Archived Story

Mirena might be right for you

Published 10:18am Monday, April 25, 2011

Over time there has been an increasing interest in the Mirena, and I think there are good reasons for that interest.

We’ll talk about it today so that you can learn more about whom the Mirena might be just the right fit for.

The Mirena follows in a long line of so-called intrauterine devices (IUD). I understand that the history of the intrauterine device dates back to the days of camel caravans when the herders would place stones inside the womb of the female camels to prevent them from conceiving along the way. It is interesting that those we might consider primitive found this effective method way back when.

The history of the intrauterine device in humans is also interesting. If you have been around a while like me, you probably remember something called the Dalkon Shield. The Dalkon Shield was one of the first modern intrauterine devices designed for contraception. The Shield looked evil if you ask me. It was flat, rounded like the head of a tadpole, and had spokes sticking backwards off the sides—EGHADS!

The real danger with the Shield appears to have been the braided string that trailed off of it. A note here—when the IUD was made more modern than the old rock thing, it was designed to be placed at the discretion of the woman and then removed as she desired. Removal was, and is, made possible by a string or thread that trails out of the cervix into the upper vagina. Current strings, like that on the Mirena, are more like fish line and are single stranded. The braided string of the Dalkon Shield supposedly allowed bacteria to “climb” up the string into the uterine cavity. Infections were the result at times and some women became seriously ill that way. Because of the infection problem, intrauterine devices lost favor for decades.

The Mirena has changed all that. It is not the first IUD to have resolved the infection problem, but it is one of the new class of IUDs that have solved the problem. While it was certainly a big deal to have resolved the higher risk of infection, the Mirena has gone on to resolve other problems as well.

First of all, of course, the intrauterine device is a contraceptive, and a highly effective one. It is placed during an office appointment and takes about 10 minutes. There is some cramping involved during the instillation, but most women relate that this is mild to moderate. The cramping generally resolves in less than 30 minutes. Once in place, the Mirena is good for five years. Most women who have the Mirena notice that the flow with their periods decreases, as does the cramping. In fact, many women stop having menstrual flows altogether while using the Mirena; what a benefit that is!

The reduction in menstrual flow can be so significant in fact that the FDA has now recognized the reduction of heavy menstrual flows as a legitimate indication for placing the Mirena, even if the woman has had a tubal sterilization.

What’s more, the Mirena is OK to place in young women who may not have had any children yet. Since young women, as a group, are likely to experience painful heavy flows, the Mirena can be very helpful, while not depending on the young woman’s ability to remember to take a pill every day.

Of course, every therapy has some risk associated with it and a woman should know all her alternatives before she makes any choices. Placement of the Mirena can temporarily raise the risk for infection and this will need to be watched for initially. Some women with the Mirena develop ovarian cysts early on. The most common nuisance side effect that some women experience is spotting.

All in all, the Mirena is a very safe and effective option for contraception, while also offering the benefit of decreasing flows. Additionally, because the Mirena does not contain any estrogen, it is safer to use in women with diabetes, hypertension, migraines, hypercholesterolemia or other medical problems.

So, if you are younger or older, healthy or with medical problems, fertile or sterile, the Mirena may be right for you.

Just ask.

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