Mirena is a type of levonorgesterel-releasing intrauterine system that’s considered one of the most popular IUDs in the world. Now if you’ve just been inserted Mirena IUD and you’re experiencing bleeding, here are some steps to help you understand this experience better and address it properly:

Know what to expect when getting a Mirena insertion

Mirena is a trusted form of contraception because it is about 99% effective at preventing pregnancy. But in some women, Mirena insertion may cause bleeding for up to 6 months, after which periods become lighter or it could stop altogether.

Reactions may differ in women, but here are some of the common things that you should expect after being inserted with Mirena:

  • The first six months. For the first three to six months after your Mirena IUD was inserted, you should expect some irregularities in your period. You could experience some spotting, get heavier-than-usual periods or not get any in a month at all. You may also notice that your periods are longer than usual and that’s normal. In fact, 20% of women have their periods for more than 8 days for the first few months after being inserted with Mirena.
  • After six months. By this time, you should get lighter periods. But it’s also not uncommon for some women to get unpredictable periods after the first year mark while others won’t have any at all. If you experience severe bleeding with or without symptoms, this should be a cause for concern and you need to follow the next few steps in knowing how to address it properly.

Have your Mirena inserted at the right time

Although your Mirena IUD can be inserted any time, there are certain periods when it’s the most ideal to reduce any pain, bleeding or cramping. So if you haven’t had an insertion yet, it’s best to have your Mirena IUD inserted at 4-6 weeks postpartum when your cervical canal is still open and your uterine cavity is still enlarged.

You’ll also less likely to experience heavy bleeding if you’re breastfeeding for the first few months after giving birth. You can also have your Mirena IUD inserted immediately after a miscarriage to reduce discomfort and bleeding.

Rule out other medical conditions

While bleeding is a common side effect of Mirena insertion, it could also be a sign of other medical conditions like sexually transmitted infections (STIs), polyps and cancer. In fact, it could also be a sign that you’re pregnant.

So if you experience severe bleeding, especially when it is accompanied by some symptoms, make sure that you seek consultation right away to rule out the presence of another medical condition.

Keep in mind that bleeding patterns associated with the Mirena IUD include spotting, heavy bleeding, irregular bleeding, frequent menstruation, continuous bleeding, amenorrhea or the complete absence of menstruation and oligomenorrhea or infrequent menstruation.

You should also look out for other red flag symptoms like pain during sex, fever, chills, foul-smelling discharges, abdominal pain, severe headaches, jaundice and sores on the vaginal area.

Learn about the different complications of Mirena

Aside from existing medical conditions, bleeding could also be associated with the different complications related to Mirena insertion that includes infection, inflammation, perforation of the intestinal wall, migration of the Mirena device into the abdomen, pregnancy that resulted to miscarriage, ovarian cysts and changes in the endometrium.

Uterine perforation is one of the most common complications of Mirena insertion and bleeding is a result of the scarring or damage in the cervix, intestines or abdominal wall.

Since most women who experience uterine perforation due to Mirena insertion don’t get diagnosed until it’s permanent injury has occurred, it could result to more serious complications like peritonitis, internal scar tissue, abscess, intestinal obstruction and erosion of the adjacent bladder.

This is why it’s very important to monitor for any bleeding or spotting, especially 6 months after Mirena insertion and report it to your doctor right away.

Seek medical consultation to be prescribed with the right medical management

Still, the best way to stop bleeding after Mirena insertion is to seek medical consultation so you can be prescribed with the right medical management depending on what’s causing your bleeding. Here are some of the most common treatment options that may be given by your doctor:

  • Combined hormonal contraceptive

If your bleeding is the result of hormonal imbalance, you could be prescribed with a combined hormonal contraceptive as long as you don’t have any contraindications to estrogen. A pill or ring may be prescribed to you for three months and you can take four-day breaks if bleeding recurs.

  • NSAID therapy

Your doctor may also prescribe the use of a non-steroidal anti-inflammatory drug (NSAID) for five days to shorten the duration of your bleeding to protect you from blood loss. This form of therapy is only used for a shorter period and can be repeated every month if bleeding recurs.

  • Other medications

Some doctors will also prescribe Tranexamic Acid for five days to reduce bleeding, a Progesterone only pill to be taken twice daily over a period of 20 days or Norethisterone 5mgs thrice a day to control bleeding. These medications cannot be taken long-term and may only be repeated monthly if the bleeding continues or recurs.

Most importantly, you need to be responsible for making sure that your Mirena IUD is in place even if you’re not experiencing any bleeding or other symptoms. Keep in mind that 5% of Mirena insertions get expelled, especially during the first few months after insertion.

So, it’s your responsibility to make sure that your IUD is still in place by checking it monthly. Feel for two find threads hanging that signifies that your coil is still intact.

If you can’t feel anything, contact your doctor right way. It’s also very important to visit your gynecologist 6 weeks after your insertion and every year after. But if you’re experiencing any pain, discomfort, cramping and bleeding, see your doctor right away.

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