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How Is the Mirena IUD Inserted?

By Sarah Harding ; Updated June 13, 2017

Preparing for Insertion

Before the Mirena IUD can be inserted, a pelvic exam must be conducted by a medical care provider. During the exam, a speculum is inserted into the vagina to reveal the cervix. The practitioner must assess the shape and size of the uterus to ensure that it is favorable for IUD placement. An antiseptic cleanser is used on the vagina and the cervix to prevent the contamination of the uterus and vagina with bacteria. Any other necessary observations and testing can be done at this time to ensure the woman is healthy and capable of having an IUD placed. These procedures may include a urine analysis before the exam, pap smear specimen gathering, or pregnancy test. According to the Mirena IUD is a favorable option for birth control only for women who have been pregnant before.

Inserting the Device

With the cervix revealed, the health care provider will prepare a new Mirena IUD and inserting tool. To do this, he will open a sterile package, remove the insertion tool and device and load the IUD into the insertion tool. The tool is then inserted into the vagina until it reaches the uterus. With forceps, the practitioner may need to move tissues gently to make the insertion more accessible. Once the device is in the uterine opening, the practitioner will release the handle on the inserting tool to let the IUD go. The IUD will be in place and the "T" of the device will spring into place. The inserting tool is withdrawn. The threads at the base of the IUD are trimmed to a length that is both accessible for the practitioner to remove the device later but also short enough that they are not in the way of normal activity for the woman.

After Insertion

Side effects immediately after insertion may include cramping, spotting and some mild discomfort from the pressure of the exam. The IUD should not be felt after insertion nor should it impact sexual intercourse or the use of tampons. After five years, the IUD should be replaced. A medical care provider must remove the existing IUD by inserting a speculum and withdrawing the threads that are attached at the base of the device. In the event that the Mirena IUD becomes dislodged, it may penetrate the uterine walls and require surgical removal. The risk of this happening is relatively low, according to, but it can lead to fertility issues or infertility. Other complications may include pelvic inflammatory disease (PID), increased menstrual flow and cramps, or a favorable decrease in menstrual flow and cramps.

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