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Mirena IUD

A Contraceptive Intrauterine Device


Updated April 21, 2014

Mirena IUD

Mirena IUD - Intrauterine Device

© 2007 Dawn Stacey


Increased Risk Factors Associated With Mirena:

Certain conditions may increase the chances of developing serious complications while using an IUD. These include being at risk for sexually transmitted infections at the time of insertion or having:
  • Serious blood clots in deep veins or lungs
  • Had PID in the past 12 months
  • Have diabetes or severe anemia
  • Have blood that doesn't clot sufficiently or take a medication to help your blood clot
  • Have had 2 or more sexually transmitted infections within the past 2 years
  • Have or had ovarian cancer
  • Take daily medication(s) containing a corticosteroid (such as prednisone)
  • Have a history of tubal infection (this does not apply for women who had a pregnancy in their uterus since the infection)
  • Have uncontrolled infections of the cervix or vagina, such as bacterial vaginosis
  • Have a uterus positioned very far forward or backward in the pelvis
  • A history of impaired fertility and the desire to get pregnant in the future




How to Obtain Mirena:

You will need to make an appointment with your doctor to see if Mirena is right for you. It is important that you honestly discuss your medical history and sexual lifestyle with your doctor because an IUD isn't right for all women.


Your doctor will most likely perform a pelvic exam to be sure that your cervix, vagina, and internal organs are normal and not infected. You may be tested for sexually transmitted infections, vaginal infections, precancerous cervical cells, or any other condition that needs to be treated before an IUD can be inserted.

If it is determined that you are a good candidate for Mirena, the doctor will have you schedule a date for its insertion. It can be inserted at any time during your menstrual cycle. However, if you want immediate pregnancy protection, Mirena should be inserted within 7 days after your period begins.

After your first period (or at least no longer than three months after insertion), schedule a checkup to make sure your IUD is still in place. After that, a regular checkups can be done at the time as your periodic gynecological exam.



Checking Your IUD:

The Mirena IUD has strings attached that hang down through the cervix into the vagina. Depending on how short the strings are cut, a woman can make sure the IUD is in place by feeling for the strings. A doctor uses the strings to remove the IUD. Some woman may have the strings cut shorter if they are felt by the woman’s sexual partner. When this is the case, sometimes the strings are cut so short that the woman cannot actually check for the strings. If this does not apply to you, it is wise to feel for the string end between periods. It is especially important to check every few days for the first few months to make sure that it is still properly in place. That being said, one of the greatest advantages of the Mirena IUD is that, for the most part, once it has been inserted, a woman doesn’t have to really do anything!




Removal of the Mirena IUD:

  • After 5 years are up, a woman must have the Mirena IUD removed. She can choose to have another one inserted during the same visit.
  • You can also have the IUD removed at anytime before the 5-year period ends.
  • The Mirena IUD must be removed by a qualified health-care professional. You should not try to take it out yourself. Under rare cases, it may become expelled on its own; however, generally speaking, a woman must schedule an appointment with her doctor to have it removed.
  • 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 the IUD 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 the IUD 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.


A woman should check with her private health insurance policy as coverage for birth control varies. 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 range from $175 to $500.




Mirena is one of the most effective reversible methods of birth control available. The Mirena IUD is 99.9 percent 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 yo 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.

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