removed at anytime before the 5-year period ends.
  • If the Mirena IUD is expelled (comes out on its own), generally, a woman doesn't even notice. This is why it is important to feel for the strings (if possible) as this is your indication that your Mirena is still in place. If this has happened, you would need to contact your doctor to have another one inserted. Your doctor will most likely perform a pregnancy test first, to make sure that you are not pregnant, before inserting a new Mirena IUD.
  • If the Mirena IUD has become partially expelled, it is important to call your health-care professional right away (and use a back-up birth control method). You will need to make an appointment to have it completely taken out and have a new Mirena IUD inserted again.

Costs Associated with Mirena:

If you plan to use birth control for at least 1 to 2 years, an IUD is the least expensive contraceptive option available. The one-time cost of Mirena, in comparison to other contraceptive methods, could save you hundreds of dollars or more over time.

Medicaid may sometimes cover these costs. In general, the charges from family planning clinics will usually be less than private health-care providers. Approximately, the cost of the exam, insertion, and follow up visit may cost up to $750. You should check with your private health insurance policy as coverage for Mirena should be covered with no out-of-pocket costs for all non-grandfathered insurance plans.

Mirena Effectiveness:

Mirena is one of the most effective reversible methods of birth control available. The Mirena IUD is 99.8% effective. This means that out of every 100 women who use Mirena in one year, less than 1 will become pregnant with typical use as well as with perfect use.

Of Note: Most pregnancies happen to Mirena users when their IUDs slip out without them realizing it. Even though the chance of pregnancy while using Mirena is extremely low, if it does happen, call your health-care provider as soon as you become aware that you're pregnant.

STD Protection:

Mirena offers no protection against sexually transmitted infections.


Nelson AL. "The intrauterine contraceptive device". Obstetrics and Gynecology Clinics of North America, 2000 27:723-740. Accessed via private subscription.

Related Video
Maximize Morning Quality Time

©2014 About.com. All rights reserved.

We comply with the HONcode standard
for trustworthy health
information: verify here.