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Therapeutic hormonal intrauterine system (coil, navy) Mirena (general characteristics and answers to the most popular questions)

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One of the important indicators of women's health is the regular menstrual cycle. Therefore, many women who use modern methods of contraception, including the IUD, are interested in the question: what are the periods after the spiral?

Modern medicine offers women a variety of methods of contraception to protect against unwanted pregnancy. The most popular method is the intrauterine device - IUD, which is a reliable, affordable and convenient way. But sometimes the IUD may cause menstrual disorders in a woman after her extraction. Experts identify several such violations: the absence of menstruation, delay or abundant menstrual flow.

No menstruation after helix removal

To avoid side effects, only the doctor should remove the intrauterine system. According to statistics, most women turn to the gynecologist with the problem: "the helix is ​​removed, there is no menstruation." However, practice shows that the absence of menstruation depends on the period of use of the IUD and its type, as well as on the thinning of the uterine mucous epithelium. The longer the drug is in the body of the uterus, the longer it takes to restore the endometrial mucosa.

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Often, young women, noticing that after removing the helix there are no periods, worry about the high probability of pregnancy. However, these suspicions are unfounded. The reason for the delay (up to 6 months) can be a hormonal disorder, as well as ovarian dysfunction. These features take place if other causes are excluded (inflammatory diseases of the pelvic area, infections of the genital tract or pregnancy). To do this, visit a gynecologist.

Late periods after the removal of the spiral

Another feature observed in patients who have removed the intrauterine contraceptive is menstruation delay. This feature appears in women who used the tool of the last generation "Mirena". Most often, the delay after removal of the helix is ​​associated with the suppression of endometrial development, as well as with inhibition of ovarian function. After all, a small dose of the hormone is injected every day with a contraceptive into the uterine cavity. As a rule, after removing the medication, all functions are restored.

Gynecologists around the world agree that the delay in menstruation after the removal of the helix is ​​quite normal. This is also due to a decrease in the reproductive function of the female body due to the action of the contraceptive. After its extraction, the reproductive function gradually returns to normal, and, consequently, the menstrual cycle is normalized.

Abundant menses after helix removal - menorrhagia

The way menstruation goes after the helix is ​​an indicator of the effect of the IUD on the body. After all, the choice of the wrong size entails the emergence of a variety of side effects: inflammatory processes, infectious diseases, thinning of the uterine mucosa, ectopic pregnancy.

Very often, women after installing the spiral appear copious periods. They may appear due to the factors enumerated above, and also become a consequence of the hormonal imbalance that occurs during long-term use of the contraceptive. Abundant menstruation causes large blood loss, which reduces hemoglobin and worsens the well-being of women, as anemia, general weakness, dizziness can develop.

Monthly after the removal of the spiral, each woman appears at different times. This is due to the characteristics of the body and the above factors.

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Therapeutic intrauterine system Mirena as an intrauterine contraceptive (IUD)

Therapeutic intrauterine system (hormonal intrauterine system, hormonal intrauterine deviceNavy) Mirena applies to intrauterine devices hormonal contraceptives.

Intrauterine devices contraceptives (VMK) began to use in the middle of the last century. They quickly became popular due to such positive qualities as high efficiency, comfort (lack of communication with sexual intercourse, they are administered once a long time, there is no need for constant monitoring of pills, etc.), no systemic effects on the woman’s body. The main problem of IUD, often leading to the rejection of their use, was the appearance in patients of the tendency to severe uterine bleeding.

In the 60-70s, copper-containing IUDs appeared, whose effectiveness was even higher. However, the problem of metrorrhagia (uterine bleeding) was not solved by the second generation of intrauterine contraceptives.

And finally, in the second half of the 70s, the first hormone-containing intrauterine contraceptives appeared - a new, third generation IUD. These medical products combine the positive aspects of IUD and hormonal oral contraceptive drugs.

Hormone-containing intrauterine contraceptives are more effective than other contraceptives this group. In addition, they do not lead to uterine bleeding. With the use of hormone-containing intrauterine contraceptives, menstrual bleeding becomes less abundant.

Description of the dosage form

The intrauterine hormonal system Mirena has a T-shaped case that provides a stable location in the uterine cavity. At one end, the body has a loop to which the threads are attached to remove the system. On the body there is a hormone-elastomer core, which is a substance of white or almost white color. The core is covered with a translucent membrane that regulates the flow of the active substance into the uterine cavity.

The active hormonal substance of the system - the progestogen drug levonorgestrel - is presented in an amount of 52 mg. Auxiliary substance - polydimethylsiloxane elastomer.

The intrauterine hormonal system Mirena is located in the cavity of the conductor tube. The conductor and the body of the drug have no impurities.

Each package Mirena contains one intrauterine hormonal system, placed in a vacuum plastic-paper shell.

Acquired dosage form Mirena before use should be kept in a place protected from sunlight, at room temperature (15-30 degrees). Shelf life is three years.

The exchange of the active substance in the body

The hormonal navy Mirena begins to release levonorgestrel immediately after being placed in the uterine cavity. The rate of release of the active substance after administration is 20 µg / day, by the end of the fifth year, it decreases to 10 µg / day.

The distribution of levonorgestrol characterizes Miren as a drug of predominantly local action. The highest concentration of the substance is stored in the endometrium (uterine lining). In the myometrium (in the muscular layer), the concentration of levonorgestrel barely reaches 1% of the concentration in the endometrium. The concentration of levonorgestrel in plasma is 1000 times less than in the endometrium.

The active substance enters the blood about an hour after the introduction of the system. The maximum concentration of levonorgestrel in the serum is reached in two weeks.

Body weight significantly affects the concentration of the active substance in the blood plasma. In women with reduced weight (37-54 kg), the concentration of levonorgestrol in the blood is on average one and a half times higher.

The active substance is almost completely metabolized (decomposed) in the liver, and excreted through the kidneys and intestines.

Operating principle

The most important contraceptive effects of the intrauterine hormonal system Mirena are due to a weak local reaction to a foreign body in the uterus, and mainly the local influence of the progestogenic drug levonorgestrol.

The functional activity of the uterine cavity epithelium is suppressed: the normal growth of the endometrium is inhibited, the activity of its glands decreases, there are transformations in the submucosa - all these changes ultimately prevent the implantation of a fertilized egg.

Another important contraceptive effect is an increase in the viscosity of the mucus secreted by the cervical glands and thickening of the mucous membrane of the cervical canal, which prevents sperm from entering the uterus.

In addition, the drug Mirena inhibits sperm motility in the uterus and fallopian tubes.

In the first months of use, due to the restructuring of the mucous membrane of the uterus, irregular thickening is possible. But further suppression of proliferation of the epithelium of the endometrium leads to a pronounced decrease in the volume and duration of menstrual bleeding, up to amenorrhea (cessation of menstruation).

Indications for use

The intrauterine hormonal system Mirena is intended, first of all, to prevent unwanted pregnancy.

In addition, the drug is used for excessively heavy menstrual bleeding of unexplained etiology (in cases where the possibility of cancer of the female genitalia is excluded).

As a local prostate medication, Mirena's intrauterine device is used to prevent endometrial hyperplasia (sprouting) during estrogenic replacement therapy (this kind of treatment is indicated after surgery to remove both ovaries, as well as with severe climax).

Contraindications

As an intrauterine contraceptive, Mirena is also contraindicated in cervical dysplasia, malignant neoplasms of the body and cervix, congenital or acquired changes in the configuration of the cavity of the body of the uterus (including fibroids).

Since the active ingredient of the drug is metabolized in the liver, the intrauterine hormonal system Mirena is contraindicated in cancer of the organ, as well as in acute hepatitis and cirrhosis. If jaundice of unexplained genesis was previously encountered, the drug should be used with great caution.

Since levonorgestrol is a gestagenic drug, Mirena is contraindicated for all gestagen-dependent cancer diseases (especially in breast cancer).

The systemic effect of levonorgestrol on the woman's body is weak. Nevertheless, Mirena’s intrauterine hormonal system should be used with extreme caution in cases where progestin preparations are contraindicated. This is especially true for severe circulatory disorders (heart attacks, strokes), a history of severe migraine attacks (including those that may indicate marked cerebral circulatory disorders), hypertension, severe diabetes mellitus, thrombophlebitis and a tendency to thromboembolic complications.

In such cases, the degree of risk (severity of symptoms of the disease, which is a relative contraindication to the prescription of the drug) and the benefits of its use should be correlated. The use of Mirena is decided upon consultation with a professional, and during the application of the helix, constant medical observation and laboratory monitoring are necessary.

Mirena is contraindicated in pregnancy (diagnosed or suspected) and in case of hypersensitivity to the drug components.

Common side effects

Common side effects are usually attributed to concomitant symptoms that appear no less than every hundredth, and no more often than every tenth patient using a helix.

In women using Mirena, unpleasant symptoms from the central nervous system are most common, such as nervousness, irritability, bad mood, decreased libido, headache.

Patients with gastrointestinal tract often suffer from abdominal pain, nausea, and vomiting.

Among the adverse effects on the exterior, the most commonly observed acne and weight gain.

Often, patients present a lot of complaints about the state of the reproductive system and the mammary glands: pain in the pelvic area, spotting, vulvovaginitis, tension and tenderness of the mammary glands.

Relatively common back pain, like sciatica.

All the symptoms described above are most pronounced in the first months of using the Mirena Navy, further their intensity decreases, and in most cases the unpleasant symptoms completely disappear.

Rare side effects

Rarely observed side effects include the accompanying signs of using the drug, appearing no more often than in every hundredth patient, and not less often than in every thousandth patient.

The following adverse effects of rarely occurring adverse side effects include Mirena:

  • emotional lability (frequent mood changes),
  • bloating
  • the appearance of edema,
  • alopecia (baldness),
  • hirsutism (increased hairiness),
  • itchy skin
  • rash,
  • eczema.

These unpleasant symptoms are most pronounced in the first months of Mirena use. In cases where their intensity does not decrease, an additional examination is indicated to exclude concomitant diseases.

Installing intrauterine device Mirena

Sterile vacuum packaging is opened immediately before installation of the system. A prematurely opened system is to be disposed of as medical waste.

Installing the intrauterine system Mirena can only be a doctor with sufficient experience in this kind of manipulation.

Before installing the Mirena Spiral, it is necessary to consult with a gynecologist and obtain information on all risks and possible adverse side effects.

Having decided on the installation of the Navy Mirena, a woman should undergo an examination of the mammary glands and mammography, as well as a gynecological examination, including examination of the pelvic organs and colposcopy (or, at least, a cervical smear test).

It is necessary to exclude cancer pathology of the female genital organs, pregnancy and sexually transmitted infections. All inflammatory gynecological diseases at the time of installation should be completely cured.

It is extremely important to install the Mirena spiral to determine the location of the uterus in the pelvis, as well as the size and configuration of the uterus. The correct location of the IUD in the uterine cavity ensures the effectiveness of the Mirena system, and prevents its expulsion (expulsion).

For women of childbearing age, Miren is prescribed in the first seven days of the menstrual cycle.

If there are no medical contraindications, Mirena's Navy can be installed immediately after an artificial or spontaneous abortion in the first trimester of pregnancy.

After delivery, in the case of normal involution of the uterus, the installation of the Mirena helix is ​​permissible only after six weeks.

You can replace the IUD on any day of the monthly cycle.

If the Mirena therapeutic intrauterine system is installed for the prevention of endometrial hyperplasia during estrogen replacement therapy, it is best to install the system on the eve of the onset of menstruation, and for women with established amenorrhea on any given day.

Precautionary measures

To date, there are no clinical data confirming the version of the occurrence of a tendency to thrombosis and varicose veins of the lower extremities when using the Navy Mirena. However, when symptoms of these diseases appear, consultation with a specialist should resolve the issue of whether to remove the IUD, correlating the possible risks of thromboembolic complications and the benefits of using the drug.

Levonorgestrol, even in small doses, can adversely affect glucose tolerance, therefore, patients with diabetes mellitus need constant monitoring of plasma glucose levels.

In women with congenital and acquired valvular heart disease, the installation and removal of the IUD Mirena is recommended under the guise of antibiotics to avoid the development of septic endocarditis.

Complications that may occur when using the Mirena Spiral

Perforation and penetration of the uterus
Perforation (perforation) and penetration (penetration into the wall) of the uterus are extremely rare (less than 1 time for 1000 cases of Mirena use). These complications usually occur during installation. Predisposing factors for this are the recent birth, lactation, atypical location of the uterus.

In the case of penetration or perforation of the uterus, the system should be immediately removed, since in this position it is ineffective and conditions are created for the development of serious pathologies.

Ectopic pregnancy

Ectopic pregnancy is a rare complication (0.1% of cases per year), which is an indication for emergency surgery.

Ectopic pregnancy can be suspected when, against the background of signs of pregnancy (prolonged menstruation, if the cycle was relatively regular, nausea, dizziness, etc.), sharp paroxysmal pains in the lower abdomen and symptoms of internal bleeding (pale skin, sharp weakness, dizziness, frequent and weak pulse).

This complication is more common in women with an ectopic pregnancy in history, as well as in the case of severe infectious and inflammatory diseases of the pelvic organs.

Infectious and inflammatory diseases of the pelvic organs
Complications in the form of infectious and inflammatory diseases of the pelvic organs are relatively rare (1/1000 - 1/100 cases of IUD application).

The greatest likelihood of such complications occurring persists during the first month of use of the Mirena helix.

A significant risk factor is the frequent change of sexual partners.

In case of recurrent infectious and inflammatory diseases of the pelvic organs, as well as in case of a serious acute infection resistant to therapy for several days, the IUD Mirena should be removed.

Helix expulsion
Expulsion (expulsion of the helix from the uterus) refers to common complications. Therefore, women are advised to check the presence of Mirena threads in the vagina after each menstruation.

The fact is that it is during menstruation that the imperceptible IUD is invisible. Of course, with the expulsion of the helix, the contraceptive effect ceases, therefore it is necessary to inspect the pads and tampons after use, so that the loss of Mirena does not go unnoticed.

Signs of the beginning of the expulsion in the middle of the cycle, as a rule, are pain and untimely bleeding that began. In such cases, the system is subject to extraction, since the disruption of the normal arrangement of the spiral negatively affects the contraceptive effect.

Development of functional ovarian cysts
Functional ovarian cysts occur in approximately 12% of women using the Mirena Navy. In most cases, they are asymptomatic, but sometimes there is a feeling of heaviness in the lower abdomen and soreness during intercourse.

Most often, enlarged follicles return to normal without any medical intervention after two to three months of observation. If this does not happen, the observation is shown using an ultrasound scan.

For surgical intervention are extremely rare.

Amenorrhea

Amenorrhea treat frequent complications of using the Mirena Navy. As a rule, it develops gradually during the first six months of use of the contraceptive.

With the disappearance of menstrual bleeding should be excluded pregnancy (to carry out the usual test). If the test is negative, then you can not repeat it. The normal menstrual cycle will resume after the removal of Mirena.

Spiral Removal

After 5 years of use, the Mirena Spiral should be removed. In cases where a woman intends to continue contraceptive measures after removing an IUD, Mirena should remove the helix at the beginning of the menstrual cycle. If the IUD is removed in the middle of the cycle, and before that unprotected sexual intercourse took place, the woman is at real risk of becoming pregnant.

If a woman wants to continue using the helix, immediately after removal you can put a new IUD. In cases where, after extraction of the IUD, a new intrauterine contraceptive is immediately installed, it can be manipulated at any time during the cycle.

After removal of the IUD, Mirena should check the integrity of the helix, because when there are difficulties in removing the product, the substance sometimes slips into the uterine cavity.

The installation and removal of Mirena helix can be accompanied by pain and bleeding of varying severity. In some cases, possible fainting. In women with epilepsy, installing or removing a spiral can cause a seizure.

Intrauterine device Mirena and pregnancy

The drug has a very high efficiency. In cases where an unwanted pregnancy does occur, ectopic pregnancy should be excluded first. When uterine pregnancy raises the question of its termination.

If the woman decides to save the child, then the spiral is carefully removed from the uterus. In cases where the intrauterine system cannot be removed, the woman is warned about the possible risks of pregnancy with an IUD in the uterus (spontaneous premature termination of pregnancy).

You should consider the possible adverse effects of the drug on the development of the fetus. Cases of carrying a child with an intrauterine system Mirena is extremely small due to the high contraceptive properties of the drug. However, a woman is advised to report that there is no clinical data on the occurrence of fetal pathology under the influence of this drug.

Use during lactation

The active substance of the Navy Mirena in low concentrations penetrates into the blood plasma, and can be released during lactation, so that the content of levonorgestrel in breast milk is about 0.1% of the daily dose of the substance secreted by the system.

It is unlikely that such a dose would affect the general condition of the infant. Experts say that the use of the drug Mirena during lactation six weeks after birth is quite safe for a child who is breastfed.

Does Mirena Helix help with endometriosis?

The intrauterine system secretes a hormone into the uterine cavity that inhibits the proliferation of the endometrium — the ability of the Mirena helix to prevent the development of endometriosis is based on this.

In recent years, works have appeared that indicate the therapeutic effect of Mirena helix in endometriosis. Clinical data are quite contradictory. In addition, it should be noted that the treatment of endometriosis with hormonal IUDs is not used in all countries.

From the standpoint of evidence-based medicine, Mirena helix in endometriosis, like any other hormone therapy, can only give a temporary result. The national leadership of the Russian Federation in gynecology recommends starting with surgical treatment, as the most radical.

However, in each particular case, a thorough examination and consultation of a gynecologist, a surgeon and an endocrinologist is necessary.

My monthly periods stopped completely six months after the installation of the Mirena helix. This is normal? Can I get pregnant after removing the helix?

Amenorrhea (cessation of menstruation) is a normal reaction of the body to the action of the Mirena hormone system, which occurs in every fifth woman using a spiral. As a rule, this condition develops gradually.

At the first disappearance of menstrual bleeding, pregnancy should be excluded. The effectiveness of the drug is very high, but experts still recommend to take the test. If the test result is negative, then you can not worry. After removing the Mirena helix, the menstruation will recover, and a normal pregnancy can be expected.

Can there be pain, discharge or uterine bleeding after installing the Mirena helix?

Immediately after the installation of Mirena, minor pain syndrome and spotting is possible. Severe pain and bleeding may indicate improper installation of the IUD. In this case, the Mirena spiral must be removed.

Pain, discharge or uterine bleeding after a considerable time after the installation of the Mirena helix may indicate the start of expulsion (expulsion of the drug from the uterus) or ectopic pregnancy. Therefore, with the appearance of such symptoms, it is necessary to urgently consult a doctor.

Does Mirena affect weight? I really want to buy Mirena's intrauterine device, but I’m afraid of losing shape (there is a tendency to be overweight).

Weight gain is a fairly frequent unpleasant side effect of the Mirena helix. However, it should be noted that not everyone is getting fat. According to clinical data, at least nine out of ten women do not notice even a slight weight gain after installing an IUD.

In addition, weight gain refers to side effects of Mirena, most pronounced in the first months after installation. As a rule, further the tendency to corpulence caused by a hormonal drug disappears.

According to the existing propensity for completeness, it is impossible to judge about the possibility of weight gain after installing the Mirena helix, since the occurrence of this side effect and the degree of its severity depends on the individual response to the hormonal drug.

I was protected by hormonal drugs. There are no side effects, but I often forget to take pills. How do I get better from pills to Miren?

If you took the pills irregularly, then the risk of pregnancy is possible, which should be excluded when prescribing the Mirena helix.

In addition, it is necessary to undergo a complete gynecological examination (examination of the pelvic organs, colposcopy) and to check the condition of the mammary glands.

If there are no contraindications to the use of the IUD, the spiral is best entered on the fourth - sixth day of the menstrual cycle. On the day of installation of the spiral Mirena, birth control pills are canceled.

When does pregnancy begin after Mirena is removed?

Clinical evidence suggests that 80% of women wishing to have a baby become pregnant in the first year after Mirena's helix is ​​removed. It is even slightly above the normal level of fertility (fertility).

Certainly, some time is needed to restore the normal state of the reproductive system, which is individual for each woman.

For patients for whom pregnancy is undesirable, doctors advise immediately after removing the Mirena helix to take measures to prevent conception, since many women are likely to develop pregnancy immediately after the system is terminated.

Reviews of doctors and women

Women’s reviews of the Mirena spiral are unusually contradictory, and contain a wide range of emotions, from admiration and immense gratitude to the inventor of this good, to the horror, disgust and curses on the head of the attending physician, who advised "to go through this nightmare."

Grateful reviews are based on the following positive points:

  • total absence of side effects (in some cases it is mentioned that "we had to endure several terrible months"),
  • amenorrhea (with special admiration is mentioned by women who suffer from heavy or / and painful periods),
  • comfort (do not count the hours before taking the pill, there is no connection with sexual intercourse, etc.),
  • despite the high price of the drug, the duration of action (5 years) gives the right to call Mirena helix a fairly cheap type of contraception.

In addition, there are reviews indicating a decrease in the severity of the symptoms of endometriosis and the restrictive effect of Mirena on the growth of fibroids.

Negative reviews contain a large number of complaints. The frequency draw attention to two groups:
1. Complaints of violations from the emotional sphere (decrease in mood, up to "did not want to live"), a sharp decrease in libido, irritability, up to hysteria,
2. Complaints about the ugly appearance (acne on the face and back, hair loss, rapid weight gain, hair growth in inappropriate places).

It is easy to guess that these two groups of side effects mutually reinforced each other: the reduced emotional background made even minor external side effects in the imagination of the patients into ugliness, and unfavorable external symptoms intensified disturbances from the emotional sphere.

Analysis of the reviews showed that some women refused to use Mirena in the first months, some continued using and later wrote that at first it was very bad, but then the state completely normalized. However, some reviews suggest that side effects such as decreased libido, irritability, and a tendency to weight gain in some patients persisted in the second year of using Mirena.

Many women complain of prolonged spotting and soreness in the lower abdomen for several weeks after installing Mirena.

There are isolated complaints of expulsion of Mirena and the occurrence of inflammatory diseases.

The attention of the woman who told about the occurrence of breast cancer during the use of the Mirena spiral deserves attention. Judging by the volume of the operation (complete mastectomy with removal of the axillary lymph nodes), the tumor took place even before the installation of the Mirena helix (cancer was diagnosed at the beginning of the second year of use). In this particular case, Mirena could indeed stimulate the growth of a malignant neoplasm (breast cancer is an absolute contraindication to the use of the hormonal coil). The reason for this complication is insufficient or careless examination of the patient.

Reviews of doctors about Mirena spiral are more restrained and unambiguous. The Navy Mirena is an effective contraceptive drug that has a healing effect, but it can be used after a full examination of the patient, taking into account all possible contraindications.

Mirena's Hormonal Spiral: Pros and Cons

The intrauterine contraceptive hormonal coil Mirena has a number of advantages:

  • high efficiency,
  • comfort,
  • reduction of pain in painful menstruation,
  • decrease in the volume of menstrual bleeding, which is especially important for women with heavy menstruation,
  • prevention of endometriosis and uterine fibroids,
  • the ability to restrain the tumor growth of myoma node and reduce the severity of signs of endometriosis,
  • prevention of hyperplasia and endometrial cancer of the uterus.

Spiral Mirena has the following disadvantages:
  • A long list of absolute and relative contraindications.
  • Mirena's spiral is not recommended for young, nulliparous women and patients with age-related atrophic changes in the endometrium.
  • Frequent change of sexual partners is a risk factor for the occurrence of inflammatory complications.
  • In the first months of spiral use, there is a high percentage of the likelihood of non-dangerous, but rather unpleasant side effects (decrease in libido and general emotional background, irritability, weight gain, acne, spotting, etc.).

Thus, Mirena helix would be an ideal choice for women with a high degree of tolerability of progestin drugs, especially in the case of heavy and painful periods, the need to prevent fibroids, endometrial hyperplasia and endometriosis.

All patients before installing Mirena should be examined to exclude the presence of contraindications to the use of the drug.

Women should be informed that the unpleasant side effects that occur in the first months of the Mirena helix, in the future in most cases completely disappear.

Description of the intrauterine device Mirena

Mirena is T-shaped, which helps to securely lock into the uterus. One of the edges is equipped with a loop of threads, designed to remove the system. In the center of the helix lies a whitish hormone. It slowly enters the uterus through a special membrane.

The hormonal component of the helix is ​​levonorgestrel (gestagen). One system contains 52 mg of this substance. An additional component is a polydimethylsiloxane elastomer. Navy Mirena is inside the tube. The spiral has an individual vacuum plastic-paper packaging. It should be stored in a dark place, at a temperature of 15-30 C. The shelf life from the date of manufacture is 3 years.

Action Mirena on the body

Mirena’s contraceptive system begins to “release” the levonorgestrel into the uterus immediately after installation. The hormone enters the cavity at a rate of 20 µg / day, after 5 years, this figure drops to 10 µg per day. The helix has a local action, levonorgestrel focuses almost entirely on the endometrium. And already in the uterine muscle layer, the concentration is no more than 1%. In the blood, the hormone is contained in microdoses.

After the introduction of the helix, the active component enters the blood in about an hour. There, its highest concentration is reached in 2 weeks. This figure can vary significantly depending on the body weight of the woman. With a weight of up to 54 kg, the blood content of levonorgestrel is about 1.5 times higher. The active substance is almost completely broken down in the liver, and is evacuated by the intestines and kidneys.

Often manifested side effects

There are several side effects of Mirena, which are found in almost every tenth woman who has established a spiral. These include:

  • Disorder of the central nervous system: irascibility, headache, nervousness, bad mood, decreased sexual desire,
  • weight gain and the appearance of acne,
  • gastrointestinal dysfunction: nausea, abdominal pain, vomiting,
  • vulvovaginitis, pain in the pelvis, spotting,
  • chest tension and tenderness
  • backache, as in osteochondrosis.

Все указанные выше признаки ярче всего проявляются в первые месяцы применения препарата Мирена. Потом их интенсивность снижается, и, как правило, неприятные симптомы бесследно проходят.

Редко проявляющиеся побочные действия

Такие побочные эффекты отмечаются у одной пациентки из тысячи. They are also usually expressed only in the first months after the installation of the IUD. If the intensity of the manifestations does not decrease with time, the necessary diagnosis is prescribed. Rare complications are bloating, frequent mood changes, itching, edema, hirsutism, eczema, alopecia, and rash.

Allergic reactions are very rarely manifested side effects. With their development, it is necessary to exclude another source of urticaria, rash, etc.

Installation spiral Mirena

The intrauterine system is packaged in a sterile vacuum bag, which is opened before installing the helix. Dispose of the opened system in advance.

Install a contraceptive Mirena can only qualified gynecologist. Before this, the doctor should conduct an examination and prescribe the necessary examination:

  • gynecological examination and breast examination,
  • cervical smear test,
  • mammography
  • colposcopy and pelvic examination.

It is necessary to make sure that there is no pregnancy, malignant neoplasms and STIs. When inflammatory diseases are detected, they are treated before staging Mirena. You should also determine the size, location and shape of the uterus. The correct position of the helix provides a contraceptive effect and protects against the expulsion of the system.

Patients of the fertile age of the IUD are administered in the first days of menstruation. In the absence of contraindications, the system may be installed immediately after the abortion. With normal uterine contraction after childbirth, Mirena can be used after 6 weeks. You can replace the helix on any day, regardless of the cycle. To prevent excessive growth of the endometrium, the intrauterine system should be administered at the end of the menstrual cycle.

Possible undesirable effects Mirena

  1. Ectopic pregnancy is extremely rare and requires emergency surgical intervention. This complication can be suspected if symptoms of pregnancy occur (long delay in menstruation, dizziness, nausea, etc.) together with severe lower abdominal pain and signs of internal bleeding (severe weakness, pale skin, tachycardia). There is a higher probability of “earning” such a complication after suffering severe inflammatory or infectious pathologies of the pelvis or a history of ectopic pregnancy.
  2. Penetration (growing into the wall) and perforation (perforation) of the uterus usually develop with the introduction of a spiral. These complications may be accompanied by lactation, recent labor, unnatural location of the uterus.
  3. Expulsion of the system from the uterus occurs quite often. For its early detection, patients are advised to check the presence of threads in the vagina after each period. Just, as a rule, it is during menstruation that the probability of an IUD is high. This process goes unnoticed by a woman. Accordingly, during the expulsion of Mirena, the contraceptive action ends. In order to avoid misunderstandings, it is recommended to inspect used tampons and gaskets for loss. Bleeding and pain may be a manifestation of the beginning of the falling out of the spiral in the middle of the cycle. If an incomplete expulsion of an intrauterine hormonal agent has occurred, the doctor must remove it and install a new one.
  4. Pelvic inflammatory and infectious diseases usually develop in the first month of Mirena system use. The risk of complications increases with frequent changes of sexual partners. The indication for the removal of the helix in this case is recurrent or severe pathology and the absence of a result from the treatment being performed.
  5. Amenorrhea develops in many women with the use of the IUD. Complication arises not immediately, but somewhere in 6 months after the installation of Mirena. At the termination of monthly it is necessary to exclude first of all pregnancy. After the helix is ​​removed, the menstrual cycle is restored.
  6. In approximately 12% of patients, functional ovarian cysts form. Most often they do not manifest in any way and only occasionally can there be pain during sex and a feeling of heaviness in the lower abdomen. Enlarged follicles usually return to normal in 2-3 months on their own.

IUD removal

The spiral must be removed 5 years after installation. If the patient does not plan pregnancy further, then the manipulation is carried out at the beginning of the month. Removing the system in the middle of the cycle, there is a chance of conception. If desired, one intrauterine contraceptive can be immediately replaced by a new one. The day of the cycle does not matter. After removing the product, you need to carefully inspect the system, since if there are difficulties in removing Mirena, the substance can slip into the uterine cavity. Both the introduction and removal of the system may be accompanied by bleeding and pain. Sometimes there is a fainting or seizure in patients with epilepsy.

Pregnancy and Mirena

The spiral has a strong contraceptive effect, but not 100%. If pregnancy does develop, then first of all it is necessary to exclude its ectopic form. In a normal pregnancy, the spiral is carefully removed or undergo a medical abortion. Not in all cases, it turns out to extract the Mirena system from the uterus, then the probability of premature termination of pregnancy increases. Also take into account the likely adverse effects of the hormone on the formation of the fetus.

Frequently asked Questions

Mirena's price is quite high, and the use of a contraceptive can cause many side effects. Does any positive effect means on the female body?

Mirena is often used to restore the state of the endometrium after bilateral removal of the ovaries or during pathological climax. Also intrauterine device:

  • increases hemoglobin level
  • performs prevention of cancer and endometrial hyperplasia,
  • reduces the duration and volume of idiopathic bleeding,
  • restores iron metabolism in the body,
  • reduces pain with algomenorrhea,
  • conducts prevention of fibroids and endometriosis of the uterus,
  • has a tonic effect.

Is Mirena used to treat fibroids?

The spiral suspends the growth of myoma node. But additional diagnosis and consultation of the gynecologist is needed. It is necessary to take into account the volume and localization of nodes, for example, in submucous masses of fibroids that change the shape of the uterus, the installation of the Mirena system is contraindicated.

Used for endometriosis intrauterine drug Mirena?

The helix is ​​used to prevent endometriosis, as it stops the growth of the endometrium. Recently, there were presented the results of studies proving the effectiveness of treatment of the disease. But the system provides only a temporary effect and each case must be considered separately.

I have six months after the introduction of Mirena developed amenorrhea. So it should be?In the future, can I get pregnant?

Lack of menstruation is a natural reaction to the effect of the hormone. She gradually develops in every 5 patients. Just in case, do a pregnancy test. If it is negative, then you should not worry, after the removal of the system, menstruation is resumed, and pregnancy can be planned.

After installing the contraceptive Mirena may be discharge, pain or uterine bleeding?

Usually these symptoms manifest themselves in a mild form, immediately after the introduction of Mirena. Severe bleeding and pain are often indications for the extraction of the helix. The cause may be ectopic pregnancy, improper installation of the system or expulsion. Urgently consult a gynecologist.

Can Mirena spiral affect weight?

Weight gain is one of the side effects of the drug. But you need to consider that it occurs in 1 woman out of 10 and, as a rule, this effect is short-lived, after a few months it disappears. It all depends on the individual characteristics of the organism.

I defended myself against unwanted pregnancy with hormone pills, but often forgot to drink them. How can I change the drug to Mirena spiral?

Irregular oral hormones can not fully protect against pregnancy, so it is better to switch to intrauterine protection. Before that, you need to consult a doctor and pass the necessary tests. Install the system is better for 4-6 days of the menstrual cycle.

When can I get pregnant after Mirena's withdrawal?

According to statistics, 80% of women become pregnant, unless of course they want it, in the very first year after the extraction of the spiral. Thanks to the hormonal action, it even slightly increases the level of fertility (fertility).

Where can I get Mirena spiral? And what is its price?

The IUD is released only by prescription and sold in a pharmacy. Its price is determined by the manufacturer, and varies from 9 to 13 thousand rubles.

Reviews of patients and doctors about Mirena

Women's feedback on the Mirena system is rather contradictory, and they combine delight and gratitude with disgust and horror. A positive impression is based primarily on the following points: the lack of heavy menstruation and side effects (some patients pass in the first months), favorable cost (based on 5 years), ease of use (set and forgotten), does not affect sexual contact . In addition, the spiral has helped many women to stop the growth of fibroids and reduce the manifestations of endometriosis.

Negative reviews were mainly based on claims to emotional disturbances (irritability, decreased sexual desire) and unaesthetic appearance (hair loss, acne).

Reviews of doctors, like women, about the IUD are also mixed, but more restrained. Experts confirm the high contraceptive effect and therapeutic effect in some diseases. But they explain that before installing the spiral Mirena necessarily need a thorough diagnosis.

How do the Navy?

Intrauterine devices are essentially foreign bodies, which, when introduced into the uterus, are irritating. They activate the receptors of the uterine mucosa, which are responsible for cleansing its cavity, and the uterus transmits a signal to the nervous system. The body begins to exert maximum effort to remove the detected foreign body. Therefore, in the first months after installing the helix, vaginal (uterine) bleeding is not uncommon: trying to remove the helix, the body rejects a small amount of the mucous membrane of the uterus.

In the future, the uterine mucosa is constantly in a "tense" state: the system of its protection is activated, which makes it impossible to attach the ovum. In other words, trying to get rid of the helix, the uterus does not allow the fertilized egg to attach as well.

Over time, depletion of the uterine mucosa occurs, and implantation becomes almost impossible. However, it is important to remember that there is also a feedback: the body, in response to the thickness of the endometrial layer, changes its hormonal background.

Changes in hormonal levels when using IUDs

IUDs containing hormones have the most pronounced effect on hormonal background. But to some extent, normal intrauterine devices also affect it.

Reducing the thickness of the endometrium leads to a decrease in the number of estrogen and progesterone receptors. The level of hormones corresponds to the first phase of the menstrual cycle, when the endometrium is still recovering from the preceding rejection (menstruation). Therefore, menstrual bleeding does not begin. Amenorrhea develops.

In your case, the thickness of the endometrium corresponds to the indicators characteristic of the first phase of the menstrual cycle. Therefore, there is a high probability that there is a hormonal imbalance, and the absence of menstruation is caused precisely by this. Some experts suggest that intrauterine contraceptives also affect the maturation of the egg and its release from the ovary. However, the majority consider this opinion to be erroneous and the lack of menstruation is associated mainly with a decrease in the level of progesterone - the main initiator of the preparation of a woman’s body for the upcoming pregnancy. Progesterone is responsible for the thickening of the endometrium (its growth), and due to the fact that the level of progesterone receptors in the uterus is reduced, the production of this hormone is suspended.

To confirm the diagnosis, it is necessary to undergo a hormonal examination - donate blood to determine the level of the main sex hormones.

In the event that you are not planning a pregnancy, the absence of menstruation during the use of the IUD can be considered a variant of the norm. When planning a pregnancy, the restoration of the endometrium should occur within 3 months, and the ability to fertilize within a year.

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