What is Mirena?
Mirena is a hormonal IUD (intrauterine device) from Bayer that releases the progestin levonorgestrel directly into the uterus. It provides very reliable contraceptive protection for up to 8 years.
Unlike the pill, Mirena acts mainly locally in the uterus. The hormone dose is significantly lower than with oral contraceptives, because the hormone is released directly at the site of action.
Mirena is also used to treat heavy menstrual bleeding and can reduce it significantly.
Active Ingredients & Mechanism of Action
Active ingredient: Levonorgestrel 52 mg (Freisetzung: ca. 20 µg/Tag initial)
Mirena works through several mechanisms:
Local effect:
- Thickening of the cervical mucus (barrier to sperm)
- Inhibition of sperm motility
- Changes to the uterine lining
In addition: In some women, ovulation is also suppressed, especially in the first year.
In clinical studies, the Pearl Index was 0.21 in the first year and 0.28 in years 6 to 8.
Who is it suitable for?
Mirena is suitable for:
- Women who want long-term contraception without having to take something daily
- Women with heavy menstrual bleeding
- Breastfeeding mothers (from 6 weeks after giving birth)
- Women who do not tolerate estrogens
- Women who have completed their family planning
Also suitable for women who have not yet had children.
Available Dosages
- 52 mg levonorgestrel in the reservoir
- Initial release: approx. 20 µg/day
- After 5 years: approx. 11 µg/day
- After 8 years: approx. 7 µg/day
- Duration of action: up to 8 years for contraception, up to 5 years for heavy menstrual bleeding
How to Take
Insertion:
- By a doctor
- During or shortly after menstruation
- The procedure takes only a few minutes
- Follow-up examination after 4-12 weeks
Removal:
- Possible at any time by the doctor
- Fertility returns immediately
Contraindications
Mirena should not be inserted in cases of:
- Pregnancy
- Acute inflammation in the pelvic area
- Cervical cancer or uterine cancer
- Unexplained vaginal bleeding
- Malformations of the uterus
- Acute liver disease
- Existing or suspected progestin-sensitive tumors, e.g. breast cancer
Possible Side Effects
Common (especially at the beginning):
- Irregular bleeding or spotting
- Absence of periods (in ~20% after 1 year)
- Headache
- Abdominal pain
- Acne
- Ovarian cysts (usually harmless)
- Breast pain
- Depressed mood or depression
- Expulsion of the IUD
Uncommon:
- Perforation during insertion
The risk of thrombosis is not increased.
Interactions
Interactions are rare because Mirena acts locally. Enzyme-inducing medications could theoretically affect its effectiveness, but this has not been clearly proven.
Frequently Asked Questions
Insertion can be uncomfortable and cause cramp-like pain. This usually subsides quickly. If needed, a pain reliever can be taken beforehand.
In many women, bleeding becomes significantly lighter or stops completely. This is harmless and, for some, a desired side effect.
Yes, Mirena is also approved for women who have not had any previous pregnancies. Insertion may be somewhat more difficult.
Fertility returns immediately after removal. Pregnancy is possible as early as the first cycle.
Similar Medications
Is Mirena right for you?
A licensed doctor will review your information and issue a prescription if suitable. Discreet and secure.
Important Notice
This information does not replace medical advice. If you have questions about your health or the suitability of this medication, please consult a doctor or pharmacist.
Important Safety Information
This service operates under German pharmaceutical law (HWG). For risks and side effects, read the package leaflet and consult your doctor or pharmacist. All medications are dispensed from a licensed pharmacy in Germany.