Can menstruation stop with the mirena coil. Mirena: indications, side effects, contraindications

Many women are concerned about the question: "How long do periods with a spiral go?" Today we will deal with the basic concepts, possible complications, contraindications and body reactions to menstruation with a spiral.

What is an IUD and why is it needed?

An IUD is inserted for a contraceptive effect. The method is used not only in Russia, but also in the Scandinavian countries and Asia. There are two types of drugs: inert and medicinal. The first are made of plastic and are various forms, while the latter have a plastic base with the addition of copper or silver wire, or with a hormone. Hormonal preparations increase efficiency and reduce the risk of complications. The installation of the IUD is carried out on the 4-8th day of the onset of menstruation. During this period, the cervical canal is ajar, and the installation of the drug is painless and easy. It is recommended to insert an IUD immediately after an abortion, two months after delivery, and six months after a caesarean section. After the introduction of the IUD for a week, you should limit yourself to physical activity, give up hot baths, saunas, baths, do not take laxatives and diuretics, and exclude sexual activity. The doctor will inform you about the service life of the drug, about possible complications and their symptoms. Remove the IUD after the expiration date, with the development of complications, at the request of the patient.

Complications

The first menstruation after the installation of the spiral is plentiful and long. The main complications after the installation of the IUD:

• perforation of the uterus;
• displacement of the contraceptive abdominal cavity;
• pain;
• inflammatory diseases;
• increase in body temperature;
• purulent or sanious discharge;
• anemia.

Cramping pains in the lower abdomen, and bleeding indicate the expulsion of the drug to the outside. An increase in temperature and the appearance of secretions indicate inflammatory reactions. After the installation of the spiral, there are abundant periods, which leads to the development of menorrhagia. With heavy blood loss, iron deficiency anemia develops. If heavy periods continue after the insertion of the spiral, then you need to contact a specialist to remove the IUD.

Menstruation after the installation of the spiral

Monthly and spiral: how does our body behave after the installation of the IUD? Normally, after the installation of the IUD, the complications described above are possible, gradually every month the effect decreases and disappears altogether. Menstruation during the spiral does not come regularly. For the first few months, bleeding may not be abundant at first, but after menstruation, menstruation will become more abundant and will last a couple of days longer than usual. Over time, the level of hormones will even out, and menstruation will come on time and with the same duration. Abundant periods with a spiral will go away on their own in a couple of months, but if it continues for a long time, consult a specialist.

Indications and contraindications

Indications for the use of IUDs are: unwanted pregnancy, dangerous partner, high fertility and contraindications to pregnancy.

Contraindications:

1. inflammation of the pelvic organs;
2. malignant formations of the cervix and body of the uterus;
3. pregnancy;
4. ectopic pregnancy;
5. algomenorrhea;
6. metrorrhagia;
7. hypoplasia;
8. anomalies in the development of the uterus and genital organs;
9. anemia;
10. etc.

Advantages of the method

• prolonged use;
• efficiency;
• instant contraceptive action;
• restoration of fertility after removal;
• use during lactation;
• The IUD has a therapeutic effect;
• low cost.

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Reviews and comments

I put a spiral when the child was six months old. Menstruation came when the child was 1.2 years old, went for three days, but plentifully, did not have time to change the pads. And there were terrible pains that I never had.

An intrauterine device (IUD) is a T-shaped device that is inserted into the uterine cavity to achieve a contraceptive effect.

There are 2 types of spirals: spirals containing copper or silver, and spirals containing hormones. Spirals containing hormones are recognized as more effective, therefore, they are now more often used in gynecological practice.

What is the Mirena intrauterine device?

The Mirena IUD is a coil containing the hormone levonorgestrel. Every day, Mirena releases a certain small dose of a hormone into the uterine cavity, which acts only within the uterus and is practically not absorbed into the blood. Due to this, the risk of side effects of hormonal effects is significantly reduced, there is no suppression of the ovaries and there is a therapeutic effect, which we will discuss below.

How effective is the Mirena IUD?

More than 20 years have passed since the advent of the Mirena Navy. During this time, Mirena has shown high efficacy in preventing unwanted pregnancy.

According to statistics, within one year of using Mirena, pregnancy occurs in one woman out of 500. Compared to birth control pills, the Mirena spiral is a more reliable contraceptive.

What are the pros and cons of the Mirena IUD compared to other contraceptive methods?

Mirena has its advantages and disadvantages, so it is not suitable for all women. After learning about the pros and cons of Mirena, you can decide if this method of protection against pregnancy is right for you.

Mirena Pros:

• Having installed a spiral once, you no longer need to worry about contraception. While birth control pills need to be taken every day in order for the contraceptive effect to remain reliable.
• The coil does not need to be changed often: you can walk with one coil for up to 5 years in a row. While stocks birth control pills or condoms need to be replenished monthly.
• Unlike condoms, during intercourse, the coil is not felt by you or your sexual partner.
• Unlike birth control pills, the spiral does not increase appetite and does not cause water retention in the body, which means it will not cause weight gain.
• It can be used as a treatment for adenomyosis (endometriosis of the uterus) and for.
• Reduces blood loss during menstruation and.

Cons of Mirena:

• It is impossible to install a spiral on your own: for this you need to visit a gynecologist.
• Unlike, it does not protect against sexually transmitted diseases (including HIV infection, herpes, etc.), therefore it is not suitable for women who have sex with unfamiliar partners.
• In the first 4 months after the installation of the spiral, a woman has an increased risk of inflammation of the fallopian tubes ().
• May cause long-term appearance in the first months after installation.
• May cause irregular periods in the first months after insertion.
• It can cause a temporary cessation of menstruation, but after the removal of the spiral, menstruation returns within 1-3 months.
• May cause . These cysts are not dangerous to health and rarely require any treatment. Usually, they resolve themselves within a few months after the appearance.
• There is a risk of unnoticeable loss of the spiral, which can lead to an unwanted pregnancy.
• If pregnancy occurs while wearing a spiral, then there is a risk or miscarriage for early term.

At what age can Mirena be installed?

Among gynecologists, there is an unspoken rule that intrauterine devices can only be installed in women who have given birth. However, there are studies in which the spirals were installed in nulliparous women, and even girls under 18 years old, and at the same time, the spirals were effective and safe.

And yet, most gynecologists will not undertake to put a spiral if you are under 25 years old and you have not yet given birth.

What tests should be taken before putting the Mirena coil?

Before installing the coil, your doctor will prescribe:

• to make sure there is no inflammation. If the smear detects inflammation, then you will need to be treated first and only after recovery, the doctor will install the spiral.
• to make sure your cervix is ​​healthy and you don't have any precancerous or cancerous changes.
• to make sure that the uterus has a normal shape and the installation of the spiral will be safe. You will not be able to put a spiral with a bicornuate uterus, the presence of partitions in the uterus or other abnormalities in the development of the uterus.
• or to make sure you are not pregnant.

For whom is the Mirena IUD contraindicated?

There are not so many contraindications for installing Mirena. It:

• Pregnancy or suspected pregnancy
• Inflammation of the vagina or cervix
• Chronic genital tract infections that often get worse
• Inflammation of the urethra or bladder
• Precancerous or cancerous changes in the cervix
• Cancer or suspected breast cancer
• Inflammation of the uterus (endometritis) after childbirth or abortion within 3 recent months
• Anomalies in the development of the uterus: bicornuate uterus, septa in the uterus, etc.

To make sure that the spiral is in place, you can try to feel its "antennae" yourself. To do this, wash your hands thoroughly and insert the fingers of one hand deep into the vagina to reach the cervix. "Antennae" to the touch resemble the threads of fishing line. The length of the "antennae" can vary: you can only feel the tips, or feel 2-3 cm. If the threads are longer than 2-3 cm, or if you have not felt them, then you need to contact a gynecologist.

How often do I need to visit a gynecologist if there is a Mirena spiral?

If nothing bothers you, then the first visit to the gynecologist should be done a month after the installation of the spiral. Then visit your doctor in another 2 months. If the doctor confirms that Mirena is in place, then further visits should be done once a year.

Smearing discharge after installing the Mirena coil

In the first months after the installation of Mirena, prolonged spotting bloody (dark brown, brown, black) discharge may appear. This is a normal phenomenon associated with the installation of the spiral. Such discharge can be observed during the first 3-6 months after the installation of Mirena. If spotting persists for more than 6 months, then you need to visit a gynecologist.

Irregular periods after Mirena

Some women who use the Mirena intrauterine device may experience irregular periods. it not connected with hormonal disorders or ovarian dysfunction. The cause of the failure of the menstrual cycle is the local effect of the spiral on the endometrium of the uterus. It is not dangerous to health and does not lead to any negative consequences.

Consult your gynecologist if irregular periods persist for 6 months or more after coil insertion.

No period after Mirena coil

Approximately 20% of women who use the Mirena coil for a year or more, menstruation stops altogether.

If the next menstruation has not come, and more than 6 weeks have passed since the last menstruation, pregnancy must first be excluded. To do this, you can either pass.

If pregnancy is excluded, then the absence of menstruation is caused by a spiral. The hormones that the intrauterine device releases affect the endometrium, inhibiting its growth. The endometrium remains thin and therefore menstruation does not occur. The absence of menstruation does not negative impact on the body and does not cause any consequences in the future.

Menstruation recovers on its own within 1-3 months after the removal of the spiral.

What should I do if I become pregnant while wearing Mirena?

The likelihood of pregnancy while wearing Mirena is quite small, and yet, such cases are described.

If the pregnancy test showed a positive result, then you need to visit a gynecologist as soon as possible. The gynecologist will examine you and send you for an ultrasound. Ultrasound will help determine where the fetus is located: in the uterus or is it an ectopic pregnancy. If the fetus is located in the uterus, then there is a chance to keep the pregnancy.

Do I need to remove the coil if pregnancy occurs?

In order to reduce the risk of early miscarriage and, doctors recommend removing the intrauterine device. In the first hours and days after the removal of the spiral, the risk of miscarriage will be quite high, but if the pregnancy can be maintained, then nothing will threaten the unborn child.

If you decide not to remove the coil, or if its removal is impossible for other reasons, then during pregnancy you will need more careful monitoring by doctors in order to prevent or detect in time possible complications(miscarriage, inflammation, premature birth).

Can Mirena cause developmental anomalies in an unborn child?

Unfortunately, this is not yet known, since there were not so many cases of pregnancy, and it is impossible to compile any reliable statistics.

Cases of the birth of healthy children after pregnancy with a helix are described. Cases of the birth of children with developmental anomalies also exist, but so far it has not been possible to establish whether there is a connection between these anomalies and the fact that the coil was not removed during pregnancy.

How is Mirena coil replaced or removed?

Mirena coil works for 5 years. After this period, the spiral should be removed (if you are planning a pregnancy or want to switch to another method of contraception), or replaced with another spiral (if you are not planning a pregnancy and do not want to switch to other methods of contraception).

You can remove the coil earlier if you are planning a pregnancy. To do this, it is not necessary to wait until the five-year term of the Mirena expires.

It is best to remove the Mirena coil during the next menstruation. If your periods stop while wearing Mirena, or if you want to remove the coil outside of your period, then you need to start using condoms 7 days before the coil is removed.

If you want to replace the coil, you do not need to use condoms, and the replacement can be done on any day of the cycle.

When can I get pregnant after Mirena removal?

The Mirena spiral does not affect the functioning of the ovaries, so you can become pregnant in the next cycle after Mirena removal.

The Mirena intrauterine therapeutic system is a white or almost white hormonal-elastomer core located on a T-shaped body and covered with an opaque membrane, which serves as a kind of regulator for the release of the active active ingredient. The T-body is provided with a loop at one end with an attached thread to remove the helix and two shoulders. The Mirena system is placed in a conductor tube and is free from visible impurities. The drug is supplied in sterile blisters made of polyester or TYVEK material in the amount of 1 piece.

pharmachologic effect

The intrauterine system or simply the IUD Mirena is a pharmaceutical preparation based on levonorgestrel , which, gradually released into the uterine cavity, has local gestagenic action . Due to the active component of the therapeutic agent, the sensitivity of the estrogen and progesterone receptors of the endometrium decreases, which manifests itself in a strong antiproliferative effect.

There are morphological changes in the inner lining of the uterus and a weak local reaction to a foreign body in its cavity. The mucous membrane of the cervical canal thickens to a large extent, which prevents the penetration of sperm into the uterus and inhibits the motor abilities of individual spermatozoa. In some cases, ovulation is also inhibited.

The use of the drug Mirena gradually changes the nature menstrual bleeding . During the first months of use intrauterine device, due to the inhibition of endometrial proliferation, there may be an increase in spotting discharge from the vagina of a bloody nature. As the pharmacological effect of the therapeutic agent develops, when the pronounced suppression of proliferative processes reaches a maximum, a period of scanty bleeding begins, which often transforms into oligo- and amenorrhea .

3 months after the start of using Mirena, the menstrual blood loss of women is reduced by 62-94%, and after 6 months - by 71-95%. This pharmacological ability to change the nature uterine bleeding used to treat idiopathic menorrhagia in the absence of hyperplastic processes in the membranes of the female genital organs or extra genital conditions, an integral part of the pathogenesis of which is a pronounced hypocoagulation , since the effectiveness of the drug is comparable to surgical methods of treatment.

Pharmacodynamics and pharmacokinetics

After the intrauterine system is established, the pharmaceutical drug begins to act immediately, which is manifested in the gradual release levonorgestrel and its active absorption, which can be judged by the change in its concentration in blood plasma. Speed the release of the active ingredient is initially 20 mcg per day and gradually decreases, reaching 10 mcg per day after 5 years. Hormonal coil Mirena sets high local exposure , which provides a concentration gradient of the active substance in the direction from the endometrium to the myometrium (the concentration in the walls of the uterus varies by more than 100 times).

Entering the systemic circulation levonorgestrel contacts whey proteins blood: 40-60% of the active ingredient non-specifically combines with , and 42-62% of the active component - specifically with selective carrier of sex hormones SHBG . About 1-2% of the dosage is present in the circulating blood as the free steroid. During the use of a therapeutic agent, the concentration of SHBG decreases, and the free fraction increases, which indicates the non-linearity of the pharmacokinetic ability of the drug.

After the introduction of the Mirena IUD into the uterine cavity, levonorgestrel in the blood plasma is found after 1 hour, and the maximum concentration is reached after 2 weeks. In clinical studies, it has been proven that the concentration of the active component depends on the body weight of a woman - with low weight and / or with a high concentration of SHBG, the amount of the main component in plasma is higher.

Levonorgestrel metabolized with isoenzyme CYP3A4 to the end products of metabolism in the form of conjugated and unconjugated 3-alpha and 5-beta tetrahydrolevonorgestrel , after which it is excreted through the intestines and through the kidneys with an excretion coefficient of 1.77. In an unchanged form, the active component is eliminated only in trace amounts. The total clearance of the biological substance Mirena from blood plasma is 1 ml per minute per kilogram of weight. The half-life is about 1 day.

Indications for use

• contraception;
• idiopathic menorrhagia;
• preventive treatment endometrial hyperplasia during hormone replacement therapy.

Mirena spiral - contraindications

Absolute contraindications for the use of a hormonal spiral:

• pregnancy ;
• inflammatory diseases of the pelvic organs;
• postpartum ;
• infectious process in the lower parts genitourinary system;
• history of septic abortion within the last three months;
• malignant neoplasms uterus or cervix;
• female reproductive system;
• uterine bleeding of unknown origin;
• hormone-dependent tumor neoplasms;
• congenital or acquired anomalies of the anatomical and histological structure of the uterus;
• acute liver disease;
• increased sensitivity to the pharmacological components of the intrauterine device.

Pathological conditions that may complicate the use of an intrauterine device with levonorgestrel :

• postpartum period from 48 hours to 4 weeks;
• deep vein thrombosis;
• benign trophoblastic disease ;
• breast cancer present or in history within the last 5 years;
• high risk of sexually transmitted infections;
• active liver disease (eg. spicy , decompensated and so on).

Side effects of Mirena

Changes in the menstrual cycle

IUD side effects should start with changes in the nature and cyclicity of menstrual bleeding , because they appear much more often than other adverse effects of therapeutic measures. Thus, the duration of bleeding increases in 22% of women, and irregular uterine hemorrhages observed in 67%, when considering the first 90 days after the installation of Mirena. The frequency of these phenomena gradually decreases, since the hormonal coil releases less biologically active substance over time and by the end of the first year, respectively, is 3% and 19%. However, the number of manifestations of other menstrual irregularities increases - by the end of the first year develops in 16%, and rare bleeding in 57% of patients.

Other side effects

• From the side immune system: skin rash and , , .
• From the side nervous system : headache, , depressed mood up to .
• Side effects from the reproductive system and mammary glands: vulvovaginitis , discharge from the genital tract, infections of the pelvic organs, , breast pain, expulsion intrauterine device, , perforation of the uterus.
• From the side gastrointestinal tract : abdominal pain, nausea.
• Dermatological disorders: , , .
• From the side of cardio-vascular system : increased blood pressure.

Mirena intrauterine device: instructions for use (Method and dosage)

General provisions for the use of the drug

The Mirena contraceptive is injected directly into the uterine cavity, where it exerts its pharmacological effects for 5 years. Release rate the active hormonal component is 20 mcg per day at the beginning of the use of the intrauterine device and gradually decreases to a level of 10 mcg per day after 5 years. Average elimination rate levonorgestrel throughout the therapeutic course is about 14 mcg per day.

There is a special contraceptive effectiveness rate , which reflects the number of pregnancies in 100 women during the use of contraception. With proper installation and compliance with all the rules for using the intrauterine device, pearl index for mirena is about 0.2% for 1 year, and the same figure for 5 years - 0.7%, which expresses the incredibly high efficiency of using this method of contraception (for comparison: for condoms, the Pearl index ranges from 3.5% to 11 %, and chemicals type of spermicide - from 5% to 11%).

Installation and removal of the intrauterine system may be accompanied by pain in the lower abdomen, moderate bleeding. Also, manipulation can cause fainting due to a vascular-vagal reaction or a seizure in patients. therefore, the use of local anesthesia of the female genital organs may be required.

Before installing the drug

It is recommended that an intrauterine device be installed only doctor who has experience with this type of contraception, as mandatory aseptic conditions and appropriate medical knowledge of female anatomy and the operation of a pharmaceutical preparation are required. Immediately prior to installation, it is necessary to carry out general and gynecological examination in order to eliminate the risks of further use of a contraceptive, the presence pregnancy and diseases that act as contraindications.

The doctor must determine the position of the uterus and the size of its cavity, since the correct location of the Mirena system ensures a uniform effect of the active ingredient on endometrium which creates the conditions for its maximum efficiency.

Instructions for Mirena for medical personnel

Visualize the cervix with the help of gynecological mirrors, treat it and the vagina with antiseptic solutions. Grab the upper lip of the cervix with forceps and straighten the cervical canal with gentle traction, fix this position of the medical instruments until the end of the manipulation to install the intrauterine device. Slowly moving the uterine probe through the organ cavity to the bottom of the uterus, determine the direction of the cervical canal and the exact depth of the cavity, in parallel, excluding possible anatomical septa, synechia, submucosal fibroma or other obstacles. If the cervical canal is narrow, it is recommended to use a local or conductive type of anesthesia to widen it.

Check the sterile packaging with the drug for integrity, then open it and remove the intrauterine device. Move the slider to the farthest position so that the system is drawn into the conductor tube and takes the form of a small stick. While holding the slider in the same position, set the upper edge of the index ring in accordance with the previously measured distance to the fundus of the uterus. Carefully advance the conductor through the cervical canal until the ring is about 1.5-2 cm from the cervix.

After reaching the desired position of the spiral, slowly move the slider to the mark of full disclosure of the horizontal hangers and wait 5-10 seconds until the system acquires a T-shape. Advance the conductor to the fundal position, as evidenced by the full contact of the index ring with the cervix. While holding the conductor in this position, release the drug using the lowest possible position of the slider. Carefully remove the conductor. Cut the threads to a length of 2-3 cm, starting from the external os of the uterus.

It is recommended to confirm the correct position of the intrauterine device using ultrasound immediately after the manipulation to install the Mirena preparation. Re-examination is performed after 4-12 weeks, and then 1 time per year. In the presence of clinical indications, gynecological examination and verification of the correct position of the spiral by functional methods of laboratory diagnostics should be carried out regularly.

Removal of the intrauterine device

Mirena must be removed after 5 years after installation, since the effectiveness of the therapeutic agent is significantly reduced after this period. The medical literature even describes cases of the adverse effects of an intrauterine device not removed in a timely manner with the development of inflammatory diseases of the pelvic organs and some other pathological conditions.

To extract the drug requires strict adherence to aseptic conditions. Removal of Mirena is a gentle pulling of the threads captured by special gynecological forceps. If the threads are not visible, and the intrauterine device is deep in the organ cavity, then a traction hook can be used. It may also be necessary to dilate the cervical canal.

After removal the Mirena drug, the system should be examined for its integrity, since in some situations separation of the hormonal-elastomer core or its slipping onto the shoulders of the T-shaped body can be observed. Pathological cases are described when such complications of intrauterine device removal required additional gynecological intervention.

Overdose

With proper use and compliance with all the rules for setting up an intrauterine device, an overdose of a pharmaceutical drug impossible .

Interaction

Pharmaceutical enzyme inducers, especially biological catalysts from the system cytochrome P 450 , which are involved in the metabolic degeneration of drugs such as anticonvulsants ( , Phenytoin , ) and ( and others), enhance the biochemical transformation gestagens . However, their influence on the effectiveness of Mirena is insignificant, since the main point of application of the therapeutic abilities of the intrauterine device is a local effect on the endometrium.

Terms of sale

It is released in pharmacy kiosks by prescription.

Storage conditions

The intrauterine hormonal coil should be stored in a sterile package out of the reach of young children, which is protected from direct sun rays. Proper temperature regime should not exceed 30 degrees Celsius.

Best before date

special instructions

Hormonal spiral Mirena with uterine myoma

(other names are fibromyoma or leiomyoma ) is a benign tumor that grows from the muscular layer of the uterus (myometrium) and is one of the most common gynecological diseases. Pathological focus is a knot of randomly woven smooth muscle fibers from a few millimeters to several centimeters. For the treatment of this nosological unit, as a rule, surgical intervention is used, however, a conservative therapy scheme has now been developed.

The drug of choice is hormonal agents with a preferred local type of interaction, therefore the Mirena intrauterine device is a kind of gold standard for the sanitation of uterine fibroids.

Antiestrogenic effect It is implemented in reducing the size of pathological nodes, preventing possible complications and reducing the volume of surgical intervention in order to preserve the maximum physiological structure of the uterus and make future pregnancies possible.

Mirena coil for endometriosis

- a pathological condition when the cells of the inner layer of the uterus grow outside of it. Histological structures have receptors for female sex hormones, which causes the same changes as in normal endometrium, manifested by monthly bleeding, in response to which an inflammatory reaction develops.

A gynecological disease is inherent in women of reproductive age and, in addition to pain, can lead to a frequent complication of endometriosis, which is why it is so important to diagnose and treat the pathological condition in a timely manner. Of course, endometriosis therapy can be a surgical intervention with a minimally invasive approach and a small number of side effects, but it is much preferable to choose conservative methods of treatment.

Mirena intrauterine device effective remedy to eliminate endometriosis for several reasons:

• proven by practical studies, the effect of the drug, manifested by inhibition of the growth of pathological foci, a decrease in their size and gradual resorption;
• fewer side effects compared to other pharmaceuticals;
• relief of the pain syndrome inherent in the problem of endometriosis;
• there is no need for daily oral tablets or injections;
• normalization of the menstrual cycle;
• there is no need for contraception.

Intrauterine device for endometrial hyperplasia

endometrial hyperplasia - this pathological condition is extremely similar to endometriosis, as it is an excessive growth and thickening of the mucous membrane of the female genital organs. The difference lies in the correct anatomical location of the histological structures, which only changes the symptoms and possible complications, but does not eliminate them.

Recognize the nosological unit allow abundant and prolonged spotting during menstruation or uterine hemorrhages not related to the cycle, the absence of ovulation and the impossibility of implanting the embryo into the altered endometrium, which is a manifestation of an increased level of estrogens in the body. The etiological treatment of this problem, aimed at eliminating the immediate cause, is a hormonal agent with a pronounced anti-estrogenic effect.

Most gynecologists prefer to use the Mirena intrauterine system because of the reliability of its pharmacological action, the convenience of everyday use, which does not require additional medical knowledge and relative cheapness compared to other therapeutic agents, because the use of Mirena does not involve daily spending on oral tablets or injections.

Pregnancy after using the Mirena intrauterine device

Since the contraceptive has predominantly local pharmacological effects, the complete restoration of all physiological parameters after removal of the drug comes quickly enough. Within a year after the evacuation of the system, the frequency of planned pregnancies reaches 79.1-96.4%. The histological state of the endometrium is restored after 1-3 months, and menstrual cycle completely rebuilt and normalized within 30 days.

Analogues

There are several pharmaceutical preparations with the same ATC code and a similar composition of active ingredients: Jaydes , , Evadir , however, only Jaides can rightfully be called an analogue, since medicine represented by an intrauterine system based on levonorgestrel with a lower dosage, and therefore designed for only three years of continuous use.

With alcohol

The pharmaceutical preparation has a pronounced local therapeutic effect and enters the systemic circulation in small quantities. female body, therefore, does not interact with the components of alcoholic beverages, however, dosed use is recommended so as not to cause other side effects or adverse effects.

During pregnancy and lactation

The use of the Mirena intrauterine device is contraindicated in pregnancy or suspicion of it, since any intrauterine contraceptive increases the risk spontaneous abortion and premature birth. Removal or probing of the system can also lead to unplanned evacuation of the fetus from the uterine cavity. If careful removal of the contraceptive is not possible, medical abortion should be discussed if indicated.

If a woman wants to keep the pregnancy, then, first of all, the patient should be fully informed about the possible risks and adverse consequences, both for her body and for the child. In the future, it is necessary to carefully monitor the course of pregnancy and be sure to exclude ectopic implantation by reliable diagnostic methods.

Due to the topical use of a hormonal contraceptive, there is a possibility virilizing effect on the fetus However, due to the high efficacy of Mirena, clinical experience with pregnancy outcomes while using an intrauterine device is very limited. The woman who wishes to continue the pregnancy should also be informed of this.

Breast-feeding is not a contraindication for the use of the intrauterine system, although small amounts of the active ingredient (about 0.1% of the dose) can enter the milk during lactation. It is unlikely that such meager amounts of levonorgestrel have any pharmacological effects on the child. The medical community overwhelmingly agrees that the use of the drug after 6 weeks after childbirth does not have adverse effects on the growth and development of a young organism.

Mirena spiral with menopause - consequences, reviews, cost, rules of use, you need to find out in advance. The contraceptive is different from the usual spiral, which prevents pregnancy. It contains a synthetic hormone - progesterone. Mirena normalizes hormonal levels, protects against unwanted pregnancy.

The action of the Mirena coil

T-shaped device with 2 antennae. In the body of the Mirena spiral there is a cavity filled with hormones. The body receives an equal amount of progesterone daily in the form of levonorgestrel - 20 mcg each. The hormone belongs to the group of gestagens. Prevents the formation of the endometrium, the growth of cancer cells. The Mirena coil balances progestins and estrogens. Does not interfere with ovarian function. Prevents the development of pathological processes in the pelvic organs, reduces the manifestation of menopause. Used as a means of contraception. Its action is especially useful at the initial stage of menopause, when it is still possible to become pregnant. The spiral thickens the discharge, prevents spermatozoa from entering the uterine cavity. Prevents the development of hyperplasia, endometriosis.

Mirena and uterine fibroids

One of the reasons for the development of fibroids is hormonal disorders. The likelihood of a tumor appearing in the process of menopause is high. Uterine fibroids provoke painful, heavy periods, bleeding during menopause. The Mirena spiral evens out the hormonal background, prevents the development of a neoplasm or helps to reduce it. While the conventional coil is contraindicated, Mirena is recommended by doctors for the prevention of many diseases. The tool regulates estrogens, prevents the development of the endometrium. Menstruation scanty may be present in the first months of treatment, then disappears altogether.

An increased amount of estrogen provokes the growth of fibroids. In the process of fading reproductive functions, the amount of estrogens in a woman's body decreases, but they replenish it with drugs containing a synthetic hormone. As a result, there is a situation with a high rate of estrogen. The spiral allows you to balance this level. Since it contains progesterone, it is possible to use drugs with estradiol. But the treatment regimen should be selected by the doctor, taking into account individual features organism. According to women, Mirena copes quite well with fibroids. It either stays the same or disappears completely.

Abundant discharge after the installation of the spiral

When using this remedy, spotting may be present for the first 4 months, which is the norm for menopause. So the body adapts to the new conditions of existence, the hormonal background stabilizes. At the same time, the risk of developing inflammation is high. Often, pathology is the cause of bleeding after the installation of the spiral. Firstly, the body is trying to get rid of a foreign object, and secondly, the hormonal background is changing. If bleeding occurs, consult a specialist. Even if there are no other warning signs.

How long does the bleeding last

With menopause, the Mirena spiral helps to avoid spotting, spotting. For the first 2 months, there may be abundant spotting if the spiral was placed at the beginning of menopause. But after 4 months everything returns to normal - there are no discharges or they come too scarce. The bleeding lasts from 5 to 7 days. After installing the Mirena spiral, the doctor should advise the woman. Tell what consequences await her. In what cases to seek help from gynecologists. In general, you should visit a doctor 2 times a year. And also 1-2 months after the installation of the spiral.

Contraindications

The tool is not suitable for everyone. Before installing the Mirena spiral, it is necessary to undergo an examination of the whole body. Contraindications are:

The consequences of installing a spiral

At first, they may appear side effects. If they are not significant, continue to use the remedy. Otherwise, you will have to refuse it. What could be?

If the body has taken the remedy without side effects, the disappearance of menopause symptoms can be felt immediately. Headache, excessive sweating, hot flashes, irritability, and other unpleasant manifestations of menopause pass.

However, there is another side of the coin. Progesterone promotes fluid retention, possibly swelling of the legs, weight gain. An allergic rash, acne appears on the skin. There is constant nausea, an incomprehensible state, a clouded state, laziness, apathy appear. Hair on the face may grow, fall out in bunches on the head. Doctors usually say that the condition of the hair and skin improves from the system, fewer wrinkles appear. If the above symptoms are present, you need to double-check the hormonal background, consult with specialists. You may have to take it out. Hormone deficiency and excess negatively affects the body. Doctors allow it negative impact systems within 3 months. Then the body adapts to the new conditions of existence, excess weight goes away, and the woman feels healthy again, without side effects, symptoms of menopause.

Mirena use for menopause

The doctor installs the remedy after a preliminary examination of the woman's body. The procedure itself does not take much time. Immediately after installation, a woman can leave the gynecologist's office. Within 2 weeks it is forbidden to lift weights. In the future, when using a spiral, heavy physical activity. There are no discharges during menopause. The use of Mirena provides for constant monitoring by the gynecologist, the woman herself. If pink, bloody discharge appears, you should consult your doctor. The rest of the woman leads a full life.

The use of Mirena prevents unwanted pregnancy. In the first years of the extinction of reproductive functions, conception is quite possible. However, it is almost impossible to determine pregnancy by your own feelings - they resemble the manifestations of menopause. Menstruation may be absent due to menopause. The pregnancy test is also not as accurate as before. Since the level of hCG during menopause in women is increased. Corresponds to the first weeks of pregnancy. Thus, a negative test result can mean pregnancy, and a positive one can deny it. Using Mirena allows a woman to have sex without the threat of conception.

Modern medicine offers a woman to use a wide variety of methods to prevent unwanted pregnancy. Among the available options, it is worth highlighting the Mirena intrauterine hormonal coil, which can be used not only as a contraceptive, but also as part of therapy for certain gynecological diseases.

The Mirena intrauterine device is a T-shaped frame from which a certain amount enters the woman's blood every day. the hormone levonorgestrel. It is this hormone that is the main component of any new generation contraceptive. The considered means of intrauterine contraception has a local effect, is installed for 5 years and then replaced with a new one (if necessary and desired by the woman).

How does Mirena work and how does it work?

The general principle of the "work" of the Mirena intrauterine device is the same as that of hormonal implants and contraceptive injections - they are designed to block (the release of the egg from the ovary) and delay the development of the uterine mucosa, which automatically makes implantation of the fetal egg almost impossible.

The considered contraceptive is considered quite effective, with a long period of action. According to statistics, only 2 out of 1,000 women who had a Mirena intrauterine device installed became pregnant in the first year of its use.

Despite such great efficiency and the ability to use Mirena for a long time, the ability to conceive in a woman is restored immediately after the removal of the intrauterine device. It is extremely rare that the ability to conceive is restored 3-6 months after the removal of the contraceptive in question.

Note:the Mirena intrauterine device, like any other hormonal contraceptive, is not able to protect a woman from.

Possible side effects

Usually, 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 the Mirena intrauterine device may note the following side effects:

• regular
• a significant increase in the sensitivity of the mammary glands;
• not associated with eating;
• the short duration of the menstrual cycle, in some cases, monthly bleeding may stop altogether;
• periodical
• violations of the psycho-emotional background - for example, a sharp change in mood;
• weight gain;

All of these side effects disappear on their own, and as for the duration of the menstrual cycle, it will be restored after the removal of the Mirena intrauterine device.

Since the remedy in question is a contraceptive, its medicinal properties can also be attributed to side effects, but they will be extremely beneficial to health. For example, the Mirena spiral is recognized by doctors as an excellent prophylactic for inflammatory diseases of the small pelvis, iron deficiency anemia,. In addition, this intrauterine device greatly facilitates the condition of a woman with painful menstruation and reduces the size of myomatous nodes.

Contraindications for Mirena placement

• congenital and / or acquired anomalies in the structure of the uterus;
• neoplasms of the uterus or malignant nature;
• hypersensitivity or individual intolerance to the hormone or the material from which the Mirena spiral is made;
• already existing pregnancy or suspicion of it;
• diseases of the pelvic organs of an inflammatory nature;
• a septic abortion performed within the last three months;
• progressive infection of the genitourinary system;
• history of lower extremities;
• breast cancer and its treatment history;
• developed after childbirth;
• inflammation of the cervical canal of the cervix (cervicitis);
• acute liver disease;
• benign and/or malignant tumors.

Insertion and removal of the Mirena intrauterine device

Only a gynecologist can determine the appropriateness of using the contraceptive in question for a particular woman. And only a doctor should also insert / install the Mirena spiral, moreover, there are some conditions for such a manipulation:

Note:if directly during the installation of the contraceptive in question, a woman complains of very severe pain, or bleeding has begun, then the gynecologist should conduct an ultrasound and physical examination to exclude perforation of the uterus (mechanical damage).

The process of removing the Mirena intrauterine device

If a woman's menstrual cycle is regular, then Mirena can be removed on any day of menstruation after its expiration date. If a woman needs further contraception, the doctor can install a new spiral on the same day.

If the spiral is not removed during menstruation, then a week before this manipulation, the woman should use additional contraceptives. The same rule applies if the patient is diagnosed with amenorrhea.

After removing the intrauterine device, the doctor must make sure that the spiral is intact. Often, during the procedure in question, the hormonal-elastomer core slips onto the horizontal “shoulders” of the T-shaped body. Once 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 complete safety of using two or more intrauterine systems in a row has been proven. No changes in women's health are noted .

Mirena intrauterine device during pregnancy and lactation

No hormonal drugs, including the one under consideration, can be used during pregnancy. If pregnancy occurs during the use of Mirena, then it must be removed, since the risk of spontaneous abortion or premature birth is significantly increased for a woman.

It is necessary to remove the contraceptive in question during pregnancy with extreme caution, but if this is not possible, then the doctor will raise the question of artificial termination of pregnancy. A woman can refuse an abortion, but in this case she should be informed about the risks and possible consequences of preterm birth for the child. The patient herself will have to carefully monitor her own well-being and, if colic-like pains in the abdomen, fever, urgently seek qualified medical help.

As for the use of Mirena by a woman who is breastfeeding, the doctors are unanimous in their opinion - if the spiral is installed 6 weeks after childbirth, then there will be no effect on the growth and development of the child. The hormone entering the blood of a 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 help. However, problems may arise.

Expulsion - prolapse of the intrauterine device

The intrauterine device can partially or completely fall out of the uterine cavity, and, most high risk a similar phenomenon occurs in nulliparous women in the first few months after the installation of the remedy. Very rarely, rejection of the system is possible at a later date of application.

Note:you can notice the loss of the Mirena spiral by carefully examining sanitary pads and tampons during menstruation. If prolapse is noticed, then you need to start using a condom during sexual intercourse and seek help from a gynecologist.

Mechanical damage to the walls of the uterus - perforation

It is extremely rare that damage to the uterine wall can occur when an intrauterine device is inserted, but this fact is detected by the doctor immediately and is immediately detected. If the perforation was not noticed by the gynecologist, then the spiral can get into other parts of the pelvis and damage the internal organs - surgery will be required.

infections

The use of intrauterine contraceptives is associated with some risk of pelvic infection, but the risk of their development is significantly reduced after 20 days after introduction Mirena in the uterine cavity. The infection can be triggered by pathogenic bacteria that enter the uterine cavity just during the installation of the spiral. If the infection is detected after 20 days after the installation of Mirena, then most likely the infection occurred during intercourse with a sick partner.

The Mirena intrauterine device is considered effective method preventing unwanted pregnancy. And her positive properties and the minimum possibility of developing complications make this remedy also extremely popular among clients of gynecological clinics.

Tsygankova Yana Alexandrovna, medical observer, therapist of the highest qualification category