When it comes to navigating long-acting reversible contraception (LARC) options, intrauterine devices, better known as IUDs, are one of the most talked about options. These T-shaped devices have gained popularity among women; about one in five sexually experienced women has used an IUD (20.4%), according to a 2023 National Health Statistics Report on contraceptive methods. When making this birth control decision, women have questions: How does an IUD work? What is insertion like? Can I get pregnant later? Is it the right option for me?
SheKnows is here with expert answers, using Mirena® IUD (levonorgestrel-releasing intrauterine system) 52 mg, the #1 prescribed IUD in the U.S. based on Symphony Health Data from 2010-2024, as our example. We asked real women from our community between the ages of 25 through 45 what they actually wanted to know about Mirena IUDs* and brought their top questions to Dr. Maria Sophocles, a gynecologist and women’s health advocate with nearly 30 years of experience.
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From the practical to the personal, here’s what Dr. Sophocles had to say about this long-term birth control option – so you can feel informed and empowered when talking to your healthcare provider (HCP). The decision for birth control is between a woman and her HCP and whether women are actively considering an IUD or simply exploring their options, this article is designed to help empower them with the knowledge they need to speak with their HCPs about whether a Mirena IUD might be right for them.
Choosing birth control is personal – what works for one woman may not be right for another. But with advice straight from experts and answers to common questions, women can be prepared to discuss options with their provider to find an option that works for them.
Is a Mirena IUD reversible?
Yes! The Mirena intrauterine device (IUD) is a small device that is inserted into the uterus to prevent pregnancy, and it can be removed at any time by a healthcare professional if plans change. “One of the most important things about an IUD is that it’s long-lasting but still reversible,” says Dr. Sophocles. “It can be removed at any time after insertion. Of course, patients need to talk to their providers about what type of birth control options are right for them because every woman’s experience and needs are unique.”
Once a Mirena IUD is removed, women can try to get pregnant right away. About 8 out of 10 women who use Mirena and want to become pregnant usually can become pregnant in the first year after Mirena is removed. According to The American College of Obstetricians and Gynecologists, IUDs don’t affect a woman’s ability to get pregnant in the future, which may be one of the reasons why many women choose them.
How effective is Mirena?
Mirena IUD is over 99% effective at preventing pregnancy. Mirena works in the uterus and contains 52 mg of a single hormone called levonorgestrel, a type of progestin, that is often used in birth control pills. Because Mirena slowly releases a continuous low dose of levonorgestrel into the uterus, only small amounts of the hormone enter the bloodstream. Mirena may not be right for everyone so it’s important for women to talk to their HCP to see if it is an option for them.
The hormone released into the uterus by Mirena prevents pregnancy most likely by thickening cervical mucus, preventing sperm from entering the uterus, inhibiting sperm movement so it’s more difficult to reach and fertilize an egg, and thinning the lining of the uterus. It is not known exactly how these actions work together to prevent pregnancy.
How long does an IUD last?
“The length of time an IUD lasts depends on the brand and type,” explains Dr. Sophocles. “For example, Mirena can last for up to 8 years when used for birth control. It also treats heavy menstrual bleeding for up to 5 years in women who chose it for birth control.”
Can women do anything beforehand to prepare for insertion?
Most importantly, everyone’s experience with IUD insertion is different. Dr. Sophocles always recommends women talk to their providers for counsel on what to expect and what options are available to help.
You may experience pain, bleeding, or dizziness during and after placement. If your symptoms do not pass within 30 minutes after placement, your IUD may not have been placed correctly. Your healthcare provider will examine you to see if your IUD needs to be removed or replaced.
Once Mirena is inserted, it’s recommended for women to check their IUD threads monthly by inserting their fingers into the vagina and feeling for threads at the far back of the vagina coming out of the cervix. Missing threads can potentially mean the IUD fell out or that it’s out of position, meaning the patient is no longer protected against pregnancy.
Ideally, a woman should check for threads soon after insertion and then monthly, so she knows what they feel like, but Dr. Sophocles notes that most women will know if their IUD is placed properly or not. “If it’s not placed properly, the patient may have spotting or bleeding or pain, so we then remove it and replace it.”
Will my partner be able to feel Mirena during sex?
Many women have questions about how Mirena might affect their intimate relationships. A common question is whether a partner can feel the IUD during sex. Partners typically cannot feel the device during intercourse since it’s placed in the uterus, not in the vagina. Sometimes your partner may feel the threads. If discomfort occurs during intimacy, talk with your healthcare provider.
At the end of the day, the choice for birth control is your decision, and getting all your questions answered is essential to feeling confident in your decision and in finding a birth control option that is right for you. Talk to your doctor and visit mirena.com to see if it may be an option for you.
INDICATION FOR MIRENA
Mirena (levonorgestrel-releasing intrauterine system) is a hormone-releasing IUD that prevents pregnancy for up to 8 years. Mirena also treats heavy periods for up to 5 years in women who choose intrauterine contraception.
IMPORTANT SAFETY INFORMATION
·If you have a pelvic or genital infection, get infections easily, or have certain cancers, don’t use Mirena. Less than 1% of users get a serious pelvic infection called pelvic inflammatory disease (PID).
·If you have persistent pelvic or stomach pain, or excessive bleeding after placement, tell your healthcare provider (HCP). If Mirena comes out, call your HCP and avoid intercourse or use non-hormonal back-up birth control (such as condoms or spermicide). Mirena may go into or through the wall of the uterus and cause other problems.
·Pregnancy while using Mirena is uncommon but can be life threatening and may result in loss of pregnancy or fertility.
·Ovarian cysts may occur but usually disappear.
·Bleeding and spotting may increase in the first 3 to 6 months and remain irregular. Periods over time usually become shorter, lighter, or may stop.
Mirena does not protect against HIV or STIs.
Only you and your HCP can decide if Mirena is right for you. Mirena is available by prescription only.
For important risk and use information about Mirena, please see the accompanying Full Prescribing Information.
*Questions were sourced from a survey sent to the SHE Media Collective.
PP-MIR-US-1313-1 09/25
