Who is not appropriate for Mirena
Use of Mirena is contraindicated in women with: known or suspected pregnancy and cannot be used for post-coital contraception; congenital or acquired uterine anomaly, including fibroids if they distort... Continue below
Women may experience unplanned pregnancies in the first year after giving birth, so you may want to counsel your appropriate patients on their options for birth control, including Mirena.1
Tell your patients that Mirena can be inserted if a minimum of 6 weeks has passed or until involution is complete following a delivery or second trimester abortion. If involution is delayed, wait until involution is complete before insertion. The risk of perforation may be increased if Mirena is inserted when the uterus is fixed retroverted or not completely involuted. You can also tell your patients that she may use Mirena when breastfeeding if more than 6 weeks have passed since delivery. Mirena is not likely to affect the quality or amount of breast milk or the health of the nursing baby. However, isolated cases of decreased milk production have been reported among women using progestin. The risk of Mirena becoming attached to (embedded) or going through the wall of the uterus is increased if Mirena is inserted while she is breastfeeding.
A large postmarketing safety study conducted in Europe over a 1-year observational period reported that lactation at the time of insertion of an IUD/IUS was associated with an increased risk of perforation. For Mirena users, the incidence of uterine perforation was reported at 6.3 per 1000 insertions for lactating women compared to 1.0 per 1000 insertions for non-lactating women.
No daily, weekly, or monthly dosing routines.
Counsel patients to check their threads once a month
Reexamine patients 4 to 6 weeks after insertion and once a year thereafter, or more frequently if clinically indicated
The only IUD birth control approved
to treat HMB for up to 5 years in those who chose
an IUD for contraception.
Use of Mirena is contraindicated in women with: known or suspected pregnancy and cannot be used for post-coital contraception; congenital or acquired uterine anomaly, including fibroids if they distort the uterine cavity; known or suspected breast cancer or other progestin-sensitive cancer, now or in the past; known or suspected uterine or cervical malignancy; liver disease, including tumors; untreated acute cervicitis or vaginitis, including lower genital tract infections (eg, bacterial vaginosis) until infection is controlled; postpartum endometritis or infected abortion in the past 3 months; unexplained uterine bleeding; current IUD; acute pelvic inflammatory disease (PID) or history of PID (except with later intrauterine pregnancy); conditions increasing susceptibility to pelvic infection; or hypersensitivity to any component of Mirena.
Counsel patients to check their threads once a month
Reexamine patients 4 to 6 weeks after insertion and once a year thereafter, or more frequently if clinically indicated
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