What you can expect

Mirena is typically inserted in a health care provider's office.

During the procedure

Your health care provider will insert a speculum into your vagina and clean your vagina and cervix with an antiseptic solution. Special instruments might be used to gently align your cervical canal and uterine cavity and to measure the depth of your uterine cavity.

Next, your health care provider will fold Mirena's horizontal arms and place the device inside an applicator tube. The tube is inserted into your cervical canal, and Mirena is carefully placed in your uterus. When the applicator tube is removed, Mirena will remain in place.

Your health care provider will trim Mirena's strings so that they don't protrude too far into the vagina, and may record the length of the strings.

During Mirena insertion, you may experience cramping, dizziness, fainting or a slower than normal heart rate.

After the procedure

Once a month, check to feel that Mirena's strings are protruding from your cervix. Be careful not to pull on the strings.

About a month after Mirena is inserted, your health care provider may re-examine you to make sure Mirena hasn't moved and to check for signs and symptoms of infection.

While you're using Mirena, contact your health care provider immediately if you:

• Think you may be pregnant
• Have unusually heavy, persistent vaginal bleeding
• Have abdominal pain or pain during sex
• Have an unexplained fever
• Have unusual or foul-smelling vaginal discharge, lesions or sores
• Develop very severe headaches or migraines
• Have yellowing of the skin or eyes
• Were exposed to an STI
• Can no longer feel the IUD strings, or they suddenly seem longer

It's also important to contact your health care provider immediately if you think Mirena is no longer in place. Your provider will check the location of Mirena and, if it's displaced, remove it if necessary.

Removal

Mirena can remain in place for up to five years. To remove Mirena, your health care provider will likely use forceps to grasp the device's strings and gently pull. The device's arms will fold upward as it's withdrawn from the uterus.

Light bleeding and cramping is common during removal. Rarely, removal can be more complicated.