Mirena is a hormonal IUD (intrauterine device) that secretes a synthetic form of the hormone progestin (levonorgestrel), into the uterus. It is inserted through the vagina into the uterus by a doctor.
Mirena is made of flexible plastic, and T-shaped. Neither you nor your partner should be able to feel Mirena once it is in place.
However, you should be able to feel a short string far up inside your vagina, which is attached to it. This string helps you know that your IUD is in its proper position. It will also be used by a doctor to remove your IUD when you’re ready to have it taken out.
If you or your partner can feel your IUD, let your doctor know. This may mean it is out of place and needs to be adjusted.
You may wish to have your IUD removed when you are ready to become pregnant. You might also need to have your IUD removed 5 years after insertion and replaced with a new one.
If you have or acquire certain health conditions, your doctor may recommend removal of your Mirena device. Some side effects also require its removal. These include:
- migraine headaches
- severe bleeding and anemia
- perforation of the uterus
- pain or discomfort during intercourse
Mirena IUDs should only be removed by a doctor. To avoid complications and undue discomfort, do not try to remove it yourself or have someone else try to remove it for you.
When your Mirena IUD is removed, you can expect to feel some pain or cramping for a few minutes.
Since the Mirena IUD works by delivering progestin, side effects may occur after its removal and before your reproductive system starts to produce progesterone on its own.
For this reason, you may experience additional symptoms, although not every woman does.
Symptoms after Mirena removal are uncommon, but can occur. They include:
- weight gain
- breast tenderness
- mood swings
According to its manufacturer, Mirena IUDs are over 99 percent effective at stopping pregnancy. If you do get pregnant while on a Mirena IUD, its removal may cause pregnancy loss to occur.
Serious symptoms of Mirena IUD removal are:
- prolonged or severe pain in the uterus or abdomen
- excessive bleeding
- anxiety, depression, and mood swings
- perforation of the uterus, although this side effect is more commonly associated with insertion than with removal
Millions of women have used Mirena and had the device removed with no problems. Anecdotal evidence indicates that some women, however, experience a phenomenon which has been dubbed the “Mirena crash.”
The Mirena crash refers to one or a cluster of symptoms that last for days, weeks, or months after the Mirena IUD has been removed. These symptoms are thought to be the result of a hormonal imbalance, which occurs when the body is no longer receiving progestin.
Some women report that they experience the same symptoms while the IUD is in their bodies, and that these symptoms continue after its removal.
Symptoms and their severity vary, but are thought to include:
- mood swings that are sometimes severe
- hair loss
- weight gain
- fatigue or malaise
- headaches that can be severe and sometimes include neck and shoulder pain
- tender or swollen breasts
- delayed fertility
- diminished sex drive
There is currently no data tying Mirena removal with these symptoms. However, this does not mean that these symptoms experienced by some women are not real.
If your symptoms are severe, talk to your doctor. They may have recommendations for alleviating certain side effects. A few suggestions include:
- Take over-the-counter medication for headache or body aches.
- If your mood swings are severe, or if you are very depressed or anxious, consider speaking to a therapist or counselor. Connecting with friends can also help.
- Activities, such as yoga and meditation, may help calm your mind and alleviate stress.
- Living a healthy lifestyle may help your body get back on track. Make sure you eat a wide variety of nutritious foods.
- Reduce or eliminate sugar.
- Reduce or eliminate alcohol.
- Do not smoke cigarettes or vape.
- Exercise daily. This can be as simple as taking a long, brisk walk.
Seek immediate medical help if you:
- have severe pain in your uterus or abdomen
- have severe headache pain
- have a high fever
- are bleeding profusely
- have thoughts of self-harm or suicide
If you’re having thoughts of self-harm or suicide, you can call the National Suicide Prevention Hotline. Day or night, 365 days a year, someone will answer who can help: 800-273-TALK (8255)
Removing a Mirena IUD may cause brief cramping or discomfort. Some women also experience other symptoms, although this is not common.