COUNSELING: An IUD is a small plastic device that is inserted into the uterus (womb) to prevent pregnancy. This IUD works mainly by changing the cervical mucus and the lining of the uterus preventing sperm’s ability to reach the egg and thereby prevents fertilization. Mirena is over 99.9 percent effective.
BEFORE IUD INSERTION: there must be absolutely no risk of pregnancy. For this to be true we ask that you avoid all intercourse after your menstrual flow until after your IUD is inserted. The best time for insertion is the middle of your cycle around the time of ovulation when more cervical mucus is present. Insertion during menses is also more comfortable. If your cervical opening is narrow, you may take a medicine called Cytotec the evening before insertion to help prepare your cervix for the procedure.
BEFORE IUD INSERTION: you MUST be aware of risks and side effects. You make a personal choice to use this method of contraception after knowing the benefits and risks. With the Levonorgestrel Intrauterine System (MIRENA), spotting or bleeding may occur between menstrual periods although total blood loss and painful periods are reduced. Most commonly reported side effects to include menstrual changes, lower abdominal pain (though Mirena is used as a treatment for low abdominal pain), acne or other skin problems, back pain, breast tenderness, headache, vaginal discharge, mood changes, and nausea.
FDA APPROVED: Mirena has been formally approved by the U.S. Government (FDA) and has been available in Europe since the mid-1990s.
FERTILITY: studies have shown 80% of women become pregnant one year after Mirena IUD removal and 87% are pregnant within two years after IUD removal.
NO PROTECTION AGAINST STDs INCLUDING HIV: Mirena does NOT protect against HIV (AIDS) and other sexually transmitted diseases. The use of IUDs has been associated with an increased risk of pelvic inflammatory disease (PID). The highest risk occurs shortly (within about three weeks) after insertion. A decision to use MIRENA must include consideration of the risks of PID. Candidates should have no history of ectopic pregnancy or a condition that would predispose to ectopic pregnancy.
THEREFORE: The IUD is best for a woman who is in a steady and faithful relationship with a partner who is faithful and does not have any sexually transmitted infections.
REMEMBER The decision to use an IUD largely up to you. Call us promptly in the event of pelvic pain, fever, troublesome discharge or ANY thought that you might be pregnant.
TELEVISION LAWSUIT ADVERTISING: My personal experience for over 8 years has been that Mirena is very popular and has excellent safety. In my opinion, the single greatest risk results from poor initial IUD placement at the time of insertion. To manage this we check ALL IUDs for proper placement. ALL METHODS OF BIRTH CONTROL INVOLVE RISKS. It is my opinion that the risks of unplanned pregnancy are far greater than the risks of the Mirena IUD. You must make a responsible personal choice.
FOLLOW-UP APPOINTMENT: After IUD insertion, we would like to check you following your first menstrual episode to assure it remains in the proper position. NOTE: THERE IS A 5% RISK THE IUD MAY COME OUT BY ITSELF DURING THE NEXT 5 YEARS! YOU SHOULD CHECK FOR THE IUD STRINGS EACH MONTH AFTER MENSTRUAL FLOW TO BE ASSURED IT IS STILL IN PLACE.
DURATION OF EFFECTIVENESS: Mirena is good for 5 years at a time.
CONVENIENCE AND SPONTANEITY: Most methods are not fully effective unless you follow a strict routine. For example, many women find it difficult to remember to take a pill every day. Women who rely on barrier methods, such as condoms or diaphragms, are faced with the inconvenience of having to “break the mood” in order to protect themselves from an unplanned pregnancy. Even injections (commonly known as “the shot”), which last up to 3 months, still require a visit to the health care professional every 90 days in order to maintain their effectiveness. While tubal sterilization (often called “getting your tubes tied”) can offer women convenience and spontaneity, it’s important to realize that this method is permanent. So if you’re thinking about sterilization, make sure you are really ready before making your decision.
KEEPS OPTIONS OPEN: The IUD is a method just as effective as sterilization, but easily and rapidly reversible (80% of women wishing to become pregnant did so within 12 months after IUD removal). Although preventing pregnancy may be a top priority for you now, it’s important to think about whether you would like to have a child in the future. If you decide later to have a baby, it’s important that your current method of birth control will not interfere with your ability to become pregnant. Some women, particularly those using hormonal injections, find it difficult to become pregnant, and some may have to wait for up to 18 months following their last shot to become pregnant. For sterilized women who later change their minds and decide to have another child, reversal surgery is very unpredictable and does not guarantee a successful pregnancy.
MIRENA can alter the bleeding pattern. During the first 3 to 6 months of use, the number of bleeding and spotting days may be increased and bleeding patterns may be irregular. Thereafter, the number of bleeding and spotting days usually decreases, but bleeding may remain irregular. This IUD is 32 millimeters across (width) and releases 20 mcg Levonorgestrel/day.
FINALLY: You must clearly understand the low but present risks of IUD expulsion and light irregular bleeding, infection, infertility, surgery, and pain with IUD use. You should have read and clearly understood the informed consent pamphlet.
REPORT NEGATIVE SIDE EFFECTS: You are encouraged to report negative side effects or quality complaints of prescription drugs to the FDA. Visit www.fda.gov/medwatch or call 1.800.FDA.1088.