Mirena: indications, side effects, contraindications
Modern medicine offers a woman to use a wide variety of contraceptives to prevent the onset of unwanted pregnancies.Among the options available is the intrauterine hormone Mirena spiral, which can be used not only as a contraceptive, but also as part of the therapy for certain gynecological diseases.
The IUS is a T-shaped frame, from which a certain amount of the levonorgestrel hormone enters the woman's blood daily.It is this hormone that is the main component of any new generation of contraceptive. This means of intrauterine contraception has a local effect, is set for 5 years and then replaced with a new one( if necessary, and the woman's desire).Contents: How Mirena works and its effectiveness Possible side effects Contraindications to Mirena installation Introduction and removal of the intrauterine device Mirena
How Mirena works and its effectiveness
The general principle of the "work" of the IUS is the same asHormonal implants and contraceptive injections - they are designed to block the process of ovulation( release of the egg from the ovary) and delay the development of the mucous membrane of the uterus, which automatically makes it practicalKi impossible implantation of the fetal egg.
The contraceptive in question is considered to be sufficiently effective, having a long period of action.According to statistics, only 2 out of 1,000 women who were fitted with the Mirren intrauterine device had become pregnant in the first year of its use.
Despite this great efficiency and the ability to use Mirena for a long time, the ability to conceive in a woman is restored right after the extraction of the intrauterine device. It is extremely rare for conception to recover after 3-6 months after removal of the contraceptive in question.
Note: IUD is similar to any other hormonal contraceptive, and can not protect a woman against sexually transmitted diseases.
Possible side effects of
As a rule, side effects appear in the first 1-3 months after the installation of the contraceptive in question, but they quickly disappear and do not require any specific treatment. A woman after installing an intrauterine spiral Mirena, can note the following side effects:
- regular headaches;
- a significant increase in the sensitivity of the mammary glands;
- nausea not associated with eating;
- a short duration of the menstrual cycle, in some cases, monthly bleeding may stop altogether;
- periodic dizziness;
- disturbances of a psycho-emotional background - for example, sharp change of mood;
- increase in body weight;
All listed side effects disappear by themselves, and as for the duration of the menstrual cycle, it will recover after removal of the intrauterine spiral Mirena.
Since the drug in question is contraceptive, its medicinal properties can also be attributed to side effects, but they will be extremely beneficial to health.For example, the spiral Mirena is recognized by doctors as an excellent preventive agent for pelvic inflammatory disease, iron deficiency anemia, endometriosis .In addition, this intrauterine device significantly alleviates the condition of a woman with painful menstruation and reduces the size of myoma nodes.
Contraindications to installation of Mirena
There are a number of categorical contraindications to the use of the intrauterine device Mirena:
- congenital and / or acquired abnormalities of the uterus;
- malignant neoplasms of the uterus or cervix of the uterus;
- hypersensitivity or individual intolerance to the hormone or material from which the Mirena spiral is made;
- an existing pregnancy or a suspicion of it;
- diseases of pelvic organs of an inflammatory nature;
- carried out during the last three months a septic abortion;
- is a progressive infection of the genitourinary system;
- deep vein thrombosis of the lower extremities in the anamnesis;
- Breast cancer and its treatment in the anamnesis;
- endometritis, developed after delivery;
- inflammation of the cervical canal of the cervix( cervicitis);
- liver diseases that occur in an acute form;
- cervical dysplasia;
- tumors of benign and / or malignant nature.
Introduction and removal of the intrauterine device Mirena
Only a gynecologist can determine the desirability of using the contraceptive in question for a particular woman. And I need to introduce / install a spiral Mirena, also, there are some conditions for carrying out such manipulation:
- To a woman of childbearing age, the intrauterine device MIRENA as a contraceptive can be placed in the uterine cavity no later than 7 days fromThe beginning of the menstrual cycle.
- If the introduction of the spiral is supposed to occur at a later date, the doctor must first be convinced of the absence of pregnancy.
- After birth, the contraceptive in question is not established before 6 weeks later - this is the time period required for complete restoration of the uterus.
- If in the postpartum period a woman has a decrease in the rate of contraction of the uterus, the timing of the introduction of the Mirena spiral is postponed to a later time.
- After an artificial or spontaneous abortion that occurred in the first and / or second trimester of pregnancy, the Mirena intrauterine device should be installed only after 7 days.In this situation, the doctor must be sure that there are no signs of infection in a woman.
Note: if a woman complains of very severe pain during the installation of the contraceptive in question, or a bleeding has begun, the gynecologist should perform an ultrasound and physical examination to exclude uterine perforation( mechanical damage).
The process of removing the intrauterine device Mirena
If a woman's menstrual cycle is regular, then Mirena can be removed on any day of menstruation after the expiration of her period.If a woman needs further contraception, then the doctor can install a new spiral on the same day.
If the spiral is not extracted during menstruation, then one week before this manipulation a woman should use additional contraceptive devices .The same rule applies if the patient is diagnosed with amenorrhea.
After the extraction of the intrauterine contraceptive, the physician must make sure that the spiral is intact.Often during the procedure under consideration, the hormone-elastomeric core slips to the horizontal "shoulders" of the T-shaped body.After the integrity of the helix is confirmed, no additional examinations and interventions are required.
Note: the installation of a new spiral is possible immediately after the removal of the old one because the full safety of the use of two or more intrauterine systems in a row has been proven.No changes in the health of women are noted .
Intrauterine device MIRENA during pregnancy and during lactation
No hormonal agents, including those considered, can be used during pregnancy.If pregnancy occurs during the application of Mirena, then it must be extracted, since the risk of spontaneous abortion or premature birth is significantly increased for a woman.
It is necessary to remove the contraceptive in pregnancy very carefully, but if this is not possible, the doctor will raise the issue of the artificial termination of pregnancy.A woman may refuse to have an abortion, but in this case she should be informed about the risks and possible consequences of premature births for the child.The patient herself will have to carefully monitor her own well-being and when there are colicky abdominal pains, fever should immediately seek qualified medical help.
As for the application of Mirena to a woman who is breastfeeding, doctors are unequivocal in the opinion - if the spiral is established 6 weeks after birth, then there will be no impact on the growth and development of the child .The hormone that enters the blood of the nursing mother does not affect the quality and quantity of breast milk.
Possible complications when using Mirena
In general, the use of the intrauterine contraceptive in question rarely leads to complications, and if any unusual symptoms appear, the woman should immediately seek qualified medical care.Nevertheless, problems can arise.
Expulsion - prolapse of the intrauterine device
The intrauterine device can partially or completely fall out of the uterine cavity, with the highest risk of such a phenomenon occurring in nulliparous women in the first few months after installation of the drug.It is extremely rare for the system to be rejected at a later date.
Note: notice the loss of the Mirena spiral when carefully inspected hygienic pads and tampons during menstruation.If the fallout is seen, then you need to start using a condom during intercourse and seek help from a gynecologist.
Mechanical damage to the walls of the uterus - perforation
It is extremely rare to damage the uterine wall when inserting an intrauterine device, but this fact is detected immediately and immediately identified.If the perforation has not been noticed by a gynecologist, the spiral can get into other parts of the pelvis and damage the internal organs - you will need to perform a surgical intervention.
The use of intrauterine contraceptives is accompanied by some risk of infection of the pelvic organs, but the risk of their development is significantly reduced 20 days after the administration of Mirena in the uterine cavity. Infection can be triggered by pathogenic bacteria that enter the uterus cavity just during the installation of the spiral.If the infection is detected after the expiration of 20 days after the installation of the Mirena, then most likely the infection occurred during sexual intercourse with a sick partner.
The IUS is considered an effective method of preventing unwanted pregnancies.And its positive properties and minimal possibility of development of complications make this remedy even more in demand among clients of gynecological clinics.
Tsygankova Yana Aleksandrovna, medical reviewer, therapeutist of the highest qualification category