20 micrograms \/ 24 hours, intrauterine insert
Levonorgestrel<\/p>\n\n\n\n
Mirena is used as:<\/p>\n\n\n\n
Children and young people<\/em><\/p>\n\n\n\n Mirena is not for use before the first menstrual period ( menarche ).<\/p>\n\n\n\n Mirena is a T-shaped uterine insert that, after insertion into the uterus, releases the\u00a0hormone\u00a0et levonorgestrel.\u00a0The T-shape means that the insert adapts well to the shape of the uterus.\u00a0On the vertical part of the white T-structure, there is a hormone capsule that releases the\u00a0hormone.\u00a0Two brown socket wires are attached to the lower end of the vertical part.<\/p>\n\n\n\n Levonorgestrel, the active ingredient in Mirena, is a synthetic hormone similar to the corpus luteum hormone, a hormone produced by the body. Mirena’s hormone capsule releases levonorgestrel directly into the uterine lining in low doses (20 micrograms per 24 hours). The insert prevents pregnancy by affecting the mucous membrane so that it is not prepared for pregnancy and by making the secretions in the cervix thicker, which makes it difficult for the sperm to enter the uterus. The insert also affects the motility of the sperm inside the uterus so that fertilization is prevented.<\/p>\n\n\n\n Do not use Mirena:<\/strong><\/p>\n\n\n\n Talk to your doctor\/midwife before using Mirena.<\/p>\n\n\n\n If you are using Mirena in conjunction with\u00a0estrogen\u00a0replacement therapy,\u00a0see also the estrogen package leaflet.<\/p>\n\n\n\n Contact a doctor\/midwife if you have any of the following conditions or if any of the following conditions occur for the first time when you use Mirena.\u00a0The doctor\/midwife can then decide whether Mirena should continue to be used or taken out.<\/p>\n\n\n\n Your doctor\/midwife also needs to know if you have any heart disease, as there is a risk of\u00a0heart\u00a0infection.<\/p>\n\n\n\n Because levonorgestrel may affect\u00a0glucose\u00a0metabolism, you should check your blood sugar if you are diabetic but it is not usually necessary to change your diabetes treatment while using Mirena.<\/p>\n\n\n\n Irregular bleeding can mask certain symptoms and signs of polyps or cancer of the uterine lining. Consult a doctor or midwife.<\/p>\n\n\n\n Mirena is not a first-line method for women who have undergone menopause and have a reduced uterus.<\/p>\n\n\n\n Medical examination<\/strong><\/p>\n\n\n\n A gynecological examination should be performed to determine the location and size of the uterus.\u00a0An examination before insertion may also include a cell sample, an examination of the breasts and, if necessary, other tests, for example for\u00a0genital infections, including sexually transmitted diseases.<\/p>\n\n\n\n Mirena is not suitable as a “day after” method against unwanted pregnancy.<\/p>\n\n\n\n Infection is<\/strong><\/p>\n\n\n\n The insertion tube protects the insert against bacteria in connection with the insertion. There is an increased risk of genital infection immediately and during the first month after insertion in copper insert users and a similar risk can not be ruled out for Mirena. Having multiple sexual partners increases the risk of genital infection. If you get a genital infection when using Mirena, it should be treated as soon as possible. Abdominal infections can affect fertility and increase the risk of future ectopic pregnancies (ectopic pregnancy). As with other gynecological and surgical procedures, severe infection or sepsis can occur in extremely rare cases after insertion of the uterus.<\/p>\n\n\n\n If acute\u00a0infection\u00a0is severe or does not improve within a few days despite treatment, as well as in recurrent genital infections or\u00a0infection\u00a0of the uterine lining, Mirena should be removed.<\/p>\n\n\n\n Contact your doctor\/midwife immediately if you experience persistent abdominal pain, fever, pain during intercourse, or abnormal bleeding.<\/p>\n\n\n\n Ejection<\/strong><\/p>\n\n\n\n Muscle contractions in the uterus during menstruation can sometimes displace the insert or repel it completely. This is more likely to occur if you are overweight at the time of insertion or if you have had heavy periods in the past. If the insert is displaced, it may not work as intended and therefore the risk of pregnancy is higher. If the post is rejected, you are no longer protected against pregnancy.<\/p>\n\n\n\n Any signs of expulsion are pain and abnormal bleeding, but Mirena can also be expelled without you noticing.\u00a0As Mirena reduces the amount of menstruation, and increased menstrual bleeding may be a sign of expulsion.<\/p>\n\n\n\n You should check the threads with your fingers e.g.\u00a0in connection with your showering.\u00a0See also section 3 “How to use Mirena – How do I know if Mirena is in place?”.\u00a0If you notice anything that indicates an ejection of the insert or if you cannot feel the threads, use another form of contraception (such as a condom) and contact your healthcare provider.<\/p>\n\n\n\n Perforation \/ Damage to the uterine wall<\/strong><\/p>\n\n\n\n Damage to the uterine wall can occur, usually during the insertion of Mirena. An injury is sometimes not discovered until after a while. If Mirena gets stuck outside the uterine cavity, it does not effectively protect against pregnancy and should be removed as soon as possible. Surgery may be needed to remove Mirena.<\/p>\n\n\n\n The risk of damage to the uterine wall is increased in breastfeeding women and in women where the insertion is made up to 36 weeks after delivery, and may be increased in women where the uterus is fixed and bent backward (retro-reflected uterus).\u00a0If you suspect that you have suffered an injury to the uterine wall, contact your doctor\/midwife immediately for advice and remind them that you have a Mirena inserted, especially if it is not the same person who inserted it.<\/p>\n\n\n\n Possible signs and symptoms of damage to the uterine wall may include:<\/p>\n\n\n\n Breast cancer <\/strong><\/p>\n\n\n\n Available data show that Mirena does not increase the risk of breast cancer in menstruating women under 50 years of age.\u00a0The risk of getting breast cancer can neither be confirmed nor rejected when Mirena is used as protection to prevent unwanted growth of the uterine lining in women who use\u00a0estrogen replacement therapy\u00a0during\u00a0menopause.\u00a0This is because there are not enough data from studies on Mirena.<\/p>\n\n\n\n Excessive pregnancy<\/strong><\/p>\n\n\n\n Pregnancy is very rare in women who use Mirena.\u00a0If you still become pregnant while using Mirena, the risk of the fetus being outside the womb (so-called ectopic pregnancy) is increased.\u00a0With the correct use of Mirena, about 1 in 1,000 women per year suffer from ectopic pregnancy.\u00a0The proportion is lower than in women who do not use contraception (where about 3 to 5 out of 1000 women per year are affected).\u00a0Women who have previously had an ectopic pregnancy performed\u00a0surgery\u00a0on the fallopian tubes or had a genital infection have a greater risk of getting an ectopic pregnancy.\u00a0Ectopic pregnancy is a serious condition that requires immediate treatment.\u00a0The following signs may indicate that you have an ectopic pregnancy and you should contact a doctor immediately:<\/p>\n\n\n\n Dizziness<\/strong><\/p>\n\n\n\n Some women feel dizzy right after Mirena is inserted. This is a normal physical reaction. You should then rest for a while after the deposit.<\/p>\n\n\n\n Enlarged follicles (ovary)<\/strong><\/p>\n\n\n\n Since the preventive effect of the insert is mainly due to its effect on the uterus, ovulation is not affected infertile women.\u00a0Sometimes, however, the normal regeneration of the follicle is delayed and the development continues.\u00a0Although most of these\u00a0follicles\u00a0do not cause any symptoms, some can cause abdominal pain or intercourse pain.\u00a0Sometimes medical treatment is required but usually, they disappear on their own within 2-3 months.<\/p>\n\n\n\n Mental disorders<\/strong><\/p>\n\n\n\n Some women who use hormonal contraceptives, including Mirena, have reported depression or depression. Depression can be severe and can sometimes lead to suicidal thoughts. If you experience mood swings and symptoms of depression, you should contact a doctor as soon as possible for advice.<\/p>\n\n\n\n Contact a doctor\/midwife if any of the following occur:<\/strong><\/p>\n\n\n\n Additional information on specific patient groups<\/strong><\/p>\n\n\n\n Elderly (over 65 years)<\/em><\/p>\n\n\n\n Mirena has not been studied in women over 65 years of age.<\/p>\n\n\n\n Patients with liver disease<\/em><\/p>\n\n\n\n Mirena should not be used in women with liver disease or liver tumors (see section 2 \u201cDo not use Mirena\u201d).<\/p>\n\n\n\n Patients with kidney problems<\/em><\/p>\n\n\n\n Mirena has not been studied in women who have kidney problems.<\/p>\n\n\n\n Tell your healthcare provider if you are taking, have recently taken, or might take any other medicines.<\/p>\n\n\n\n Pregnancy<\/strong><\/p>\n\n\n\n Mirena should not be used if you are pregnant or think you may be pregnant.<\/p>\n\n\n\n Pregnancy is very rare in women who use Mirena.<\/p>\n\n\n\n Some women (about 20%) do not menstruate when they use Mirena.\u00a0It does not have to mean that you are pregnant if you do not get your period.\u00a0If you do not menstruate for 6 weeks and have other signs of pregnancy (eg nausea, fatigue, sore breasts), you should see a doctor\/midwife for examination and pregnancy test.<\/p>\n\n\n\n If you become pregnant with Mirena on the spot, you should see a doctor or midwife immediately to remove Mirena.\u00a0Taking out Mirena can cause a miscarriage.\u00a0However, if Mirena is left in place during pregnancy, not only does the risk of miscarriage increase but also the risk of premature birth.\u00a0If Mirena can not be taken, talk to a doctor or midwife about the benefits and risks of continuing the pregnancy, and the effects the\u00a0hormone\u00a0can have on the baby’s development.<\/p>\n\n\n\n Breast-feeding<\/strong><\/p>\n\n\n\n Mirena can be used during breastfeeding 6 weeks after the baby is born.\u00a0A small amount of the\u00a0hormone\u00a0in Mirena ends up in breast milk (approximately 0.1% of the total\u00a0dose\u00a0), but it is unlikely that infants older than 6 weeks can be affected.\u00a0Mirena does not seem to affect either the amount or the quality of breast milk.<\/p>\n\n\n\n Consult your doctor\/midwife or pharmacist before taking any medicine while breastfeeding.<\/p>\n\n\n\n Mirena has no known effects affecting the ability to drive and use machines.<\/p>\n\n\n\n You are responsible for assessing whether you are fit to drive a motor vehicle or perform work that requires sharpened vigilance.\u00a0One of the factors that can affect your ability in these respects is the use of drugs due to their effects and\/or\u00a0side effects.\u00a0Descriptions of these effects and\u00a0side effects\u00a0can be found in other sections.\u00a0Read all the information in this leaflet for guidance.\u00a0If you are not sure, talk to your doctor or pharmacist.<\/p>\n\n\n\n Mirena’s T-skeleton contains barium sulfate, which makes the insert visible on X-ray examination.<\/p>\n\n\n\n How effective is Mirena?<\/strong><\/p>\n\n\n\n As a contraceptive, Mirena is at least as effective as of today’s most effective copper coils.\u00a0Clinical studies\u00a0show that about 2 out of 1000 women who use Mirena become pregnant during the first year.\u00a0The risk of pregnancy may increase with ejection or perforation (see section 2 \u201cEjection\u201d and \u201cPerforation \/ Damage to the uterine wall\u201d).<\/p>\n\n\n\n When treating abnormally abundant menstrual bleeding, Mirena gives a strong reduction of the bleeding already after three months. Some users do not get a period at all.<\/p>\n\n\n\n When should Mirena be deployed?<\/strong><\/p>\n\n\n\n The insert can be inserted within 7 days after the start of menstruation. The insert can also be inserted immediately after an abortion in the first trimester if genital infections can be ruled out. The insert should be inserted when the uterus has returned to its normal size after delivery and not earlier than 6 weeks after delivery (see section 2 \u201cWhat you need to know before using Mirena – Perforation \/ Damage to the uterine wall\u201d). Mirena can be replaced with a new post at any time during the menstrual cycle. When Mirena is used to protect the uterine lining during estrogen treatment during menopause, it can be used at any time in a woman who is not bleeding or during the last days of menstruation or bleeding.<\/p>\n\n\n\n It is strongly recommended that Mirena is only inserted by a doctor\/midwife with previous experience of inserting Mirena.<\/p>\n\n\n\n How is Mirena deployed?<\/strong><\/p>\n\n\n\n After a gynecological examination, the doctor\/midwife inserts an instrument called a speculum into the\u00a0vagina\u00a0and the cervix is \u200b\u200bwiped with an\u00a0antiseptic\u00a0solution.\u00a0The insert is then inserted into the uterus via a thin, flexible plastic tube.<\/p>\n\n\n\n After Mirena is inserted, you will receive a patient card from your doctor\/midwife for future examinations.\u00a0Bring this card for all return visits.<\/p>\n\n\n\n Should Mirena be checked regularly?<\/strong><\/p>\n\n\n\n Mirena should be checked 4-12 weeks after deposit and thereafter regularly, at least once a year.\u00a0Your doctor\/midwife decides how often and what type of check-ups are required in your case.<\/p>\n\n\n\n Bring the patient card that you received from your doctor\/midwife for all return visits.<\/p>\n\n\n\n How long can Mirena be used?<\/strong><\/p>\n\n\n\n The same Mirena can be used for 6 years when used as a contraceptive (to prevent pregnancy) and for 5 years when used to treat abnormally abundant menstrual bleeding or as protection to prevent unwanted growth of the uterine lining in women who use\u00a0estrogen replacement therapy\u00a0during\u00a0menopause. , then the post must be removed.\u00a0If you wish to continue treatment, a new Mirena must be inserted.<\/p>\n\n\n\n Can Mirena cause pain or discomfort?<\/strong><\/p>\n\n\n\n You can feel the deposit but it usually does not hurt much. In some cases, local anesthesia may be needed.<\/p>\n\n\n\n Some women experience pain and dizziness after insertion.\u00a0If these symptoms do not disappear after half an hour of rest, it is possible that the insert is not seated correctly and if necessary the insert is removed.\u00a0Some women may experience pain (such as menstrual cramps) during the first few weeks after insertion.\u00a0You should contact your doctor\/midwife again if you have severe pain or if the pain continues for more than 3 weeks after the insertion of the insert.<\/p>\n\n\n\n How long should I wait to have intercourse after the deposit?<\/strong><\/p>\n\n\n\n For your body to rest, it is best to wait a few days after the deposit before you have intercourse.\u00a0However, Mirena protects against pregnancy as soon as it is inserted.<\/p>\n\n\n\n Does Mirena affect intercourse?<\/strong><\/p>\n\n\n\n Neither you nor your partner senses the post during intercourse.\u00a0If any of you should do so, intercourse should be avoided until a doctor\/midwife has checked that the insert is correct.<\/p>\n\n\n\n Does Mirena affect menstruation?<\/strong><\/p>\n\n\n\n All women of childbearing potential using Mirena have an altered bleeding pattern.<\/p>\n\n\n\n In the first 3-6 months after insertion, irregular bleeding is common.\u00a0This is completely normal, but the bleeding pattern after this period should be fairly regular and the amount of bleeding should have decreased significantly.\u00a0The irregular bleeding pattern may be more frequent and last longer if the woman uses Mirena to treat heavy menstruation.\u00a0You will likely have a gradual decrease each month in the number of bleeding days and the amount of blood.\u00a0For some women, menstruation disappears completely.<\/p>\n\n\n\n If menstruation stops completely, it depends on the effect the\u00a0hormone\u00a0has on the uterine lining.\u00a0About 20% of women of\u00a0childbearing\u00a0age become bleeding-free over time.\u00a0Your hormone levels remain normal, even though your period may have stopped.\u00a0When the insert is removed, menstruation returns to normal.<\/p>\n\n\n\n Even in women who use Mirena in combination with estrogen therapy, irregular bleeding is common during the first 3-6 months. About 40% of menopausal women become bleeding-free.<\/p>\n\n\n\n For all Mirena users, if the irregular bleeding persists after 6 months, you should contact your doctor\/midwife, as well as if you experience bleeding after a period of missed or sparse menstruation.<\/p>\n\n\n\n Can you use a tampon or menstrual cup?<\/strong><\/p>\n\n\n\n The use of sanitary napkins is recommended.\u00a0If tampons or menstrual cups are used, you should change them carefully so that you do not pull on Mirena’s threads.\u00a0If you think you have pulled Mirena out of position (see section 2 “Contact a doctor\/midwife if any of the following occur” for possible signs), avoid intercourse or use a\u00a0barrier\u00a0method as a contraceptive (such as a condom) and contact a doctor\/midwife.<\/p>\n\n\n\n How do I know if Mirena is in place?<\/strong><\/p>\n\n\n\n You can check for yourself if the threads are in place. Carefully insert a finger into the vagina and feel for the threads in the back of the vagina near the opening to the uterus.<\/p>\n\n\n\n Do not pull the threads<\/strong>\u00a0because then you can accidentally pull out Mirena.\u00a0If you can not feel the threads, it may indicate that an ejection or damage to the uterine wall has occurred.\u00a0In this case, you should use extra protection,\u00a0a barrier method\u00a0(such as a condom), and consult your doctor.<\/p>\n\n\n\n If you want to get pregnant or want to have Mirena withdrawn for other reasons?<\/strong><\/p>\n\n\n\n Your doctor\/midwife can remove the insert at any time and it is then possible for you to become pregnant.\u00a0Removing the post is usually a painless procedure.\u00a0Fertility\u00a0returns to normal after Mirena is removed.<\/p>\n\n\n\n If you want to avoid pregnancy, Mirena should not be taken after the seventh day of the menstrual cycle (monthly period) unless another contraceptive is used (eg a condom) for at least 7 days before removal. If you have irregular menstruation (menstruation) or no menstruation, you should use a barrier method as a contraceptive for 7 days before withdrawal and until your period returns. A new Mirena can also be inserted immediately after the old one is removed. In such cases, no additional protection is required.<\/p>\n\n\n\n Can I get pregnant when I stop using Mirena?<\/strong><\/p>\n\n\n\n Yes. Once Mirena has been removed, fertility is back to normal. You may become pregnant during the first menstrual cycle once Mirena has been removed.<\/p>\n\n\n\n If you have any further questions on the use of this product, ask your doctor\/midwife or pharmacist.<\/strong><\/p>\n\n\n\n Like all medicines, Mirena can cause\u00a0side effects, although not everybody gets them.<\/p>\n\n\n\n Very common (may affect more than 1 user in 10)<\/em> :<\/p>\n\n\n\n Common (may affect up to 1 in 10 people):<\/em><\/p>\n\n\n\n Uncommon (may affect up to 1 in 100 people):<\/em> <\/p>\n\n\n\n Has been reported (occurs in an unknown number of users):<\/em><\/p>\n\n\n\n The partner can feel the pulling threads during intercourse.<\/p>\n\n\n\n If you become pregnant while using Mirena, there is a risk that the fetus is outside the womb (see section 2 \u201cOutbreaks of pregnancy\u201d).<\/p>\n\n\n\n The following side effects have been reported with the introduction or withdrawal of Mirena<\/strong><\/p>\n\n\n\n Pain and bleeding when inserting and removing the insert, dizziness, or fainting in connection with inserting the insert (vasovagal reaction).\u00a0Insertion\/withdrawal can trigger a seizure in patients with\u00a0epilepsy.<\/p>\n\n\n\n Keep this medicine out of the sight and reach of children.<\/p>\n\n\n\n Do not use this medicine after the expiry date which is stated on the carton. The expiration date is the last day of the specified month.<\/p>\n\n\n\n No special storage instructions.<\/p>\n\n\n\n Medicines should not be disposed of via wastewater or household waste. Ask your pharmacist how to dispose of medicines no longer required. These measures will help to protect the environment.<\/p>\n\n\n\n The package contains a sterile uterine insert.<\/p>\n\n\n\n Marketing Authorisation Holder:<\/strong><\/p>\n\n\n\n Bayer AB<\/p>\n\n\n\n Box 606<\/p>\n\n\n\n SE-169 26 Solna<\/p>\n\n\n\n Manufacturer<\/strong> :<\/p>\n\n\n\n Bayer Oy<\/p>\n\n\n\n Passionate 47<\/p>\n\n\n\n 20210 Turku<\/p>\n\n\n\n Finland<\/p>\n","protected":false},"excerpt":{"rendered":" 20 micrograms \/ 24 hours, intrauterine insertWhat you need to know before you use Mirena<\/h2>\n\n\n\n
General notes<\/h2>\n\n\n\n
Before you can start using your Mirena, the midwife\/doctor will ask you some questions about your own and your immediate relatives’ medical history.
This leaflet describes several situations where Mirena should be removed or when Mirena’s reliability may be impaired.\u00a0In such situations, you should either refrain from having intercourse or use other non-hormonal contraceptives, such as condoms or any other\u00a0barrier method.\u00a0Do not use the rhythm method (safe periods) or the temperature method.\u00a0These methods can be unreliable, as Mirena affects the monthly changes in body temperature and cervical secretions. Mirena, like other hormonal contraceptives, does not protect against\u00a0HIV\u00a0infection\u00a0(\u00a0AIDS\u00a0)\u00a0or other sexually transmitted diseases.<\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\nWarnings and cautions<\/h2>\n\n\n\n
Other medicines and Mirena<\/h2>\n\n\n\n
Pregnancy and breastfeeding<\/h2>\n\n\n\n
Driving and using machines<\/h2>\n\n\n\n
Mirena contains barium sulphate<\/h2>\n\n\n\n
How to use Mirena<\/h2>\n\n\n\n
Possible side effects<\/h2>\n\n\n\n
How to store Mirena<\/h2>\n\n\n\n
Contents of the pack and other information<\/h2>\n\n\n\n
Content declaration<\/h2>\n\n\n\n
Pack sizes<\/h2>\n\n\n\n
Marketing Authorization Holder and Manufacturer<\/h2>\n\n\n\n
\nLevonorgestrel<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"cybocfi_hide_featured_image":"","footnotes":""},"categories":[2200,15580],"tags":[14914,17712,2424,17707,2427,17708,17711,17709,12054,17710],"class_list":["post-18072","post","type-post","status-publish","format-standard","hentry","category-medicines","category-m","tag-benefits-of-levonorgestrel","tag-benefits-of-mirena","tag-levonorgestrel","tag-levonorgestrel-dosage","tag-levonorgestrel-side-effects","tag-mirena","tag-mirena-side-effects","tag-what-is-mirena","tag-what-levonorgestrel-is-used-for","tag-what-mirena-is-used-for"],"_links":{"self":[{"href":"https:\/\/zeepedia.com\/medical\/wp-json\/wp\/v2\/posts\/18072","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/zeepedia.com\/medical\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/zeepedia.com\/medical\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/zeepedia.com\/medical\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/zeepedia.com\/medical\/wp-json\/wp\/v2\/comments?post=18072"}],"version-history":[{"count":3,"href":"https:\/\/zeepedia.com\/medical\/wp-json\/wp\/v2\/posts\/18072\/revisions"}],"predecessor-version":[{"id":18094,"href":"https:\/\/zeepedia.com\/medical\/wp-json\/wp\/v2\/posts\/18072\/revisions\/18094"}],"wp:attachment":[{"href":"https:\/\/zeepedia.com\/medical\/wp-json\/wp\/v2\/media?parent=18072"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/zeepedia.com\/medical\/wp-json\/wp\/v2\/categories?post=18072"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/zeepedia.com\/medical\/wp-json\/wp\/v2\/tags?post=18072"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}