Daily Archives: 25/11/2013

The female blogger Silverdrop, shown from shoulders to waist, nude, with her long brown hair covering her breasts.

Our Contraception Journey Part 8: Mirena IUS

Mirena IntraUterine System

Part 8 of a weekly series. We’ve been through nearly every available contraception method in our efforts to find the right solution for us. This week, we consider the Mirena IntraUterine System.

A model of a human uterus with a Mirena Intrauterine system in place.

This is not the same IUD I tried before.

After deciding that female sterilisation was probably our only solution, we went back to the Family Planning Clinic for one last, desperate hope that there was something available that wouldn’t require surgery.

We took a long printout of everything we’ve tried before and why it hasn’t worked for us. The nurse practitioner who spoke to us spent quite a while looking over it, and then said, “I think there is one thing you may have overlooked.”

At this point, we were rather surprised – we had hoped there was something, but we’d done so much research, we didn’t know how it was possible that we could have missed anything. And then she asked us what we knew about the Mirena – an intrauterine device with hormones.

My first question was, “Would that work for me when I’ve had problems with an IUD before?” and before she could answer “And what about all the problems I’ve had with hormonal contraception?”

She explained the hormone issue first. The hormone would be the same hormone used in the contraceptive patch, implant, or pill, but because it’s being released locally within the uterus, rather than systemically, the dosage is much lower. The migraines and libido problems would hopefully not occur, or would occur to a more manageable degree.

As for the second question, it turns out this IUD is built completely differently than the one I used before. I had looked at Mirena and thought ‘This has all the problems I had before, plus hormones? NO THANKS!’ But the Paraguard IUD that I used before worked by releasing copper into the uterus which makes the uterus hostile to sperm. It can also act as an irritant to the uterine lining, which is probably what caused me a low level of daily bleeding rather than a monthly period.

Mirena, however, has no copper. It works by releasing progestogen, thinning the uterine lining to prevent implantation and thickening cervical mucous to make it more difficult for sperm to enter the uterus. The nurse explained to me that rather than causing bleeding, the way the Paraguard IUD does, the Mirena often causes periods to diminish or stop completely.

We were told that if this doesn’t work for us, then we really do have no other options other than female sterilisation. The nurse asked if we wanted to go home and discuss it first, and I said, “No. I want to try this. How soon can we get it inserted?” She made us an appointment for the following week, and warned us not to have vaginal sex at all before then, even with condoms, just to be absolutely sure there’s no pregnancy.

A week later, we turned up for our appointment. I don’t know what it is about the NHS, but even though stirrups are standard practice in the US for gynaecological exams, I’ve never yet seen them used over here. What’s up with that? Are stirrups too expensive or something? It certainly would have been more comfortable if I’d had them.

It wasn’t quite as painful as I remembered from the last time. After cranking me open with the speculum, the nurse did use a local anaesthesia, though it wasn’t nearly as anaesthetic as I would have liked. I couldn’t really see what he was doing, but there seemed to be lots of things entering and exiting at various times. There were two really painful moments. One was when something went up into the cervix. That was not fun. Then there was some poking around in my uterus, which was like menstrual cramps on steroids and carrying a switchblade. Okay, I’ve never been pregnant, never had endometriosis, and never had uterine fibroids, so I am SO not qualified to whine about uterine pain. But it was not pleasant.

Finally he was done, but it still took a while to get everything inside swabbed up again and the speculum removed. I put a pad in when I dressed, but there was no obvious bleeding. Just lots of cramping. I’m home now, with a hot water bottle on my abdomen, which feels nice.

Aftercare instructions are these: No unprotected sex for 7 days, no tampons for 2 weeks, followup appointment in 6 weeks to check placement, self-check of the strings each month, and replace it in 5 years. Assuming it works for me, and it doesn’t have to come out early.

I just really really hope Mirena is finally the contraception option that will work for us. Because the next stop after this is the operating table.

Find out how it went in Part 9


To be continued…

Our Contraception Journey Part 1: Why is Contraception so Hard?
Our Contraception Journey Part 2: Sterilisation
Our Contraception Journey Part 3: Vasectomy Complications
Our Contraception Journey Part 4: Cerazette
Our Contraception Journey Part 5: Further Vasectomy Complications
Our Contraception Journey Part 6: Cerazette Complications
Our Contraception Journey Part 7: Female Sterilisation