Where is mirena inserted

These side effects nearly always settle with time. The hormonal IUD has not been shown to cause weight gain. If you cannot feel the IUD strings, you can abstain from sex or use condoms until a doctor or nurse confirms the IUD is in the right place.

If you have had unprotected sex in the 5 days before you notice the string missing, you might need emergency contraception. Once the hormonal IUD is in for more than 5 years, you can abstain from sex or use condoms until you can have it replaced. If you have unprotected sex and your IUD has been in for more than 5 years, you might need emergency contraception.

It is important that you see a doctor or nurse as soon as possible and have the IUD removed. The doctor or nurse will also need to rule out a pregnancy in your fallopian tubes ectopic pregnancy. If the IUD is removed, you can continue the pregnancy or have an abortion. If the IUD cannot be removed and you continue the pregnancy, there is a higher risk of losing the pregnancy. Find out more about having your IUD removed. The hormonal IUD can be inserted straight after you give birth.

If not inserted straight after you give birth, then you need to wait until at least four weeks later. The hormonal IUD is safe to use if you are breastfeeding. The hormonal IUD can be removed at any time by a trained doctor or a nurse. Your fertility will quickly return to what is normal for you.

Close menu Close. Search Search. On this page What are the hormonal intrauterine devices IUDs? How effective are the hormonal IUDs? How does the hormonal IUD work? How do I use the hormonal IUD? When does it start to be effective? Where can I get the hormonal IUD?

What stops the hormonal IUD from working? Your health care provider will trim Mirena's strings so that they don't protrude too far into the vagina, and may record the length of the strings. During Mirena insertion, you may experience cramping, dizziness, fainting or a slower than normal heart rate. Once a month, check to feel that Mirena's strings are protruding from your cervix. Be careful not to pull on the strings.

About a month after Mirena is inserted, your health care provider may re-examine you to make sure Mirena hasn't moved and to check for signs and symptoms of infection.

It's also important to contact your health care provider immediately if you think Mirena is no longer in place. Your provider will check the location of Mirena and, if it's displaced, remove it if necessary.

Mirena can remain in place for up to five years. To remove Mirena, your health care provider will likely use forceps to grasp the device's strings and gently pull. The device's arms will fold upward as it's withdrawn from the uterus. Mayo Clinic does not endorse companies or products. Advertising revenue supports our not-for-profit mission. This content does not have an English version. This content does not have an Arabic version.

Overview Mirena is a hormonal intrauterine device IUD that can provide long-term birth control contraception. To prevent pregnancy, Mirena: Thickens mucus in the cervix to stop sperm from reaching or fertilizing an egg Thins the lining of the uterus and partially suppresses ovulation. Mirena placement Open pop-up dialog box Close. Mirena placement The Mirena intrauterine device IUD is inserted into the uterus by a health care provider using a special applicator.

Request an Appointment at Mayo Clinic. Share on: Facebook Twitter. Show references Hatcher RA, et al. Intrauterine contraceptives IUDs. In: Contraceptive Technology. At this point, your healthcare professional will hold open the vagina by using a speculum, which resembles a metal beak of a duck.

The instrument is inserted into the vagina, then its sides are separated and held open by a special action device on the handle. Once this is accomplished, due to the importance of having a completely sterile environment to reduce the likelihood of infections, the cervix and the adjacent anterior front and posterior back recesses in the vagina will be cleansed with an antiseptic solution.

Your healthcare provider will then use a tenaculum to help stabilize the cervix and keep it steady. The tenaculum is a long-handled, slender instrument that is attached to the cervix to steady the uterus. Your healthcare provider will now insert a sterile instrument called a sound to measure the length and direction of the cervical canal and uterus.

This procedure reduces the risk of perforating the uterus having the IUD puncture through , which usually occurs because the IUD is inserted too deeply or at the wrong angle. Your healthcare provider will make sure to avoid any contact with the vagina or speculum blades. The uterine sound has a round tip at the end to help prevent perforation puncturing the uterus. Some healthcare providers may use an endometrial aspirator as an alternative to the uterine sound, which does the same thing.

It is important that the healthcare provider determines that your uterine depth is between 6 and 9 centimeters as an IUD should not be inserted if the depth of the uterus is less than 6 centimeters. After the sound is withdrawn, the healthcare provider will prepare the IUD for insertion by removing it from its sterile packaging. The IUD is pushed into place, to the depth indicated by the sound, by a plunger in the tube.

Once out of the tube and when the IUD is in the proper position in the uterus, the arms open into the "T" shape. The insertion of an IUD is usually uncomplicated. Although there may be some discomfort, the whole procedure only takes a few minutes. A woman may experience cramping and pinching sensations while IUD insertion is taking place. Some women may feel a bit dizzy.

It may be helpful to take deep breaths. Additionally, these reactions do not affect later IUD performance. Women who have never given birth, have had few births, or have had a long interval since last giving birth are most likely to experience these problems. Once the IUD is in place, the tube, plunger, tenaculum, and speculum are removed from the vagina. The intrauterine device will stay in place. The IUD will have strings attached to it that the healthcare provider will leave intact.

They hang down through the cervix into the vagina. At this point, the healthcare provider will cut the ends of the strings but will allow about 1 to 2 inches to hang out of the cervix.

The strings are not able to be seen from outside of the vagina but are long enough to be felt by a finger inserted into the vagina this is how you can check if your IUD is still in place. Your healthcare provider should then instruct you on how to feel for the strings. Additionally, be sure that your healthcare provider informs you of the type of IUD that was inserted ParaGard, Skyla, Kyleena, Liletta, or Mirena and when it needs to be replaced. Most healthcare providers should give you a little card that you can put in your wallet with all of this information.

If not, it is a smart idea to write down this information and keep it in a reliable place or put it in your electronic calendar or reminder app.

This information is important should you switch healthcare providers later on, as a healthcare professional cannot tell, just by looking, which IUD you have and when it was inserted and, therefore, when it should be removed. Since most women only feel slight discomfort during the procedure, they are usually fine to drive themselves afterward and resume their daily activities.

Since you may not know how you will react to your insertion procedure, you may wish to arrange for somebody to drive you home.

Some women may still feel some cramping afterward as the uterus adjusts to the placement of the IUD. If this is the case, the cramps should lessen with some time and, perhaps, some rest or pain medication.

You may have some bleeding and spotting during the first few days after your IUD insertion. This is normal, so there is no reason to worry. If the bleeding is constant or heavy, it may be a good idea to call your healthcare provider just to make sure that there is not an infection.

Also, be prepared that your first period after the insertion could very well be heavier than normal. Try to schedule a follow-up appointment after your first period sometime within four to six weeks of the IUD insertion just to make sure that the IUD is still in place.

It is OK to have sexual intercourse as soon as you feel comfortable after your IUD is inserted unless your IUD has been inserted within 48 hours after giving birth. But when pregnancy protection can be expected varies:. Some healthcare professionals recommend using a condom as a backup method during the first month after your insertion to reduce your risk of infection. It may be helpful to check the IUD strings every few days for the first few weeks and to feel for the string ends between periods to make sure that the IUD is still properly in place.

After your first period or at least no longer than three months after insertion , schedule a checkup to make sure your IUD is still where it is supposed to be. If this is the case, sometimes the strings are cut so short that the woman cannot actually check for the strings anymore.

Intrauterine device IUD insertion can cause discomfort and cramping, but is not painful for most women. The Mirena, Kyleena, Liletta, and Skyla release small amounts of progestin, a type of hormone that prevents sperm from being able to enter the uterus. ParaGuard, on the other hand, contains copper, which acts as an extremely effective spermicide when used in the IUD.