Insertion & Removal of Mirena IUD

Matryoshka · May 13th, 2008, 01:05 PM

I was planning to have the Mirena IUD inserted asap after the birth (around 6 weeks after), but recently discovered i will need treatment for abnormal cells on my cervix some time around 4-6 months after the birth (depending how urgent it is). I mentioned the IUD and they said if i had gone ahead and had it already they would simply remove and insert it again during/after the procedure.

So i am wondering now if i should just hold off on the insertion as i've heard it is painful? Is it worth going through twice? I am also nervous about its reliability as i know it needs to be inserted properly and i guess once its in i want it to stay in and not be messed around with, if that makes sense. For those who've had it what would you suggest?

**MantaRay** · May 13th, 2008, 01:10 PM

The insertion wasn't too bad - I had labour pain type cramping from the cervix dilation but it was bearable - better than labour LOL! Personally I would prefer to do it once than twice, but I suspect that if they reinsert it during the procedure it will be no more invasive than the procedure itself anyway, so my guess is that it won't cause any extra discomfort. I have no idea if this would affect the effectiveness in any way though.

I relied on bfing for 5 months and was ok. I guess it depends on how much you don't want to fall pg!! I hope you find an option that works for you!

Matryoshka · May 13th, 2008, 01:15 PM

Our family will be complete after this one and i really want to take every precaution there are no accidents, hence the Mirena seems the most reliable and long term solution while breastfeeding.

To be honest i wouldn't rely on breastfeeding as i was breastfeeding DS1 around the clock (hourly) and got AF back at 4 months so i guess we'd just abstain if i held off on the mirena. I also tried the mini pill but it affected the breastfeeding so not really an option.

They didn't think the removal and re-insertion was a big deal but i'm not so sure.... they are gynacologists so i guess they are qualified....

**MantaRay** · May 13th, 2008, 01:18 PM

Definitely the removal is no biggie. And the insertion only hurts as they have to dilate your cervix to put it in. So if they have to do that anyway for your procedure having it reinserted should make no difference (in theory!!). I know my ob/gyn who I totally trust told me re-insertion is no big deal.

**Sana** · May 13th, 2008, 03:23 PM

Insertion and removal didn't cause any problems for me. Only very minor cramping, less than a normal period. From the info I read before deciding to go for Mirena, it isn't suitable for people who haven't had a pregnancy and labour, as your cervix is closed too tight. Otherwise it should be fine. You may need to took around for a trained GP or gynae, as some GPs don't put them in.

paradise lost · May 13th, 2008, 07:26 PM

Mumma B i had no problems getting it inserted - like period pain but i haven't had period pain since (over a year now) so well worth it. One question though, my friend had to have abnormal cells removed from her cervix and was told she couldn't have the Mirena...??? They said it counts as "cervical surgery" and means it's unsuitable. But it could be because she's not had kids yet? Might be worth double checking that one though.

Bx

Matryoshka · May 13th, 2008, 08:44 PM

Wow i didn't know that Hoobley... i will have to look in to it properly, though you would have thought they would have told me that.

paradise lost · May 13th, 2008, 08:58 PM

Yeah you would, but i wonder if it's to do with having more kids...? They basically told her that IUS use after cervical surgery can be a factor in incompetant cervix pregnancy loss. It does say on Mirena's site you can't have it if you have or may have cancer of the uterus or cervix...? But she didn't have cancer, i think it was stage 2 changes she had. Perhaps she also had PID and never mentioned it - she got HPV from a cheating ex, he could have given her anything really. Also she has ME in her history and they don't like to put it into people with weakened or malfunctioning immune systems as it makes you more prone to infection. I dunno, i'm sure they'd have said if it wasn't an option - they actually SPECIFICALLY said they'd put another one in after, not some vague thing like "we'll see afterwards" or anything.

Bx

**missya** · May 14th, 2008, 02:21 PM

Hiya MummaB,
Just a word of warning, if you google 'curezone' and search for Mirena IUD side effects you will find posts from hundreds of woman around the world who have suffered numerous side effects from this device and I am one of them. There are law suits apparently being made against it in the US. Don't get me wrong it works fine for some people my doctor included but if you are going to get it and read this first at least if you start to have any side effects you won't blindly carry on feeling terrible and not knowing what the reasons are. Some woman like me absolutely loved it but at the 2 1/2 yr mark my trouble began and it took me 6 months to connect the dots and find that site. If you have trouble finding it just let me know and I'll find out exactly what the address is. Please don't let me scare you off as everyone is different but I couldn't say nothing. They say forwarned is forearmed.
Cheers Missy

Matryoshka · May 14th, 2008, 02:40 PM

Hoobley, yeah they are pre-cancerous cells - not sure if that is counted.

Missya - i was really against the IUD at first as my friend had one and had lots of side effects and ended up having it removed after a year. But for someone breastfeeding who wants reliable contraception there aren't many options and i read a thread on here where lots of women were happy with it.... so i don't know what else to try.

I'm too scared to get my tubes tied and DH won't have the snip.

**SJmumof2** · May 14th, 2008, 02:52 PM

The mirena hurt a little bit when they inserted it....but its done really fast
When mine was taken out i didnt feel a thing. But i do want to add that the day after i had the mirena inserted i started having panic attacks. Apparently it triggers depression in one out of 100 people. So i ended up getting it removed for those reasons. It was a trigger in my mental health problems.
But it is an excellent form of contraception. I wish i could have used it.

**missya** · May 14th, 2008, 04:49 PM

Hi again,
Just a note that if you look at the website I mentioned you will see alot of woman finding out that they shouldn't have been put on it while they were breast feeding. I haven't looked into that issue myself much but I do recall woman discussing it in the posts and were very worried due to complications and some issues their babies were having. might pay to have a look.
If you do go ahead the insertion was uncomfortable but the the removal was fine and I had SEVERE thrush at the time (just one of the many joys of the mirena) cheers Missy

Matryoshka · May 14th, 2008, 05:24 PM

Missya thank you so much... i thought i'd researched this but obviously not enough. I've also come across the info about it not being the first choice for breastfeeding mothers on the mirena website!

paradise lost · May 14th, 2008, 07:05 PM

MummaB, it's not the first choice for BFing mums because the uterus stays softish and contracts during feeding for a good few months while one is BFing. This raises the chance of perforation, because the uterine walls are softer. Your care provider will have their own stats - you can ask what their perforation rate is like and how many of those women were BFing. I never asked about BFing because i'd weaned by the time i got my Mirena, but my doctor had had zero perforations, although, as she put it "i've only done 900 insertions" (the rate is 2 per 1000 i think). In addition a small amount of the hormone passes in the milk (i think i read 6% of mum's blood level - your blood level with Mirena is 10% of what it'd be on the mini-pill). SOME women have supply issues on levongestrel (the mirena hormone). I had slower let-down and my already failing (thyroid issues) supply suffered even more.

I'm kind of in the same conundrum (not PG yet though!) as between and after kids i'm aiming to use Mirena. For me so far (only about 17 months) though i had mildly annoying spotting for 10 or so months and STILL get my period and a day of post ovulation spotting every month, so long as i take my EPO i don't have any other symptoms and i'm loving this method. I wouldn't have my tubes tied (too permanent and invasive) and i wouldn't want DP to get the snip either (same reason) so i'm researching my eyes out just now! LOL. I am thinking next time i will had a copper IUD from 6wks-12months PP and then have the Mirena put in when bubs is eating food well - that's if i don't want to have another one soon after. I don't plan to BF much longer than 12-18 months anyway, so i'm happy to continue feeding until my supply drops off, if it does, after re-insertion.

Anyway, those are my thoughts. LOL.

Missya, i'm so sorry you had terrible side effects. I had a similar experience on Depo provera and it was hell.

Bx

Matryoshka · May 14th, 2008, 07:38 PM

I've been doing a lot of reading and have re-considered this.

I managed to download a PDF for practitioners (all i had to click was yes to the question 'are you a medical practioner' lol).

Firstly its contraindicated for those who've had abnormal pap smear, which i have. I take that to mean unsuitable?

Secondly it says Do NOT re-insert mirena - and this is exactly what they said they would do during my procedure.

I've also been reading other peoples experiences and come across a lot to do with issues and pain breastfeeding. It reminds me much like they tell you the mini pill has no effect on milk or breastfeeding but for me and many others it did - i know because i know my body so well and the issues stopped the day i stopped the mini pill.

So i guess i'm reconsidering this.

paradise lost · May 14th, 2008, 08:37 PM

Hmm, when my clinic says "re-insert" they definitely mean "the system" not "that specific Mirena". No coil gets re-inserted, copper or IUS - you always get a brand new sterile one.

I just emailed the friend i was talking about. She says she had stage 3 changes, which meant she had to have laser ablation of the cells then pap smears every 6 months for 2 years and every year for 3 years and until the end of those 5 years post treatment they still consider her to potentially have cancer, so they don't use the Mirena. She could have one now but wants a baby instead

Bx

Matryoshka · May 15th, 2008, 12:03 AM

Oh i see.... no wonder i was confused, because she literally said "we'll just take it out and put it back in again" - sounds like she meant the same one!

I've had to have 6 monthly pap smears for 5 years now, and changes have gone from 1-3 and back again in the past 3 years. They have held off on treatment because i've either been pregnant or ttc or pregnant again etc. But this is my final pregnancy and they are currently stage 2 so treatment is planned for after the birth.

From what i've read, and the contraindications of my situation i don't think this is the contraceptive for me.... shame because i had high hopes for it and don't really have any other options.

I am glad to hear your friend is in the clear now and is planning for a baby

**shell_l_d** · August 16th, 2008, 02:27 PM

Had a Mirena (type of IUD/contraceptive) put in 7Aug08 at a Day Surgery, got script at my GP ($30).
For first fitting, they should be fitted whilst you have your period (yuk), coz cervix is softer or something.
They don't need to dialate your cervix to fit the mirena if you've had you're cervix dialated before (eg: had a vaginal birth or dialated during a failed vaginal birth).
I've had 2 emerg c/s after labouring & with the 2nd birth, I was definitely 10cm dialated obgyn said, so didn't have to dialate my cervix to fit the mirena.

Cost $215 at the day surgery clinic all up but got about $190 back from Medicare as have reached safety net for this calendar year.
Was very quick & just bit uncomfortable on 2nd attempt. On first attempt they put speculum in deep in usual spot where your cervix would be & opened it up but didnt work for me, she said coz she could see scarring from previous surgeries & coz my cervix wasn't in that spot (works for most other women though), so took it out (speculum) & tried again. My cervix is to the left & at the back (remembered from IVF clinic when they did the AIH/IUI coz it took them a while to find it & from other gynae type aptmts too).

Anyhow it's sooooo cheap & easy compared to the pill/condoms, lasts 5years, then can just get another fitted after 5yrs, they remove old one & insert new one at same time. It reduces the length & flow of your periods & quite often you dont get a period after about 4-12mths (perfectly fine/normal), which also saves on pads/tampons, so a real cost saver.

I had Cin2 (stage 2) precancerous cervical cells removed (laser ablation & cone biopsy) in May95, several mths after discovering it & about 12mths since my last pap. Then had to have yearly pap smears for 10yrs after, now on 2yrly (normal) paps.

Relative had stage 3 precancerous cervical cells by time it was diagnosed & removed, within 12mths from her last smear - can grow quickly.