Insertion of Mirena (intrauterine system)

A small hormonal coil providing long-term contraception and lighter periods

Mirena is a type of intrauterine system (IUS) – a small T-shaped device placed inside the womb that releases a low dose of progestogen hormone. Insertion of a Mirena coil is a quick outpatient procedure that provides highly effective contraception for up to 5 years. In addition to preventing pregnancy, the Mirena often makes menstrual periods much lighter and less painful (with many women experiencing only minimal bleeding). It’s a popular choice for women seeking convenient, long-term birth control, as well as those looking to manage heavy periods without major interventions.

Why might you need it?
A Mirena IUS is often recommended for:

• Long-term contraception – Mirena is over 99% effective in preventing pregnancy and lasts for five years (or up to 5 years before replacement is needed)
• Heavy menstrual bleeding – it can significantly reduce period flow and cramping, making it a treatment option for menorrhagia
• Hormone therapy support – for women who need progesterone as part of hormone replacement therapy (HRT), Mirena can protect the womb lining while also providing contraception

Many women choose Mirena as a “fit and forget” solution, as it requires no daily pills or frequent injections. It is suitable for those who prefer a reliable, low-maintenance contraceptive that also offers menstrual benefits.

What does the procedure involve?

• Mirena insertion is done in a clinic setting and usually takes only a few minutes. It does not typically require general anaesthetic – most insertions are done with you awake. A local anaesthetic or numbing gel may be applied to the cervix if needed, but often it’s not necessary.
• A speculum is inserted into your vagina (just like during a smear test) so the doctor can see your cervix. The cervix may be gently steadied with an instrument.
• The Mirena device, which is small and T-shaped with flexible arms, is placed into a thin applicator tube. This tube is passed through the cervical opening into the uterus. You may feel a brief cramp as it passes through.
• The Mirena is released into the uterus, where its arms open into the T shape. The applicator tube is then removed. The doctor will trim the Mirena’s threads so that about 1-2 cm of fine thread extends into the top of the vagina – these threads are needed for later removal and for you or your doctor to check that the coil is in place.
• The speculum is removed and the insertion is complete. The entire process is quite quick. You’ll be advised on how to feel for the threads later and given any after-care instructions before you go home.

What to expect during recovery

After a Mirena insertion, it’s common to experience some lower abdominal cramping or period-like discomfort for a few hours, and sometimes intermittently over the next few days. This is your uterus adjusting to the device. Over-the-counter pain relievers can help if needed. You might also have light spotting or bleeding in the days following insertion, and irregular spotting is common in the first few months as the hormone takes effect. It’s generally fine to return to normal activities either immediately or the next day – many women have the coil fitted and go about their day as usual, though you might choose to take it easy for the rest of that day if you feel crampy.

You’ll be advised to avoid sexual intercourse or using tampons for 24-48 hours after insertion to reduce infection risk. The Mirena begins working as contraception right away if inserted during the first week of your menstrual cycle; otherwise, your doctor may recommend using condoms for seven days until it becomes fully effective. A follow-up appointment or check-up may be scheduled a few weeks later to ensure the device is positioned correctly (or you may be shown how to check the threads yourself). Over time, you’ll likely notice your periods become lighter and less painful. In fact, after about 3-6 months, many women experience only very light periods or occasional spotting. Should you wish to become pregnant or stop using it, the Mirena can be removed at any time, and fertility usually returns quickly.

What are the benefits?

• Provides up to 5 years of extremely effective contraception (over 99% efficacy) with a single placement
• Makes periods significantly lighter and can reduce period pain – in some cases periods stop altogether, which can greatly improve day-to-day life for those with heavy periods
• Low maintenance: you don’t have to remember a daily pill or frequent clinic visits – once it’s in place, you can essentially forget about it
• Reversible: the IUS can be removed if you decide to try for a baby or no longer need it, and your normal fertility will resume
• Can be used to manage or treat gynaecological issues like heavy menstrual bleeding, endometriosis symptoms, or to provide womb lining protection during HRT, all while also serving as birth control

If you’re considering a Mirena coil for contraception or to help with heavy periods, we’re here to support you. We can answer any questions you have and ensure you feel comfortable with the decision. Get in touch to discuss whether the Mirena IUS is the right choice for you and to arrange a consultation for insertion.