Mirena removal: things to keep in mind

Reasons to remove the Mirena coil | How is the coil removed? | Does removing Mirena have any side effects? | How to prepare for Mirena coil removal? | The ‘Mirena crash’: what we know | Mirena removal: frequently asked questions (FAQs)

You can remove Mirena at any time, and for any reason. Mirena also needs to be replaced once every 4–8 years. The exact timeframe for a replacement depends on what your doctor prescribed Mirena for.

Reasons to remove the Mirena coil

Mirena should only be removed by a qualified healthcare provider such as a doctor or nurse. You should not try to remove Mirena yourself. A qualified healthcare provider can remove it at any time if you do not want to use it anymore.

There are several reasons why you may choose to have your Mirena removed. These include:

I want to have a Mirena replacement

Mirena can remain in your womb for:

• up to 8 years to prevent pregnancy
• up to 4 years if it was prescribed as part of an HRT plan
• up to 8 years for heavy periods (however, if your symptoms come back, please contact your doctor or nurse)

If you become pregnant while on Mirena, you should see your doctor immediately.

I no longer want to use Mirena

You can stop using Mirena at any time by asking your healthcare provider to remove it. If you want to prevent pregnancy after Mirena is removed, you should use another method of birth control. Talk to your doctor about this, as your new method may need to be started 7 days before Mirena is removed to prevent pregnancy.

How is the coil removed?

If you've made the decision with your doctor to remove Mirena, they can schedule an appointment at your convenience.

Mirena is an intrauterine system (IUS), a small T-shaped device fitted into your womb, that is fitted and removed without surgery. To remove Mirena, your healthcare provider will use a tool called forceps to gently pull at the Mirena threads to remove it. The healthcare provider may sometimes not be able to easily see the Mirena threads. In this case, they may need to use ultrasound or other tools to locate Mirena. They may use narrow forceps to remove it, and a tool called a speculum (the same tool used for smear tests) to open the cervix.

Mirena should only be removed by trained healthcare professionals. You should not try pulling at the Mirena threads yourself.

Does removing Mirena have any side effects?

You may experience the following symptoms during the removal process:

• Pain
• Bleeding
• Dizziness
• Feeling faint or passing out

If you have epilepsy, make sure to tell your doctor. While rare, it is possible to have a seizure while Mirena is being removed.

While most coil removals are straightforward, there might be situations where it needs to be removed differently. This may be due to the shape of your womb, how the IUS is positioned, or if you’re experiencing pain. In cases like this, your healthcare provider may refer you to another care provider who is more experienced with your circumstances.

Talk to your doctor if you have concerns about getting Mirena removed, and read the Mirena Patient Information Leaflet.

How to prepare for Mirena coil removal?

If you do not wish to get pregnant, avoid unprotected sex at least 7 days before your Mirena removal. Otherwise it is important to use another form of contraception such as condoms.

If you want to switch to another method of birth control, make sure you use barrier contraceptives such as condoms starting at least 7 days before your removal appointment. After the removal, start your new contraceptive of choice immediately. Ensure you follow the instructions for your new contraceptive and consult your doctor.

Everyone’s body is different, and if you are concerned about pain during your Mirena removal, there are options available. There is no single best option for pain relief. Your doctor can advise on the best option for you.

The ‘Mirena crash’: what we know

The ‘Mirena crash’ is a term sometimes used in women’s social media communities to describe the symptoms women may experience after getting Mirena removed. Some symptoms that are thought of as being a part of the ‘crash’ include:

• mood changes
• fatigue
• reduced libido
• headaches
• tender breasts

Currently, there is no medical definition of the ‘Mirena crash’. There is also no scientific evidence for, or research into this.

While some of these are known side effects of Mirena, they are not specifically known to be linked to its removal.

If you feel you are experiencing any side effects from your ongoing/previous Mirena treatment, speak to your doctor. All bodies are different. Your doctor will consider your unique medical history and information known about Mirena.

You should read your Mirena Patient Information Leaflet and talk to your doctor for correct information about Mirena.

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.

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.

Perimenopause: The time in a woman’s life when her periods become irregular before menopause.

Abbreviations

HRT, hormone replacement therapy; IUS, intrauterine system.