Hormonal IUD
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What is Hormonal IUD/Mirena?

The hormonal IUD is put in place by a doctor, and can stay in the body for up to five years. It works by giving off a steady low dose of the hormone progestogen (levonorgestrel).

 Similar to  the copper IUD, hormonal IUDs are also T-shaped plastic devices. However, instead of copper, they have a reservoir that contains and releases hormones.  

Hormonal IUDs are sold under the brand name Mirena. The hormonal IUD makes the mucus around your cervix thicker so the sperm can’t get through and it can also stop your ovaries producing an egg. Also, the hormone makes it harder for sperm to travel up towards the egg. And finally, it thins and suppresses the lining of the uterus, so that in the rare case an egg does get fertilised, it can't be implanted.

Failure rate

  • Typical use: 0.2%
  • Perfect use: 0.1%

What happens to my period while I use a hormonal IUD?

Any problems you may have with your periods may be relieved if you use a hormonal IUD. It's normal that after a few months of use you will stop having heavy periods. Or your periods may stop altogether.

The hormonal IUD may also stop cramps and/or pain before your period.

After one year of use, only about half the women with a hormonal IUD still have their periods. And even if you still have your period, there is up to 70% less blood loss in women with  a hormonal IUD compared to those who don't use birth control.

Some women find it difficult to accept that this is normal. In fact, not having their periods is the number one reason for women to stop using the hormonal IUD.

So it is a good idea to think about this before having it placed, and talk to your healthcare provider about any concerns you have regarding your period before having the IUD placed.

What are the side effects?

  • Headaches
  • Acne
  • Weight gain
  • Mood changes
  • Ovarian cysts
  • Breast tenderness
  • Spotting

Who shouldn't use the hormonal IUD?

  • Women with a history of pelvic inflammatory disease (PID) (recent or not) can have an IUD inserted  as long as the PID is resolved, with no need to wait for pregnancy. Therefore,  only current PID is a contraindication for insertion. 
  • Women with an untreated pelvic infection
  • Women with breast, cervical or uterine cancer
  • Women with undiagnosed and abnormal vaginal bleeding
  • Women with liver tumours
  • Women at high risk of STDs, unless they use condoms with all their sex partners
  • Women who have a blood clot in the deep veins of the legs or in the lungs

Most women with HIV/AIDS can use an IUD but need to check with a doctor first.

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