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Getting Mirena fitted: what to expect?

Before having a coil fitting appointment | What happens during the Mirena coil fitting? | After Mirena insertion | Mirena coil fitting: frequently asked questions (FAQs)

Mirena is a treatment called an intrauterine system (IUS) that is fitted into the womb (uterus). It can be prescribed by your doctor as a contraceptive for up to 8 years, and to treat heavy periods for up to 8 years unless your symptoms return. Mirena is also prescribed as part of hormone replacement therapy (HRT) for up to 4 years.

Mirena is fitted by a trained healthcare professional.

Before having a coil fitting appointment

Your doctor or nurse will ask you about your health or medical history to make sure that Mirena is suitable for you.

Mirena can be fitted by an experienced healthcare professional at sexual health clinics, GP surgeries, or young people's services. You should speak to your doctor or nurse about Mirena safety concerns and pain relief options before your appointment.

A picture of the Mirena coil box and insertion tool.

Collecting Mirena from the pharmacy

Mirena may be supplied by a healthcare professional, or you may need to collect it from the pharmacy.

Mirena is small, but is packaged in a large box that contains everything needed by the healthcare professional for Mirena fitting. The contents should not be opened or changed in any way and should be taken along as is to the fitting appointment.

Sex before Mirena insertion

If Mirena is being inserted after the first 7 days of your period, you should not have unprotected vaginal sex before your fitting. You should use a barrier method of contraception, such as condoms, or you should avoid vaginal sex. Your doctor or nurse will need to confirm that you are not pregnant before fitting Mirena.

Pain management

Taking pain medication before your appointment could ease any discomfort during the fitting and manage any symptoms after the fitting. You should discuss pain management options with your nurse or doctor. There is no single best method to relieve pain during a Mirena coil fitting. Some options that can reduce pain during the appointment include:

Local anaesthetic spray or gel
Numbing cream
A local anaesthetic injection (called a cervical block)
Pain-relief tablets before your fitting
Non-steroidal anti-inflammatory drugs (NSAIDs) like naproxen

What happens during the Mirena coil fitting?

Your doctor or nurse will explain the procedure, discuss any risks and answer any questions you have. You should ask your doctor or nurse about pain management options and remind your doctor of any underlying conditions, such as epilepsy.

Before the fitting, the doctor or nurse may need to do a pelvic and breast examination. A healthcare assistant will also be there to support you during the fitting. You are also welcome to bring a support person with you if it helps you feel more comfortable.

You are in control during the fitting. You should speak to your doctor if you experience any pain, and you can ask your doctor to pause or stop at any time.

You should read the patient information leaflet before your fitting.

Mirena coil insertion

During the fitting, your doctor or nurse will:

Confirm that you are not pregnant.
Gently open your vagina using a speculum (a tool to open the vagina) so they can see your cervix (neck of the womb).
Cleanse your cervix and vagina.
Your doctor may use a tenaculum (a scissor-like tool) to keep your womb steady during the fitting.
Check the size and position of your womb and rule out any problems that could affect the Mirena IUS insertion.
If needed, your doctor or nurse may gently widen the opening of your cervix to make the fitting easier.

Mirena will then be gently placed inside the womb using a thin insertion tube. It will be inserted through your cervix (the neck of your womb). Once complete, the doctor or nurse will then cut the threads at the bottom of Mirena to the right length.

The fitting of Mirena only takes 5 to 10 minutes, but the full appointment may take 30 minutes or more. Remember, you can ask your doctor or nurse to take a break during the procedure, and you can stop at any time.

Image showing Mirena IUS positioned inside the womb, shown alongside a full-body outline of a woman highlighting where the womb is located

Side effects during coil fitting?

Everyone's fitting experience is different. Some women feel little or no pain, others may find it uncomfortable, describe it as similar to a smear test, or experience period-like pain after Mirena coil fitting. It is not always possible to know which women will experience more pain. You may be more likely to experience pain if you feel anxious, expect the fitting to be painful, have painful periods, or have not given birth vaginally before.

Talk to your doctor or nurse before the fitting about pain management options and remind your doctor of any health conditions you have, including epilepsy, as Mirena insertion could trigger a fit. You may experience light bleeding, feel dizzy or faint following the fitting. This is normal, and your doctor or nurse may tell you to rest for a while.

Read the patient information leaflet for more information.

Bleeding during the appointment

In some cases, light bleeding (spotting) may occur during your appointment. You can take a sanitary towel or panty liner to your appointment to prepare in case this happens.

After Mirena insertion

Your doctor or nurse will explain how you can make sure Mirena is in place. They will also show how to feel for the Mirena threads and what to do if you can’t feel the threads. Tell your doctor or nurse if you feel faint after Mirena is fitted. They may ask you to rest for a while.

Your doctor or nurse should give you a patient reminder card, if so, you should bring this with you to every appointment. Learn about the next steps after your Mirena has been fitted.

Carefully read your Mirena Patient Information Leaflet for everything you need to know about your newly fitted Mirena.

Mirena coil fitting: frequently asked questions (FAQs)

Is the Mirena coil fitting painful?

Every woman’s fitting experience is different. Some women experience mild to moderate discomfort during IUD insertion, while other women experience more severe pain. It is not always possible to predict which women will experience pain. Speak to your doctor about pain management options.

Can you use tampons with a Mirena coil?

The use of sanitary pads is recommended, and if you use tampons, you should change them with care to avoid pulling the strings of Mirena. Some doctors or nurses may recommend that tampons should not be used immediately and only be used 4 weeks post-insertion to avoid dislodging of threads.

Can I use menstrual cups with a Mirena coil?

Similarly to tampons, menstrual cups can be used with care to avoid pulling the strings of Mirena.

Can the coil be fitted during a period?

Yes, the ideal time to have Mirena fitted is within 7 days of the start of your period. If Mirena is fitted during this time, it will work immediately in preventing pregnancy. If Mirena is fitted at another time in your cycle, it may not protect you from pregnancy straight away. You should use other methods of contraception such as condoms, or avoid vaginal sex for 7 days after Mirena is inserted.

Will I bleed after Mirena fitting?

Light bleeding post coil insertion can occur. You should contact your doctor or nurse immediately if you experience:

severe bleeding
severe pain or fever after insertion, as this may be due to an infection
severe pain and continued bleeding, as this might be a sign of a tear in your womb
unexpected bleeding or lower abdominal pain, fever, and a missed period, as these may be due to an ectopic pregnancy

How long after Mirena is fitted am I protected from pregnancy?

If Mirena is fitted within 7 days of the start of your period, it will work immediately in preventing pregnancy. If Mirena is fitted at another time in your cycle, it may not protect you from pregnancy straight away. After the fitting, you will need to use another method of contraception (e.g. condom) or avoid vaginal sex for the first 7 days.

Can I have Mirena fitted while pregnant?

No, you cannot. The doctor will use a pregnancy test to confirm that you are not pregnant before Mirena is fitted.

Glossary

Coil: A common name for an IUS or an IUD. It is a small device placed inside the womb to prevent pregnancy.

Intrauterine system (IUS): A small T-shaped device placed inside the womb that slowly releases a hormone.

Hormone replacement therapy (HRT): Treatment that replaces the hormones that the body makes less of during menopause, including oestrogen to relieve menopause symptoms and progesterone to protect the lining of the womb.

Levonorgestrel: One of the hormones that performs the function of a progestogen.

Menopause: Menopause is a condition caused by a fall in hormone levels in women between the ages of 45 or 55, but it can happen earlier.

Oestrogen: A hormone that is naturally made by the body. Oestrogen, along with progesterone is essential to puberty, the menstrual cycle, pregnancy, and menopause.

Progesterone: A natural hormone made by the body. It helps control the menstrual cycle and supports pregnancy.

Abbreviations

HRT, hormone replacement therapy; IUS, intrauterine system; NHS, National Health Service; STI, sexually transmitted infections.

PP-MIR-GB-0321 | October 2026

References

1
Mirena 20 micrograms/24 hours intrauterine delivery system. Accessed July 19, 2026.
2
Mirena® 20 micrograms/24 hours intrauterine delivery system (levonorgestrel) Patient Information Booklet. January 2026. Accessed July 19, 2026.
3
NHS. Getting an IUS (intrauterine system) or hormonal coil fitted or removed. February 22, 2024. Accessed July 19, 2026.
4
NHS. Who can get an IUS (intrauterine system) or hormonal coil. February 22, 2024. Accessed July 19, 2026.
5
NHS. Where to get an IUS (intrauterine system) or hormonal coil. February 29, 2024. Accessed July 19, 2026.
6
IUD Complications & Considerations. Comprehensive Women’s Health Center. Accessed July 19, 2026.
7
COSRH. Pain Shouldn’t Be a Part of the Plan Patient Toolkit (Poster). Accessed September 11, 2026.
8
COSRH. Pain shouldn’t be part of the plan. Accessed July 17, 2026.
9
Staples D. Advice before the fitting of Intrauterine Contraception (Copper or hormone coil). Accessed July 19, 2026.
10
Having a copper coil (IUD) or Mirena/Kyleena (IUS) fitted. Macclesfield Primary Care Network. Accessed July 19, 2026.
11
Let’s Talk About It - NHS. Coils. Hampshire and Isle of Wight Healthcare Sexual Health. January 10, 2025. Accessed July 15, 2026.
12
NHS. About oestrogen tablets, patches, gel and spray. January 5, 2023. Accessed August 31, 2026.
13
PubChem. Levonorgestrel. Accessed July 15, 2026.
14
NHS. What are menopause and perimenopause? May 19, 2026. Accessed July 14, 2026.
15
NHS. Types of hormone replacement therapy (HRT). March 9, 2023. Accessed June 26, 2026.
16
My Menopause Centre. The key things you need to know about progestogens and progesterone. mymenopausecentre.com. Accessed July 15, 2026.