In detail

IUD

IUD

Question:

- What information could you give me about the hormonal intrauterine contraceptive Mirena? The gynecologist recommended me as a contraceptive after which the fertilized egg cannot be removed - practically no fertilization is achieved. I was especially interested if it could be reached - practically, not theoretically, using this contraceptive method, at the fertilization of the egg. What negative effects can they have and how often do they occur? Thanks!

Answer:


Mirena is a small intrauterine T-shaped device (also known as a sterilizer), which, after insertion, releases the levonorgestrel hormone into the uterus, where it prevents the installation of pregnancy by action on the uterine mucosa (prevents the thickening of the mucosa needed to install the pregnancy) and increases viscosity of mucus in the cervical canal (this mucus will prevent sperm from entering the uterus); thus it prevents fertilization (binding of the sperm with the egg) and then, even if this is done, it prevents nesting (fixing the fertilized egg in the uterine mucosa).
So theoretically, using this method should not reach the fertilization of the egg, but if it does then it should then be removed from the uterus, due to the action of the device Mirena in the uterine mucosa. Basically, there is no contraceptive method that provides absolute protection (except abstinence). However, the efficiency of this device is significant: clinical studies have shown that only 2 pregnancies / year have been installed in 1000 women using the Mirena device.
Adverse reactions that may occur following the use of the Mirena device are: menstrual disorders (small bleeding in the form of drops-called spotting, shorter or longer menstruation, irregular bleeding, reduced quantity or amenorrhea-lack of menstruation, heavy or painful menstruation), lower abdominal pain (cramps) or back pain, acne or other skin conditions, sensation of breast tension, vaginal discharge, mood swings, nausea, water retention (edema), body weight gain, decreased libido, sweating, hair loss, thinning hair.
Mirena does not protect against sexually transmitted infections; if you or your partner have more sexual partners, the risk of infection increases and these untreated infections can lead to structural changes of the genital tract, ectopic pregnancies, even infertility. It may happen that the device is expelled without realizing it (which is why the wires of the device must be checked especially after menstruation, but without pulling them because there is a risk of extraction). This event can happen especially in the first month after insertion, and then the efficiency disappears; In rare cases it can cause uterine perforation. Some women may have lipothymia (lesion) at insertion; In rare cases, extrauterine pregnancies have been reported after using Mirena.
If you are at risk for diabetes, then you need to know that Mirena can affect glucose tolerance. It is advisable to use extravaginal pads during menstruation, but if you use internal pads you must be careful not to pull the wires of the device.
Mirena must be removed after a period of maximum 5 years; it should be checked twice in the first year (at 3 months and at 12 months) and then once a year, unless your doctor recommends otherwise or any genital symptoms or changes occur (bleeding, amenorrhea, vaginal discharge abnormal, abdominal pain, stop feeling the wires or feel the hard part of the device, remove the device, etc.). Its insertion and removal is done by the gynecologist; after elimination, the fertility is not modified, you can become pregnant again during the first month after elimination.
Dr. Ciprian Pop-Began
- Obstetrics and Gynecology -
Clinical Hospital of Obstetrics-Gynecology Prof. Dr. Panait Sarbu