How long does discharge last after installing the Mirena coil? Causes of discharge after insertion of an intrauterine device (IUD)

The intrauterine device is one of the most effective methods of contraception exclusively for women. You won’t be able to use it yourself, since its administration must be done by a gynecologist. But before such a procedure, you must first undergo an appropriate examination in order to prevent possible complications.

Types of intrauterine device

Today, there are 2 most common types of IUDs known: the hormone-containing IUD and the copper IUD. They both look like the letter "T" with two small tendrils at the end. After insertion, the hormone-containing coil begins to release the hormone progesterone, and the copper coil accordingly releases copper ions. The service life of a hormone-containing IUD should not exceed 5 years, and a copper IUD can be inside the uterus for 10 years.

There are opinions that after removing such a device, a woman will no longer be able to give birth. This is absolutely not true, and to be more precise, it is not true for everyone. Many people become pregnant after removing the IUD and have a successful birth. It is also worth noting that two types of IUDs provide excellent protection against sexually transmitted diseases.

In what cases is it necessary to install spirals?

All installations of the IUD are done purely to prevent unwanted pregnancy. But, despite this, these types of contraceptives can be installed for other purposes. Most often this occurs to treat diseases such as pelvic pain, precancerous conditions or early endometrial cancer, heavy and painful menstruation. This rather short series of reasons why coils are installed may seem pointless at first. But this is absolutely not true, because many women really cannot do without it, especially if we are talking about a young girl with early problems of female function. After installing such a spiral, health improves.

Complications after installation of an IUD coil

The most common complication after installation is the IUD falling out of the uterus. It is worth noting that this phenomenon can occur not only immediately after it is introduced into the uterus, but also for three months after the procedure. The body gets used to the spiral and loss in some cases can be normal. We can say with confidence that it is during this period that complications of various types occur.

Uterine bleeding is another type of complication after insertion of the IUD. As a rule, the problem occurs if the bleeding is strong enough. Then the woman needs individual treatment, which is prescribed either after removal of the IUD or with its presence. If the bleeding is not significant, then there is no cause for concern. After appropriate treatment, the IUD should be removed if it does not have any contraceptive effect.

Today, another quite serious complication is known after the installation of an intrauterine device - uterine perforation. This complication occurs quite rarely, but if it occurs, it must be treated urgently. Further use of the spiral after such a complication is strictly not recommended.

Why does blood bleed after insertion of the IUD?

There is no cause for concern if, during the first six months after insertion of the intrauterine device, light uterine bleeding or spotting occurs. Such phenomena do not pose any danger to a woman’s health and may well be observed in every patient. You should only worry if the bleeding is strong enough and for a long time. In this case, you need to consult a doctor for help, because self-medication will not help.

Normally, light bleeding should subside, but if after eight months after installation of the IUD it does not stop, you should consult a doctor. As for the issue of menstruation, you can take special anti-inflammatory drugs to normalize them. They will help not only restore the cycle, but also slightly protect against unwanted inflammatory processes around the inserted IUD in the uterus. Such inflammations also happen sometimes. Most often this is explained by individual intolerance to this type of contraceptive.

What to do if there is heavy bleeding after inserting the IUD?

Most often, patients with severe bleeding after installation of the coil are prescribed special and regular monitoring for a certain time. The necessary tests are taken and examined for possible gynecological diseases. If nothing special or serious is revealed, and the blood continues to flow heavily, then the spiral is removed. If this is not done, then cases of anemia in women are known as a complication. To prevent the disease, medications containing iron and all kinds of food products rich in iron are prescribed.

Other complications that arise after installation of the IUD

In addition to the fact that women often complain of bleeding after insertion of the IUD, other side effects may also occur. These are cramps, severe pain during menstruation, the IUD falls out of the uterus, subsequent infertility, various pelvic infections, mechanical damage to the uterus during installation of the IUD, irregular periods or their absence. Most often, complications of this nature arise after the installation of a copper spiral. If a woman becomes pregnant while the IUD is present, there is a high probability that this pregnancy is ectopic. Other problems may also occur, namely miscarriage, pelvic infections and early labor.

It is worth noting that the intrauterine device is not suitable for all women. Therefore, before installing it, it is necessary to carefully check and pass all the necessary tests and only after that decide on this procedure. Let us highlight the main cases when the use of a spiral is strictly prohibited:

• uterine deformation;
• vaginal bleeding of various types;
• the occurrence of an ectopic pregnancy by inheritance;
• previous abortion in the last three months or pelvic infections;
• the presence of various sexually transmitted diseases;
• presence of cervical or cervical cancer;

All of the above problems must be detected and clarified during an examination with a doctor, and only after that should you prepare to install the IUD.

Spiral installation procedure

Before proceeding directly to the procedure, a woman must undergo the following examination:

• pregnancy test and the presence of sexually transmitted diseases;
• examination of the uterus, vagina and other organs;
• The most suitable type of intrauterine device for installation is determined.

Anesthesia is not used for this procedure. You can only use a special gel, which will slightly numb all the doctor’s actions. In some cases, a special injection is given to the cervical area to reduce possible pain and discomfort. The insertion of the IUD itself resembles a routine examination by a gynecologist with a gynecological speculum. Only before the actual installation, the doctor should measure the size of the uterus and its depth. The whole procedure takes no more than 10 minutes. This procedure does not cause much pain.

There may only be discomfort during the insertion of the spiral or after. If desired, some patients are given painkillers to reduce unpleasant sensations.

What to do after installing the spiral?

Recovery after insertion of the IUD may take some time. As a rule, everything happens differently for each woman. As generally accepted rules, it is recommended to get more rest at first and not to overexert yourself with physical activity, especially if heavy bleeding is observed. If nothing hurts and there is practically no bleeding, you can return to your normal work schedule. But remember, any tension can lead to malfunction.

This is already a new phenomenon for the body, and additional stress can only do harm. For a certain period of time every month, check with your fingers for the presence of antennae in the vagina. This will help you independently control the position of the device in the uterus. If you cannot do this on your own, then visit a gynecologist monthly for a check and an accurate result. In order for the recovery process to be successful, follow the doctor’s instructions as much as possible. in this case, the rehabilitation period will be successful.

In what cases should you consult a doctor if you have bloody discharge?

As mentioned above, spotting or light spotting during the first 4 months is normal. There are cases, of course, when this is not the case. But this is so rare that long-term discharge has begun to be considered the norm. You should sound the alarm only in cases where the bleeding is too strong and for a long time. It may look like your period continues for several weeks. With such a diagnosis, you should definitely go to the hospital for help to make sure there are no serious violations or to stop them in time.

Quite often there are cases when bleeding is a signal of the presence of serious diseases, which was provoked by the introduction of the IUD. Then the IUD must be urgently removed and other possible methods of contraception prescribed.

Using the IUD while breastfeeding

Scientists have found that it does not pose any danger to the baby. This can be explained by the fact that the IUD substance still penetrates into the blood plasma, but the harmful contents constitute only 0.1% of the daily dose of milk secreted. This amount cannot harm the baby. Therefore, using the IUD after childbirth is completely safe for both the child and the mother. Just remember that the IUD must be installed six weeks after the birth of the child.

In what cases is it necessary to remove the spiral?

1. After five years of use, in particular a hormonal intrauterine device. The copper coil must be removed after 10 years of successful use.
2. Removal of the IUD with possible other contraceptives must be done at the beginning of the menstrual cycle.
3. It is possible to install a second IUD one month after the removal of the previous IUD.
4. If there is heavy bleeding for a long time.
5. For constant pain in the lower abdomen and discomfort during sexual intercourse. Perhaps the IUD is not suitable for you and it is better to choose another method of contraception.

Intrauterine device and pregnancy

This type of contraception is almost 100% reliable. The chance of getting pregnant with the IUD is almost zero. But there are quite tricky cases when a woman still gets pregnant. This can happen if the instrument was initially installed incorrectly or came off during violent sexual intercourse. If pregnancy is detected, it is necessary to first exclude an ectopic pregnancy. If the pregnancy is progressing normally and the woman decides to keep the baby, the IUD must be carefully removed.

There are cases when it is not possible to remove the IUD without terminating the pregnancy. It also depends on the professionalism of the doctor. The development of temporality is also possible in the presence of a spiral. But in this case, it is necessary to take into account the possible adverse effects on the development of the fetus and its further growth. To date, there are very few cases of successful pregnancy in the presence of an intrauterine device. But, if this happens, then it is necessary to carefully monitor the child’s development with regard to pathologies.

For the safest period of pregnancy, it is necessary to completely remove the IUD, or initially terminate the pregnancy. The two phenomena are simultaneously incompatible and can harm not only the unborn child, but also the woman herself.

How did I become a doctor? Quite a difficult question... If you think about it, there was no choice. I was born into the family of a resuscitation doctor, and every day at dinner I heard my father’s story about how his day went. As a child, this all seemed fantastic, beyond reality.

Women who have an intrauterine device installed sometimes notice spotting. This causes some discomfort and may be accompanied by an unpleasant odor and pain. Let us consider in more detail which symptoms are normal and in which cases pathology should be suspected.

Doctors warn that after installing an IUD, side effects are possible in the form of pain in the lower abdomen and blood after the installation of the IUD. As a rule, discharge can normally be present for 1-2 weeks. Usually this phenomenon occurs about 5 days after the procedure. Menstruation may be more abundant and longer; some women experience pain during this period, which has the nature of a spasm. In the periods between menstruation, bloody discharge sometimes appears during the spiral.

When does bleeding occur with an IUD?

The intrauterine device is usually placed in the last days of your period, so a few days after the procedure, spotting after insertion of the device is completely natural and should not be a cause for concern. If after installing the IUD you have heavy periods that last longer than usual and cause severe pain, it is better to seek advice from a specialist. Let us consider in more detail the situations in which you need to consult your doctor:

1. Heavy bloody or brown discharge that continues for more than a week after IUD insertion;
2. Severe pain in the lower abdomen;
3. Unpleasant odor from the vagina (may be caused by infection);
4. Delayed menstruation.

If the discharge is scanty and there is no pain, this situation is normal, and in some cases it can last for several months. The first menstruation after installation of the IUD sometimes begins later than usual; to normalize the cycle, it is recommended to take anti-inflammatory drugs, which will be prescribed by the gynecologist after the procedure. In some cases, after installing such contraceptives, a cycle failure is observed, this is not a pathology, the cycle is gradually restored. Inflammatory processes in such cases occur quite often, so taking medications is mandatory. The drugs will not only restore the monthly cycle, but will also help avoid possible complications.

In cases where prolonged spotting is observed during the coil, the doctor will refer the patient for tests to rule out gynecological pathologies. If test results do not show the presence of diseases, the IUD is recommended to be removed due to the fact that prolonged bleeding can cause anemia in a woman. For preventive purposes, an additional course of treatment with drugs containing iron is prescribed. It is also important to follow a diet and proper daily routine; increased exercise is not recommended. You should include more foods that contain iron in your diet.

It is important to know that sometimes there are cases when the intrauterine contraceptive is not installed correctly. This can usually happen within three months of the procedure. In this case, it can fall out unnoticed by the woman, which may lead to an unwanted pregnancy. If signs of possible pregnancy appear, you should immediately consult a doctor.

Bloody discharge after insertion of the IUD is a normal process that can take from several days to several months. If the discharge is not accompanied by pain and other signs, this phenomenon is considered normal. In some cases, there may be virtually no discharge, but this happens quite rarely.

When is it necessary to visit a gynecologist after installation?

If the brown discharge with a spiral is scanty, you should visit your doctor a month after the procedure. The next visit is scheduled by the gynecologist, usually after one and a half to two months. If you bleed profusely and with pain after installing the IUD, it is better not to delay going to the doctor. The sooner the pathology is identified, the faster the doctor will prescribe the necessary measures for treatment and prevention of complications. If the cycle is disrupted for more than six months, it is better to consult your gynecologist. Experts say that in the first months after the IUD was inserted, cycle failure is caused by disruption of the endometrium of the uterus. This is not dangerous to the woman’s health and the process gradually normalizes without the intervention of a doctor.

In some cases, periods disappear for a long period of time, sometimes up to six months or more. In such cases, it is necessary to exclude pregnancy and do a test. If the result is positive, you should definitely see a gynecologist to rule out possible complications.

Brown discharge with a spiral appears most often during an inflammatory process. If they do not disappear after a few days, a course of anti-inflammatory drugs is prescribed, which should be taken according to a clear regimen prescribed by the doctor. With proper and timely treatment, such discharge disappears within a few weeks.

Spiraling and spotting are normal if they are not accompanied by pain and the amount of discharge is small. If a woman notices that after installing the IUD there is bleeding, but not profusely and not for a long time, this process is normal and should not cause concern.

Possible consequences from the IUD

In some cases, an intrauterine contraceptive may cause discomfort in the abdominal area. It should be understood that it is a foreign body, the body must adapt to it, get used to it. Therefore, such pains are quite common; painkillers will help get rid of them. Aching pain may accompany several months, but does not appear in all cases.

Sometimes women experience mastalgia - an increase in the size of the mammary glands, which can be accompanied by pain and fever. Typically, such symptoms go away quickly without drug treatment.

In rare cases, the intrauterine device provokes bleeding, which persists for a long time. Some experts argue that the IUD is not suitable for all women and can be rejected by the body. In such a situation, it is better to remove it and choose another method of contraception. This is caused by individual intolerance to the spiral or to the material from which it is made. Modern medicine offers many methods of contraception, the intrauterine device is only one of them.

Many women think about how to protect themselves from unwanted pregnancy when living together with a man. Medicine offers many methods of contraception that ensure safe sex life. Many patients resort to contraception with a spiral. This method allows you to maintain your health without hormonal changes and risks, as well as prevent unwanted pregnancy.

What is a spiral and what are they?

There are about 50 types of intrauterine contraceptive devices. They are inserted into the uterine cavity to prevent sperm from fertilizing the egg. In modern medicine, the following types are offered:

1. Devices containing copper, silver.
2. Spirals containing hormones.

They differ from each other not only in material, but also in shape: S, T-shaped. The IUD containing hormones has become widely known because it is more effective and reliable. Mirena spirals are considered the most popular.

This type of contraceptives is prescribed exclusively by a doctor. The installation is carried out in a gynecological office. It is important to undergo an examination, as there are a number of contraindications. Mandatory examinations include:

• smear from the vagina and cervix;
• blood for HIV, hepatitis and syphilis;
• general urine analysis;
• analysis for sexually transmitted infections;
• Ultrasound of the pelvic organs.

Positive qualities of the Mirena spiral in relation to other contraceptives:

1. When a woman gets an IUD with hormonal content, she no longer has to be afraid of getting pregnant for several years. This is a fairly reliable tool that allows you to make your sex life free and safe.
2. The spiral does not need to be changed often. Its effect lasts for 5 years. While the pills must be taken every day.
3. Once the IUD is inserted, you will not feel it. Your partner is also protected from unpleasant sensations. This makes sexual relations more relaxed.
4. Despite the hormonal contents of the device, it is absolutely safe for the female body. Does not contribute to weight gain, and also does not affect the functioning of the ovaries.
5. After installing an intrauterine device, a woman can hope for a speedy recovery from such unpleasant diseases as fibroids and endometriosis.

What are the disadvantages that accompany the installation of an IUD:

1. There is no way to use it yourself.
2. Discharge appears after installing the coil. This may include brown spotting or bleeding.
3. Does not protect against sexually transmitted infections.
4. The IUD falls out on its own, making pregnancy possible.
5. Menstrual irregularities. After removing the IUD, periods become regular again and with the same abundance.
6. Installation of the Mirena spiral is carried out only for women who have given birth. Doctors believe that such contraceptives are safe and effective only for those patients who have children. Therefore, a specialist may refuse installation if you are under 25 years old and do not yet have children.

Discharge while using an IUD

Many women note various discharge during the spiral. The installation of a contraceptive may be accompanied not only by bleeding, but also by pain in the lower abdomen. All this brings discomfort. If discharge is observed for no more than 2 weeks, this is considered normal. Doctors warn a woman that after installing a contraceptive device, she bleeds much more in the first days. Subsequently, spotting is observed. The first menstruation after installation of the IUD will be long and heavy. Brown discharge during the spiral also appears in the middle of the cycle.

The time of installation of the IUD is determined by the doctor. Most often, the procedure is planned during the last menstrual days of a woman. Therefore, spotting persists after the contraceptive is installed. This is a completely natural phenomenon. No anesthetic is used during the procedure. The gynecologist treats the cervix with an anesthetic. On average, the procedure lasts 5-7 minutes. If heavy discharge appears after installation, you must inform a specialist.

The following are not the norm:

1. Prolonged bleeding. They may progress to heavy periods. This condition continues for a week or longer.
2. Severe pain in the abdominal area.
3. Specific odor from the vagina. This may indicate an introduced infection or a developing bacterial environment.
4. Absence of menstruation for several months.

There are very scanty brown discharges when spiraling. It is normal for them to occur for a few days after installation. Don't worry if your period starts later than usual. The cycle shifts by several days. After the IUD is removed, the cycle will return to normal.

Important! The body, getting used to a foreign device, becomes vulnerable, and the risk of infection and inflammatory processes increases.

Possible complications

When wearing a spiral, a woman should regularly visit her gynecologist. The doctor will monitor the process of getting used to the device and will also help to avoid inflammatory processes. A visit is recommended if:

• prolonged, scanty discharge that does not go away for more than a month. In this case, the woman should undergo tests to detect infection;
• bleeding accompanied by unbearable pain. This occurs when the IUD does not take root in the body. You should immediately remove the IUD and choose another method of contraception;
• menstrual irregularities;
• absence of menstruation for more than six months. This condition requires examination by a gynecologist;
• brown discharge. This symptom indicates that the inflammatory process has begun;
• swelling;
• nausea;
• inflammation of the mucous membrane of the cervix;
• back pain.

The following side effects occur after installing a contraceptive device:

• discomfort in the lower abdomen. The spiral is a foreign object in the female body, so it takes time for it to get used to and adapt. Unpleasant sensations are observed in the first 1-2 days after installation of the IUD and pass quickly;
• swelling of the mammary glands and high body temperature. These symptoms are also short-lived and go away without medical intervention;
• heavy bleeding. The reason may be individual intolerance. In such cases, you should remove the foreign device and try another remedy;
• perforation of the uterine wall. This occurs because the IUD was inserted into a woman who was not pregnant or immediately after giving birth.

Possible side effects also include anemia, migraines, skin irritation and rashes, pain during intercourse, and inflammation of the vagina. When using an IUD with hormones, you may experience mood swings, depression, and irritability.

Removal of the IUD

After the IUD, you can plan a pregnancy within the first month. Removal of the IUD is carried out for the following indications:

• at the request of the woman;
• expiration of the period of use. The contraceptive device is valid for 5 years. After this time, you should undergo examination by a specialist and remove the device;
• when the spiral is displaced or partially falls out;
• during menopause.

Removal is carried out in a gynecological hospital. The procedure is carried out during menstruation. The appearance of discharge after the IUD will last only for the period of the remaining menstruation. The regularity of the cycle is restored. The IUD can be removed on any other day of the cycle. The removal procedure is simple and painless.

Important! If the intrauterine contraceptive has grown into the wall of the uterus, then it is not possible to remove it in the usual way. In this case, removal is carried out in a gynecological hospital using diagnostic curettage of the uterine cavity.

There are no specific recommendations after removal of the IUD, but there are a number of simple rules that must be followed for 1 week: sexual rest, maintain intimate hygiene, do not use tampons, limit physical activity, do not douche, do not visit baths and saunas.

The intrauterine device (IUD) is a safe, modern and effective method of contraception. This method is quite popular among women who avoid the use of hormonal contraceptives and, at the same time, need long-term contraception. The modern intrauterine device is quite safe, but is sometimes accompanied by minor side effects (mainly during the first 3-6 months after insertion). with IUD is a common occurrence.

An IUD is a small, flexible device made of metal and/or plastic. The IUD may be inert, or may contain copper or a hormone (gestagen). Modern intrauterine devices can be inserted into the uterus for a fairly long period - for 5-10-12 years, which allows women to relax and not worry about unwanted and unplanned pregnancy for a long time.

The contraceptive properties of the IUD are achieved in several ways:

• Inhibition of sperm migration to the upper parts of the female genital organs;
• Inhibition of egg transport,
• Blocking fertilization
• Hormonal IUDs (levonorgestrel-releasing IUD, Mirena), in addition to the above, also cause thickening of cervical mucus and suppress endometrial proliferation.

Brown spotting with IUD - side effects of intrauterine devices

The appearance of brown spotting or spotting between periods in the first 3-6 months after insertion of the IUD is a common side effect of this method of contraception.

Brown spotting with an IUD can be caused by a vaginal infection. Sometimes, in the presence of vaginal infections, the IUD can become a conduit for infection and cause the development of pelvic inflammatory disease (PID), which in turn can cause brown spotting from the vagina. In this case, it is advisable to remove the spiral and undergo appropriate treatment.

Vaginal discharge (mostly brown spotting) may occur during the first few weeks after IUD insertion due to a reaction in the lining of the uterus (endometrium). This should not be a cause for concern, but if the discharge is accompanied by pelvic pain and/or fever, you should contact your gynecologist immediately.

Spastic pain may occur during the first 24-48 hours after insertion of the IUD. The following medications can be taken as painkillers: aspirin, ibuprofen, paracetamol.

Brown discharge from an IUD (immediately after insertion) can be cause for concern, so it is necessary to understand the cause of such discharge, its likelihood and possible duration.

Brown daub with IUD - causes

The main reasons for the appearance of brown spotting during the use of an IUD may be:

• Vaginal and/or pelvic infections;
• Changes in the structure of the endometrium (if the IUD has a hormonal component);
• Damage to the endometrium (inner lining of the uterus).

The percentage of women whose appearance of brown spotting due to an IUD is associated with the presence of PID is approximately 1-3%. The risk of developing PID is highest during the first 20 days after insertion of an IUD, provided there is a vaginal infection at the time of the procedure. After the first 20 days, the risk of developing PID decreases.

The appearance of a brown spot after the installation of an IUD during the first week is extremely unpleasant, although it is a fairly common phenomenon.

During the first 3-6 months after the IUD is inserted, your periods may be heavier than your normal. The amount of spotting may also increase. After the specified period, the amount of vaginal discharge, as a rule, is significantly reduced. Minor short-term irregular spotting may persist in some cases.

However, if the brown spotting is continuous, this condition may be caused by the presence of PID, in which case you should consult your doctor.

Compound

1 intrauterine device contains:

Release form

The Mirena intrauterine therapeutic system is a white or almost white hormonal-elastomer core located on a T-shaped body and covered with an opaque membrane, which serves as a kind of regulator for the release of the active ingredient. The T-shaped body has a loop at one end with an attached thread to remove the coil and two arms. The Mirena system is placed in a guide tube and is free of visible impurities. The drug is supplied in sterile blisters made of polyester or TYVEK material in the amount of 1 piece.

pharmachologic effect

The intrauterine system, or simply the Mirena IUD, is a pharmaceutical drug based on l evonorgestrel . which, gradually released into the uterine cavity, has local gestagenic effect . Thanks to the active component of the therapeutic agent, the sensitivity of estrogen and progesterone receptors of the endometrium is reduced, which is manifested in a strong antiproliferative effect.

There are morphological changes in the inner lining of the uterus and a weak local reaction to a foreign body in its cavity. The mucous membrane of the cervical canal becomes significantly denser, which prevents the penetration of sperm into the uterus and inhibits the motor abilities of individual sperm. In some cases, suppression of ovulation is also noted.

The use of Mirena gradually changes the character menstrual bleeding . In the first months of using an intrauterine device, due to inhibition of endometrial proliferation, an increase in spotting and bloody discharge from the vagina may be observed. As the pharmacological effect of the therapeutic agent develops, when the pronounced suppression of proliferative processes reaches a maximum, a period of scanty bleeding begins, which often transforms into oligo- And amenorrhea .

3 months after starting to use Mirena, menstrual blood loss in women is reduced by 62-94%, and after 6 months - by 71-95%. This pharmacological ability to change the nature of uterine bleeding is used to treat idiopathic menorrhagia in the absence of hyperplastic processes in the membranes of the female genital organs or extra genital conditions, an integral part of the pathogenesis of which is a pronounced hypocoagulation . since the effectiveness of the drug is comparable to surgical treatment methods.

Pharmacodynamics and pharmacokinetics

Once the intrauterine system is installed, the pharmaceutical drug begins to act immediately, which is manifested in the gradual release levonorgestrel and its active absorption, which can be judged by changes in its concentration in the blood plasma. Speed The release of the active component is initially 20 mcg per day and gradually decreases, reaching 10 mcg per day after 5 years. Hormonal IUD Mirena installs high local exposure . which provides a concentration gradient of the active substance in the direction from the endometrium to the myometrium (the concentration in the walls of the uterus varies more than 100 times).

Entering the systemic circulation, levonorgestrel contacts whey proteins blood: 40-60% of the active component nonspecifically combines with albumin . and 42-62% of the active component – ​​specifically with selective sex hormone carrier SHBG . About 1-2% of the dosage is present in the circulating blood as free steroid. During use of a therapeutic agent, the concentration of SHBG decreases and the free fraction increases, which indicates the nonlinearity of the pharmacokinetic ability of the drug.

After insertion of the Mirena IUD into the uterine cavity, levonorgestrel in blood plasma is detected after 1 hour, and the maximum concentration is reached after 2 weeks. In clinical studies, it was proven that the concentration of the active component depends on the woman’s body weight - with low weight and/or with a high concentration of SHBG, the amount of the main component in the plasma is higher.

Levonorgestrel metabolized with the participation isoenzyme CYP3A4 to the final metabolic products in the form of conjugated and non-conjugated 3-alpha and 5-beta tetrahydrolevonorgestrel . after which it is excreted through the intestines and through the kidneys with an excretion coefficient of 1.77. In its unchanged form, the active component is eliminated only in trace amounts. The total clearance of the biological substance Mirena from blood plasma is 1 ml per minute per kilogram of weight. The half-life is about 1 day.

Indications for use

Mirena spiral - contraindications

Absolute contraindications for the use of hormonal IUDs:

Pathological conditions that may complicate the use of an intrauterine device with levonorgestrel :

Side effects of Mirena

Side effects of the IUD should start with changes in the nature and cyclicity of menstrual bleeding . after all, they occur much more often than other adverse effects of therapeutic measures. Thus, the duration of bleeding increases in 22% of women, and irregular uterine hemorrhages observed in 67%, when considering the first 90 days after installation of the Mirena drug. The frequency of these phenomena gradually decreases, since the hormonal spiral releases less biologically active substance over time and by the end of the first year it is 3% and 19%, respectively. However, the number of manifestations of other menstrual cycle disorders increases - by the end of the first year amenorrhea develops in 16%, and rare bleeding in 57% of patients.

Other side effects

Mirena intrauterine device: instructions for use (Method and dosage)

General provisions for using the drug

The contraceptive Mirena is injected directly into the uterine cavity, where it exerts its pharmacological effects for 5 years. Release speed the active hormonal component is 20 mcg per day at the beginning of the use of the intrauterine device and gradually decreases to a level of 10 mcg per day after 5 years. Average elimination rate levonorgestrel throughout the entire therapeutic course is about 14 mcg per day.

There is a special contraceptive effectiveness indicator . which reflects the number of pregnancies in 100 women while using a contraceptive. If installed correctly and all rules for using the intrauterine device are followed, Pearl index for Mirena is about 0.2% for 1 year, and the same figure for 5 years is 0.7%, which expresses the incredibly high effectiveness of this method of contraception (for comparison: condoms have a Pearl index of 3.5% to 11 %, and for chemicals such as spermicides - from 5% to 11%).

Installation and removal of the intrauterine system may be accompanied by pain in the lower abdomen and moderate bleeding. Also, manipulation can cause fainting due to a vascular-vagal reaction or a convulsive seizure in patients epilepsy . Therefore, the use of local anesthesia of the female genital organs may be required.

Before installing the drug

It is recommended that the IUD be placed only doctor . who has experience working with this type of contraception, since mandatory aseptic conditions and appropriate medical knowledge of female anatomy and the functioning of the pharmaceutical drug are required. Immediately before installation it is necessary to carry out general and gynecological examination . in order to eliminate the risks of further use of contraception, the presence pregnancy and diseases that act as contraindications.

The doctor must determine the position of the uterus and the size of its cavity, since the correct location of the Mirena system ensures a uniform influence of the active component on endometrium . which creates the conditions for its maximum efficiency.

Instructions for Mirena for medical personnel

Visualize the cervix using gynecological mirrors, treat it and the vagina with antiseptic solutions. Grasp the upper lip of the cervix with forceps and, using gentle traction, straighten the cervical canal, secure this position of the medical instruments until the end of the procedure for installing the intrauterine device. Slowly moving the uterine probe through the organ cavity to the fundus of the uterus, determine the direction of the cervical canal and the exact depth of the cavity, in parallel, excluding possible anatomical septa, synechiae, submucosal fibroma or other obstacles. If the cervical canal is narrow, it is recommended to use local or conduction anesthesia to widen it.

Check the sterile packaging with the drug for integrity, then open it and remove the intrauterine device. Move the slider to the farthest position so that the system is pulled inside the conductor tube and takes on the appearance of a small stick. Holding the slider in the same position, set the upper edge of the index ring in accordance with the previously measured distance to the fundus of the uterus. Carefully advance the guidewire through the cervical canal until the ring is approximately 1.5-2 cm from the cervix.

After reaching the required position of the spiral, slowly move the slider until the horizontal arms are fully opened and wait 5-10 seconds until the system acquires a T-shape. Advance the guidewire to the fundal position, as evidenced by complete contact of the index ring with the cervix. While holding the conductor in this position, release the drug using the lowest position of the slider. Carefully remove the conductor. Cut the threads to a length of 2-3 cm, starting from the external os of the uterus.

It is recommended to confirm the correct position of the intrauterine device using ultrasound immediately after the procedure for installing Mirena. Repeated examination is performed after 4-12 weeks, and then once a year. If there are clinical indications, a gynecological examination and verification of the correct position of the spiral using functional laboratory diagnostic methods should be carried out regularly.

Removing the intrauterine device

Mirena should be removed after 5 years after installation, since the effectiveness of the therapeutic agent is significantly reduced after this period. The medical literature even describes cases of the adverse effects of an intrauterine device not removed in a timely manner with the development of inflammatory diseases of the pelvic organs and some other pathological conditions.

To extract the drug requires strict adherence to aseptic conditions. Removing Mirena involves carefully pulling the threads grasped with special gynecological forceps. If the threads are not visible and the intrauterine device is located deep in the organ cavity, then a traction hook can be used. It may also be necessary to dilate the cervical canal.

After removal Mirena preparation should inspect the system for its integrity, since in some situations the hormonal-elastomer core may separate or slip onto the shoulders of the T-shaped body. Pathological cases have been described in which such complications of intrauterine device removal required additional gynecological intervention.

Overdose

When used correctly and following all the rules for placing an intrauterine device, an overdose of a pharmaceutical drug impossible .

Interaction

Pharmaceutical enzyme inducers, especially biological catalysts from the system cytochrome P 450 . which are involved in the metabolic degeneration of drugs such as anticonvulsants ( Phenobarbital . Phenytoin . Carbamazepine ) And antibiotics (Rifampicin and others), enhance biochemical transformation gestagens . However, their influence on the effectiveness of Mirena is insignificant, since the main point of application of the therapeutic abilities of the intrauterine device is the local effect on the endometrium.

Mirena. Instructions

Reviews about the Mirena spiral (4111) Price in Moscow

Composition and release form

An intrauterine therapeutic system (IUD) with a release rate of 20 mcg/24 hours consists of a white or off-white hormonal elastomeric core placed on a T-shaped body and covered with an opaque membrane that regulates the release of levonorgestrel. The T-shaped body has a loop at one end and two arms at the other; threads are attached to the loop to remove the system. The IUD is placed in a guide tube. The system and conductor are free of visible impurities.

1 IUD contains levonorgestrel 52 mg. Excipients: polydimethylsiloxane elastomer.

pharmachologic effect

The levonorgestrel-releasing intrauterine system (IUD) has a primarily local progestational effect. Progestin (levonorgestrel) is released directly into the uterine cavity, which allows it to be used in an extremely low daily dose. High concentrations of levonorgestrel in the endometrium help to reduce the sensitivity of its estrogen and progesterone receptors, making the endometrium resistant to estradiol and having a strong antiproliferative effect. When using Mirena, morphological changes in the endometrium and a weak local reaction to the presence of a foreign body in the uterus are observed. Thickening of the mucous membrane of the cervical canal prevents the penetration of sperm into the uterus. Mirena® prevents fertilization due to inhibition of sperm motility and function in the uterus and fallopian tubes. In some women, ovulation is also suppressed.

Previous use of Mirena does not affect reproductive function. Approximately 80% of women who want to have a child become pregnant within 12 months after removal of the IUD.

In the first months of using Mirena, due to the process of suppressing endometrial proliferation, an initial increase in spotting may be observed. Following this, pronounced suppression of the endometrium leads to a decrease in the duration and volume of menstrual bleeding in women using Mirena. Scanty bleeding often transforms into oligo- or amenorrhea. At the same time, ovarian function and the concentration of estradiol in the blood remain normal.

Mirena can be successfully used to treat idiopathic menorrhagia, i.e. menorrhagia in the absence of genital diseases (for example, endometrial cancer, metastatic lesions of the uterus, submucosal or large interstitial node of uterine fibroids leading to deformation of the uterine cavity, adenomyosis, endometrial hyperplastic processes, endometritis), extragenital diseases and conditions accompanied by severe hypocoagulation (for example , von Willebrand disease, severe thrombocytopenia), the symptoms of which are menorrhagia.

By the end of the third month after Mirena installation, in women with menorrhagia, the volume of menstrual bleeding decreased by 88%. Reducing menstrual blood loss reduces the risk of iron deficiency anemia. Mirena® also reduces the severity of dysmenorrhea.

The effectiveness of Mirena in preventing endometrial hyperplasia during chronic estrogen therapy was equally high with both oral and transdermal estrogen use.

Indications for use

Mode of application

Mirena is inserted into the uterine cavity and remains effective for 5 years. The in vivo release rate of levonorgestrel is initially approximately 20 mcg/day and decreases after 5 years to approximately 10 mcg/day. The average release rate of levonorgestrel is approximately 14 mcg/day for up to 5 years. Mirena can be used in women receiving hormone replacement therapy in combination with oral or transdermal estrogen preparations that do not contain progestogens.

With correct installation of Mirena, carried out in accordance with the instructions for medical use, the Pearl index (an indicator reflecting the number of pregnancies in 100 women using a contraceptive during the year) is approximately 0.2% within 1 year. The cumulative rate reflecting the number of pregnancies in 100 women using contraception for 5 years is 0.7%.

Mirena should not be used for postcoital contraception.

Rules for using the IUD

Mirena is supplied in sterile packaging, which is opened only immediately before insertion of the IUD. It is necessary to observe aseptic rules when handling an opened system. If the sterility of the packaging appears to be compromised, the IUD should be disposed of as medical waste. The IUD removed from the uterus should also be handled as it contains hormone residues.

Installation, removal and replacement of the IUD

Removing Mirena

Mirena is removed by carefully pulling the threads grasped with forceps.

Special instructions

If further contraception is necessary in women of childbearing age, the system should be removed during menstruation, subject to a monthly menstrual cycle. Otherwise, you should use other methods of contraception (for example, a condom) for at least 7 days before removal. If a woman is amenorrheic, she should start using barrier contraception 7 days before removal of the system and continue until menstruation returns.

A new Mirena can also be introduced immediately after the old one is removed, in which case there is no need for additional contraception.

After removing Mirena, you should check the system for integrity. When it was difficult to remove the IUD, there were isolated cases of the hormonal-elastomer core slipping onto the horizontal arms of the T-shaped body, as a result of which they were hidden inside the core. Once the integrity of the IUD is confirmed, this situation does not require additional intervention. Stoppers on the horizontal arms usually prevent the core from completely separating from the T-body.

Side effect

Side effects usually do not require additional therapy and disappear within a few months.

Expulsion of the intrauterine system, uterine perforation, and ectopic pregnancy, described with the use of other intrauterine contraceptives, may develop.

Side effects most often develop in the first months after Mirena is inserted into the uterus; With prolonged use of the IUD, they gradually disappear.

Very common (more than 10%): uterine/vaginal bleeding, spotting, oligo- and amenorrhea, benign ovarian cysts. The average number of days of spotting in women of childbearing age gradually decreases from 9 to 4 days per month during the first 6 months after IUD insertion. The number of women with prolonged (more than 8 days) bleeding decreases from 20% to 3% in the first 3 months of using Mirena. Clinical studies found that in the first year of Mirena use, 17% of women experienced amenorrhea lasting at least 3 months. When Mirena is used in combination with estrogen replacement therapy, most peri- and postmenopausal women experience spotting and irregular bleeding in the first months of treatment. Subsequently, their frequency decreases, and in approximately 40% of women receiving this therapy, bleeding disappears altogether in the last 3 months of the first year of treatment. Changes in bleeding patterns are more common in the perimenopausal period than in the postmenopausal period. The frequency of detection of benign ovarian cysts depends on the diagnostic method used. According to clinical trials, enlarged follicles were diagnosed in 12% of women who used Mirena. In most cases, the enlargement of follicles was asymptomatic and disappeared within 3 months.

The table shows side effects, the frequency of which corresponds to data from clinical studies.

Uterine bleeding - causes and symptoms, how to stop. Dicinone for uterine bleeding

What is uterine bleeding?

Uterine bleeding is the release of blood from uterus. Unlike menstruation. with uterine bleeding, either the duration of discharge and the volume of blood released changes, or their regularity is disrupted.

Causes of uterine bleeding

Causes of uterine bleeding may be different. They are often caused by diseases of the uterus and appendages, such as fibroids and endometriosis. adenomyosis), benign and malignant tumors. Bleeding can also occur as a complication of pregnancy and childbirth. In addition, there are dysfunctional uterine bleeding - when, without visible pathology of the genital organs, their function is disrupted. They are associated with disruption of hormone production. affecting the genitals (disorders in the hypothalamic-pituitary-ovarian system).

Much less often, the cause of this pathology can be so-called extragenital diseases (not related to the genital organs). Uterine bleeding can occur with liver damage. for diseases associated with blood clotting disorders (for example, von Willebrand disease). In this case, in addition to the uterine, patients are also worried about nosebleeds, bleeding gums, and the appearance of bruises with minor injuries. prolonged bleeding from cuts and others symptoms .

Symptoms of uterine bleeding

The main symptom of this pathology is bleeding from the vagina.

Unlike normal menstruation, uterine bleeding is characterized by the following features:

1. Increased blood volume. Normally, during menstruation, 40 to 80 ml of blood is released. With uterine bleeding, the volume of blood lost increases, amounting to more than 80 ml. This can be determined if there is a need to change hygiene products too often (every 0.5 - 2 hours).

2. Increased duration of bleeding. Normally, during menstruation, discharge lasts from 3 to 7 days. In case of uterine bleeding, the duration of bleeding exceeds 7 days.

3. Irregularity of discharge - on average, the menstrual cycle is 21-35 days. An increase or decrease in this interval indicates bleeding.

4. Bleeding after sexual intercourse.

5. Bleeding in postmenopause - at an age when menstruation has already stopped.

Thus, the following symptoms of uterine bleeding can be distinguished:

In addition, due to the loss of fairly large volumes of blood, a very common symptom of this pathology is iron deficiency anemia (decreased amount of hemoglobin in the blood). It is often accompanied by weakness and shortness of breath. dizziness. pallor of the skin.

Types of uterine bleeding

Depending on the time of occurrence, uterine bleeding can be divided into the following types:

1. Uterine bleeding during the newborn period is scanty bloody discharge from the vagina. occurring most often in the first week of life. They are connected with the fact that during this period there is a sharp change in hormonal levels. They go away on their own and do not require treatment.

2. Uterine bleeding in the first decade (before the onset of puberty) is rare and is associated with ovarian tumors that can secrete increased amounts of sex hormones (hormone-active tumors). Thus, so-called false puberty occurs.

3. Juvenile uterine bleeding - occurs at the age of 12-18 years (puberty).

4. Bleeding during the reproductive period (ages 18 to 45) can be dysfunctional, organic, or associated with pregnancy and childbirth.

5. Uterine bleeding during menopause is caused by impaired hormone production or diseases of the genital organs.

Depending on the cause of occurrence, uterine bleeding is divided into:

Juvenile uterine bleeding

Juvenile uterine bleeding develops during puberty (age 12 to 18 years). The most common cause of bleeding in this period is ovarian dysfunction - the proper production of hormones is adversely affected by chronic infections. frequent ARVI. psychological trauma. physical activity, unhealthy diet. Their occurrence is characterized by seasonality - winter and spring months. Bleeding in most cases is anovulatory – i.e. due to disruption of hormone production, ovulation does not occur. Sometimes the cause of bleeding can be bleeding disorders, tumors of the ovaries, body and cervix, tuberculosis of the genital organs.

The duration and intensity of juvenile bleeding may vary. Heavy and prolonged bleeding leads to anemia, which is manifested by weakness, shortness of breath, pallor and other symptoms. In any case of bleeding in adolescence, treatment and observation should take place in a hospital setting. If bleeding occurs at home, you can provide rest and bed rest, give 1-2 tablets of Vikasol. put a cold heating pad on your lower abdomen and call an ambulance.

Treatment, depending on the condition, can be symptomatic - the following remedies are used:

• hemostatic drugs: dicinone. vikasol, aminocaproic acid;
• uterine contractants (oxytocin);
• vitamins;
• iron supplements;
• physiotherapeutic procedures.

If symptomatic treatment is insufficient, bleeding is stopped with the help of hormonal drugs. Curettage is performed only in cases of severe and life-threatening bleeding.

To prevent recurrent bleeding, courses of vitamins and physiotherapy are prescribed. acupuncture. After bleeding has stopped, estrogen-progestin agents are prescribed to restore the normal menstrual cycle. Hardening and physical exercise, good nutrition, and treatment of chronic infections are of great importance in the recovery period.

Uterine bleeding during the reproductive period

During the reproductive period, there are quite a few reasons that cause uterine bleeding. These are mainly dysfunctional factors - when a disruption in the proper production of hormones occurs after abortion. against the background of endocrine, infectious diseases, stress. intoxications. taking certain medications.

During pregnancy, in the early stages, uterine bleeding can be a manifestation of a miscarriage or ectopic pregnancy. In the later stages, bleeding is caused by placenta previa and hydatidiform mole. During childbirth, uterine bleeding is especially dangerous; the amount of blood loss can be large. A common cause of bleeding during childbirth is placental abruption. atony or hypotension of the uterus. In the postpartum period, bleeding occurs due to parts of the membranes remaining in the uterus, uterine hypotension or bleeding disorders.

Often, various diseases of the uterus can be the causes of uterine bleeding during the childbearing period:

• myoma;
• endometriosis of the uterine body;
• benign and malignant tumors of the body and cervix;
• chronic endometritis (inflammation of the uterus);
• hormonally active ovarian tumors.

Bleeding associated with pregnancy and childbirth

In the first half of pregnancy, uterine bleeding occurs when there is a threat of interruption of a normal or ectopic pregnancy. These conditions are characterized by pain in the lower abdomen. delay of menstruation. as well as subjective signs of pregnancy. In any case, if there is bleeding after pregnancy is established, you should urgently seek medical help. In the initial stages of spontaneous miscarriage, with prompt and active treatment, pregnancy can be maintained. In the later stages, the need for curettage arises.

An ectopic pregnancy can develop in the fallopian tubes and cervix. At the first signs of bleeding, accompanied by subjective symptoms of pregnancy against the background of even a slight delay in menstruation, it is necessary to urgently seek medical help.

In the second half of pregnancy, bleeding poses a great danger to the life of the mother and fetus, so it requires urgent medical attention. Bleeding occurs when placenta previa (when the placenta does not form along the back wall of the uterus, but partially or completely blocks the entrance to the uterus), abruption of a normally located placenta, or uterine rupture. In such cases, bleeding may be internal or external, and requires an emergency caesarean section. Women at risk of such conditions should be under close medical supervision.

During childbirth, bleeding is also associated with placental previa or placental abruption. In the postpartum period, common causes of bleeding are:

• decreased uterine tone and ability to contract;
• parts of the placenta remaining in the uterus;
• bleeding disorders.

In cases where bleeding occurs after discharge from the maternity hospital, it is necessary to call an ambulance for urgent hospitalization.

Uterine bleeding during menopause

During menopause, hormonal changes in the body occur, and uterine bleeding occurs quite often. Despite this, they can become a manifestation of more serious diseases, such as benign (fibroids, polyps) or malignant neoplasms. You should be especially wary of the appearance of bleeding in postmenopause, when menstruation has already completely stopped. It is extremely important to see a doctor at the first sign of bleeding because... In the early stages, tumor processes are more treatable. For diagnostic purposes, separate diagnostic curettage of the cervical canal and the uterine body is performed. Then a histological examination of the scraping is carried out to determine the cause of the bleeding. In case of dysfunctional uterine bleeding, it is necessary to select the optimal hormonal therapy.

Dysfunctional uterine bleeding

Dysfunctional bleeding is one of the most common types of uterine bleeding. They can occur at any age - from puberty to menopause. The cause of their occurrence is a disruption in the production of hormones by the endocrine system - a malfunction of the hypothalamus. pituitary gland ovaries or adrenal glands. This complex system regulates the production of hormones that determine the regularity and duration of menstrual bleeding. Dysfunction of this system can be caused by the following pathologies:

• acute and chronic inflammation of the genital organs (ovaries, appendages, uterus);
• endocrine diseases (thyroid dysfunction, diabetes, obesity);
• stress;
• physical and mental fatigue;
• climate change.

Very often, dysfunctional bleeding is a consequence of artificial or spontaneous abortion.

Dysfunctional uterine bleeding can be:

1. Ovulatory – associated with menstruation.

2. Anovulatory – occurs between menstruation.

With ovulatory bleeding, deviations occur in the duration and volume of blood released during menstruation. Anovulatory bleeding is not associated with the menstrual cycle and most often occurs after a missed period, or less than 21 days after the last menstrual period.

Ovarian dysfunction can cause infertility. miscarriage, so it is extremely important to consult a doctor promptly if any menstrual irregularities occur.

Breakthrough uterine bleeding

Uterine bleeding that occurs while taking hormonal contraceptives is called breakthrough bleeding. Such bleeding may be minor, which is a sign of a period of adaptation to the drug.

In such cases, you should consult a doctor to review the dose of the drug used. Most often, if breakthrough bleeding occurs, it is recommended to temporarily increase the dose of the drug taken. If the bleeding does not stop or becomes more profuse, additional examination should be carried out, since the cause may be various diseases of the reproductive system. Bleeding can also occur if the walls of the uterus are damaged by the intrauterine device. In this case, it is necessary to remove the spiral as soon as possible.

Which doctor should I contact if I have uterine bleeding?

If uterine bleeding occurs, regardless of the age of the woman or girl, you should contact gynecologist (make an appointment). If uterine bleeding begins in a girl or young girl, it is advisable to contact a pediatric gynecologist. But if for some reason it is impossible to get to one, then you should contact a regular gynecologist at a antenatal clinic or a private clinic.

Unfortunately, uterine bleeding can be a sign not only of a long-term chronic disease of a woman’s internal genital organs, which requires routine examination and treatment, but also symptoms of an emergency condition. Emergency conditions mean acute diseases in which a woman needs urgent qualified medical care to save her life. And if such assistance in case of emergency bleeding is not provided, the woman will die.

Accordingly, you need to contact a gynecologist at the clinic for uterine bleeding when there are no signs of an emergency. If uterine bleeding is combined with signs of an emergency condition, then you should immediately call an ambulance or use your own transport as soon as possible to get to the nearest hospital with a gynecological department. Let's consider in what cases uterine bleeding should be considered as an emergency.

First of all, all women should know that uterine bleeding at any stage of pregnancy (even if the pregnancy is not confirmed, but there is a delay of at least a week) should be considered an emergency condition, since the release of blood, as a rule, is provoked by threats to the life of the fetus and future mothers with conditions such as placental abruption, miscarriage, etc. And in such conditions, a woman should be provided with qualified assistance to save her life and, if possible, preserve the life of the gestating fetus.

Secondly, uterine bleeding that begins during or some time after sexual intercourse should be considered a sign of an emergency. Such bleeding may be due to pregnancy pathology or severe trauma to the genital organs during previous intercourse. In such a situation, help for a woman is vital, since in her absence the bleeding will not stop, and the woman will die from blood loss incompatible with life. To stop bleeding in such a situation, it is necessary to sutured all ruptures and injuries to the internal genital organs or terminate the pregnancy.

Thirdly, uterine bleeding should be considered an emergency condition, which is profuse, does not decrease over time, is combined with severe pain in the lower abdomen or lower back, and causes a sharp deterioration in well-being, paleness, and decreased blood pressure. heartbeat. increased sweating. possible fainting. A general characteristic of an emergency condition with uterine bleeding is the fact of a sharp deterioration in a woman’s well-being, when she cannot perform simple household and everyday activities (she cannot get up, turn her head, it is difficult for her to speak, if she tries to sit up in bed, she immediately falls, etc.) , but literally lies flat or even unconscious.

What tests and examinations can a doctor prescribe for uterine bleeding?

Despite the fact that uterine bleeding can be provoked by various diseases, when they occur, the same examination methods (tests and instrumental diagnostics) are used. This is due to the fact that the pathological process during uterine bleeding is localized in the same organs - the uterus or ovaries.

Moreover, at the first stage, various examinations are carried out to assess the condition of the uterus, since most often uterine bleeding is caused by the pathology of this particular organ. And only if, after the examination, the pathology of the uterus was not detected, methods of examining the functioning of the ovaries are used, since in such a situation the bleeding is caused by a disorder of the regulatory function of the ovaries. That is, the ovaries do not produce the required amount of hormones at different periods of the menstrual cycle, and therefore bleeding occurs as a response to hormonal imbalance.

So, in case of uterine bleeding, first of all, the doctor prescribes the following tests and examinations:

• General blood analysis;
• Coagulogram (indicators of the blood coagulation system) (sign up) ;
• Gynecological examination (make an appointment) and inspection in mirrors;
• Ultrasound of the pelvic organs (sign up) .

A complete blood count is needed to assess the extent of blood loss and whether the woman has developed anemia. Also, a general blood test can reveal whether there are inflammatory processes in the body that can cause dysfunctional uterine bleeding.

A coagulogram allows you to evaluate the functioning of the blood coagulation system. And if the coagulogram parameters are not normal, then the woman should consult and undergo the necessary treatment with hematologist (make an appointment) .

A gynecological examination allows the doctor to feel with his hands various neoplasms in the uterus and ovaries, and determine the presence of an inflammatory process by changes in the consistency of the organs. And examination in the mirrors allows you to see the cervix and vagina, identify neoplasms in the cervical canal or suspect cervical cancer.

Ultrasound is a highly informative method that allows you to identify inflammatory processes, tumors, cysts, polyps in the uterus and ovaries, and endometrial hyperplasia. as well as endometriosis. That is, in fact, ultrasound allows you to identify almost all diseases that can cause uterine bleeding. But, unfortunately, the information content of ultrasound is not sufficient for a final diagnosis, since this method only provides guidance in the diagnosis - for example, ultrasound can detect uterine fibroids or endometriosis, but it is possible to establish the exact location of the tumor or ectopic foci, determine their type and assess the condition of the organ and surrounding tissues - it is impossible. Thus, ultrasound makes it possible to determine the type of existing pathology, but to clarify its various parameters and determine the causes of this disease, it is necessary to use other examination methods.

When a gynecological examination, speculum examination, ultrasound, and a general blood test and coagulogram will be performed, it depends on what pathological process was identified in the genital organs. Based on these examinations, the doctor may prescribe the following diagnostic procedures:

So, if endometrial hyperplasia, polyps of the cervical canal or endometrium, or endometritis are detected, the doctor usually prescribes separate diagnostic curettage followed by histological examination of the material. Histology allows us to understand whether there is a malignant tumor or malignancy of normal tissue in the uterus. In addition to curettage, the doctor may prescribe hysteroscopy, during which the uterus and cervical canal are examined from the inside with a special device - a hysteroscope. In this case, hysteroscopy is usually performed first, and then curettage.

If fibroids or other uterine tumors are detected, the doctor prescribes hysteroscopy in order to examine the organ cavity and see the tumor with the eye.

If endometriosis has been identified, the doctor may prescribe magnetic resonance imaging in order to clarify the location of ectopic foci. In addition, if endometriosis is detected, the doctor may prescribe a blood test for the content of follicle-stimulating, luteinizing hormones, and testosterone in order to clarify the causes of the disease.

If cysts, tumors or inflammation have been identified in the ovaries, additional examinations are not carried out, as they are not needed. The only thing the doctor can prescribe in this case is laparoscopic surgery (make an appointment) for removal of tumors and conservative treatment for the inflammatory process.

In the case when, according to the results Ultrasound (sign up). Gynecological examination and speculum examination did not reveal any pathology of the uterus or ovaries; dysfunctional bleeding is assumed due to a hormonal imbalance in the body. In such a situation, the doctor prescribes the following tests to determine the concentration of hormones that can affect the menstrual cycle and the appearance of uterine bleeding:

• Blood test for cortisol (hydrocortisone) levels;
• Blood test for the level of thyroid-stimulating hormone (TSH, thyrotropin);
• Blood test for triiodothyronine (T3) level;
• Blood test for thyroxine (T4) level;
• Blood test for the presence of antibodies to thyroid peroxidase (AT-TPO);
• Blood test for the presence of antibodies to thyroglobulin (AT-TG);
• Blood test for follicle-stimulating hormone (FSH) levels;
• Blood test for luteinizing hormone (LH) levels;
• Blood test for prolactin level (sign up) ;
• Blood test for estradiol levels;
• Blood test for dehydroepiandrosterone sulfate (DEA-S04);
• Blood test for testosterone levels;
• Blood test for sex hormone binding globulin (SHBG) levels;
• Blood test for the level of 17-OH progesterone (17-OP) (sign up) .

Treatment of uterine bleeding

Treatment of uterine bleeding is aimed primarily at stopping bleeding, replenishing blood loss, as well as eliminating the cause and preventing it. All bleeding is treated in a hospital setting, because First of all, it is necessary to carry out diagnostic measures to determine their cause.

Methods to stop bleeding depend on age, its cause, and the severity of the condition. One of the main methods of surgically stopping bleeding is separate diagnostic curettage - it also helps to identify the cause of this symptom. To do this, a scraping of the endometrium (mucous membrane) is sent for histological examination. Curettage is not performed for juvenile bleeding (only if severe bleeding does not stop under the influence of hormones and is life threatening). Another way to stop bleeding is hormonal hemostasis (use of large doses of hormones) - estrogen or combined oral contraceptives (non-ovlon. rigevidon. mersilon. Marvelon).

During symptomatic therapy, the following medications are used:

• hemostatic drugs (vicasol, dicinone, aminocaproic acid);
• for low hemoglobin values ​​- iron supplements (maltofer, fenyuls) or blood components (fresh frozen plasma, red blood cells);
• vitamins and vascular-strengthening drugs (ascorutin, vitamins C, B 6, B 12, folic acid).

After the bleeding stops, prevention of its resumption is carried out. In case of dysfunction, this is a course of hormonal medications (combined oral contraceptives or gestagens), installation of a hormone-producing intrauterine device (Mirena). If intrauterine pathology is detected, chronic endometritis, endometrial polyps, and uterine fibroids are treated. adenomyosis, endometrial hyperplasia.

Hemostatic agents used for uterine

bleeding

Hemostatic agents are used for uterine bleeding as part of symptomatic treatment. Most often prescribed:

• dicinone;
• ethamsylate;
• vikasol;
• calcium preparations;
• aminocaproic acid.

In addition, drugs that contract the uterus - oxytocin, pituitrin, hyfotocin - have a hemostatic effect during uterine bleeding. All of these drugs are most often prescribed in addition to surgical or hormonal methods of stopping bleeding.

Dicinone for uterine bleeding

Dicynone (etamsylate) is one of the most common drugs used for uterine bleeding. Belongs to the group of hemostatic (hemostatic) drugs. Dicynone acts directly on the walls of capillaries (the smallest vessels), reduces their permeability and fragility, improves microcirculation (blood flow in the capillaries), and also improves blood clotting in places where small vessels are damaged. However, it does not cause hypercoagulation (increased blood clot formation) and does not constrict blood vessels.

The drug begins to act within 5-15 minutes after intravenous administration. Its effect lasts 4-6 hours.

Dicinone is contraindicated in the following cases:

• thrombosis and thromboembolism;
• malignant blood diseases;
• hypersensitivity to the drug.

The method of administration and dose is determined by the doctor in each specific case of bleeding. For menorrhagia, it is recommended to take dicinone tablets, starting on the 5th day of the expected menstruation and ending on the fifth day of the next cycle.

What to do with prolonged uterine bleeding?

With prolonged uterine bleeding, it is important to seek medical help as soon as possible. If signs of severe anemia appear, it is necessary to call an ambulance to stop the bleeding and further observation in the hospital.

Main signs of anemia:

Folk remedies

Decoctions and extracts of yarrow are used as folk remedies for the treatment of uterine bleeding. water pepper, shepherd's purse. nettles raspberry leaves. burnet and other medicinal plants. Here are some simple recipes:

1. Infusion of yarrow herb: 2 teaspoons of dry herb are poured with a glass of boiling water, left for 1 hour and filtered. Take 4 times a day, 1/4 cup of infusion before meals.

2. Infusion of shepherd's purse herb: 1 tablespoon of dry herb is poured with a glass of boiling water, left for 1 hour, pre-wrapped, then filtered. Take 1 tablespoon, 3-4 times a day before meals.

3. Stinging nettle infusion: Pour 1 tablespoon of dry leaves into a glass of boiling water, boil for 10 minutes over low heat, then cool and filter. Take 1 tablespoon 4-5 times a day.

The use of folk remedies is permissible only after consultation with a doctor. because Uterine bleeding is a symptom of various diseases, often quite serious. Therefore, it is extremely important to find the cause of this condition and begin treatment as early as possible.

Therapeutic hormonal intrauterine system (spiral, IUD) Mirena (general characteristics and answers to the most popular questions)

General characteristics

Therapeutic intrauterine system Mirena as an intrauterine contraceptive (IUD)

Therapeutic intrauterine system (hormonal intrauterine system, hormonal intrauterine device. Navy) Mirena refers to intrauterine hormonal contraceptives .

Intrauterine contraceptives(VMK) began to be used in the middle of the last century. They quickly became popular due to such positive qualities as high efficiency, comfort (no connection with sexual intercourse, they are administered once for a long period of time, there is no need to constantly monitor the intake of pills, etc.), and the absence of a systemic effect on the woman’s body. The main problem with IUDs, which often leads to refusal to use them, was the tendency of patients to experience severe uterine bleeding.

In the 60-70s, copper-containing VMCs appeared, the efficiency of which was even higher. However, the problem of metrorrhagia (uterine bleeding) was not solved by the second generation of intrauterine contraceptives.

And finally, in the second half of the 70s, the first hormone-containing intrauterine contraceptives appeared - the new, third generation of IUDs. These medications combine the positive aspects of IUDs and hormonal oral contraceptives.

Description of the dosage form

The Mirena intrauterine hormonal system has a T-shaped body that ensures stable placement in the uterine cavity. At one end the body has a loop to which threads are attached to remove the system. On the body there is a hormonal-elastomer core, which is a white or almost white substance. The core is covered with a translucent membrane that regulates the flow of the active substance into the uterine cavity.

The active hormonal substance of the system - the progestin drug levonorgestrel - is presented in the amount of 52 mg. The excipient is polydimethylsiloxane elastomer.

The Mirena intrauterine hormonal system is located in the cavity of the guide tube. The conductor and body of the drug do not have any impurities.

Each package of Mirena contains one intrauterine hormonal system, placed in a vacuum plastic and paper shell.

Before use, the purchased Mirena dosage form should be kept in a place protected from sunlight, at room temperature (15-30 degrees). The shelf life is three years.

Metabolism of active substance in the body

The hormonal Mirena IUD begins to release levonorgestrel immediately after placement in the uterine cavity. The release rate of the active substance after administration is 20 mcg/day, by the end of the fifth year it decreases to 10 mcg/day.

The distribution of levonorgestrol characterizes Mirena as a drug of predominantly local action. The highest concentration of the substance is stored in the endometrium (the lining of the uterus). In the myometrium (in the muscular layer), the concentration of levonorgestrel barely reaches 1% of the concentration in the endometrium. The concentration of levonorgestrel in the blood plasma is 1000 times less than in the endometrium.

The active substance enters the blood approximately an hour after administration of the system. The maximum concentration of levonorgestrel in the blood serum is achieved after two weeks.

Body weight significantly affects the concentration of the active substance in the blood plasma. In women with reduced weight (37-54 kg), the concentration of levonorgestrol in the blood is on average one and a half times higher.

The active substance is almost completely metabolized (broken down) in the liver. and is excreted through the kidneys and intestines.

Operating principle

The most important contraceptive effects of the Mirena intrauterine hormonal system are due to a weak local reaction to a foreign body in the uterine cavity, and predominantly to the local influence of the progestin drug levonorgestrol.

The functional activity of the epithelium of the uterine cavity is suppressed: the normal growth of the endometrium is inhibited, the activity of its glands is reduced, transformations occur in the submucosa - all these changes ultimately prevent the implantation of a fertilized egg.

Another important contraceptive effect is the increase in the viscosity of the mucus secreted by the glands of the cervix and the thickening of the mucous membrane of the cervical canal, which prevents the penetration of sperm into the uterine cavity.

In addition, Mirena inhibits sperm motility in the uterine cavity and fallopian tubes.

In the first months of use, due to the restructuring of the uterine mucosa, irregular spotting is possible. But subsequently, suppression of the proliferation of the endometrial epithelium leads to a pronounced decrease in the volume and duration of menstrual bleeding, up to amenorrhea (cessation of menstruation).

The Mirena intrauterine hormonal system is intended, first of all, to prevent unwanted pregnancy.

In addition, the drug is used for excessively heavy menstrual bleeding of unknown etiology (in cases where the possibility of cancer of the female genital area is excluded).

As a local progestin drug, the Mirena intrauterine device is used to prevent endometrial hyperplasia (proliferation) during estrogen replacement therapy (this type of treatment is indicated after operations to remove both ovaries, as well as during severe menopause).

Contraindications

Mirena is an intrauterine contraceptive, so it is strictly contraindicated for inflammatory diseases of the female genital area, such as:

• acute and chronic inflammatory diseases of the pelvic organs;
• cervicitis;
• infectious lesions of the lower genitourinary tract;
• postpartum endometritis;
• septic abortion. occurring less than three months before installation.

Since the occurrence of an acute inflammatory disease of the pelvic organs, which is difficult to treat, will be an indication for removal of the IUD, Mirena is contraindicated in case of an increased tendency to the occurrence of acute infectious diseases, including the female genital area (frequent change of sexual partners, a general decrease in the body's resistance, AIDS in the stage detailed clinical symptoms, etc.).

As an intrauterine contraceptive, Mirena is also contraindicated for cervical dysplasia. malignant neoplasms of the body and cervix, congenital or acquired changes in the configuration of the uterine body cavity (including fibroids).

Since the active substance of the drug is metabolized in the liver, the Mirena intrauterine hormonal system is contraindicated in case of oncological pathology of this organ, as well as in acute hepatitis and cirrhosis. If jaundice of unknown origin has previously occurred, the drug should be used with great caution.

Since levonorgestrol is a progestin drug, Mirena is contraindicated in all gestagen-dependent cancers (primarily breast cancer).

The systemic effect of levonorgestrol on a woman’s body is weak. However, the Mirena intrauterine hormonal system should be used with extreme caution in cases where progestin drugs are contraindicated. This is especially true for severe circulatory disorders (heart attacks, strokes), a history of severe migraine attacks (including those that may indicate severe cerebral circulatory disorders), and arterial hypertension. severe forms of diabetes. thrombophlebitis and a tendency to thromboembolic complications.

In such cases, the degree of risk (the severity of the symptoms of the disease, which is a relative contraindication to the prescription of the drug) should be correlated with the benefits of its use. The question of using Mirena is decided in consultation with a professional, and during the use of the spiral, constant medical supervision and laboratory monitoring are required.

Mirena is contraindicated during pregnancy (diagnosed or suspected) and in case of hypersensitivity to the components of the drug.

Side effects

Common side effects

Common side effects include associated symptoms that appear no less frequently than in every hundredth and no more often than in every tenth patient using the IUD.

Women using Mirena most often experience unpleasant symptoms from the central nervous system, such as nervousness, irritability, bad mood, decreased libido. headache.

From the gastrointestinal tract, patients are often bothered by pain in the abdominal area. nausea. vomit.

Among the adverse effects on appearance, the most common are acne and weight gain.

Patients often present many complaints about the condition of the reproductive system and mammary glands: pain in the pelvic area, spotting, vulvovaginitis. tension and tenderness of the mammary glands.

Back pain is relatively common. resembling radiculitis.

All the symptoms described above are most pronounced in the first months of using the Mirena IUD; subsequently, their intensity decreases, and in the vast majority of cases, the unpleasant symptoms completely disappear.

Rare side effects

Rare side effects include accompanying signs of drug use, which appear no more often than in every hundredth patient, and no less often than in every thousand.

Rarely encountered adverse side effects of Mirena include the following:

These unpleasant symptoms are most pronounced in the first months of using Mirena. In cases where their intensity does not decrease, additional examination is indicated to exclude concomitant diseases.

Very rare side effects

Very rare effects of Mirena (less than one in a thousand) include allergic reactions such as rashes and hives. If such signs appear, other possible causes of skin allergies should be excluded and, if necessary, stop using the IUD.

Instructions for use

Installation of the Mirena intrauterine device

The sterile vacuum packaging is opened immediately before installing the system. A prematurely opened system must be destroyed as medical waste.

Only a doctor with sufficient experience in performing this type of manipulation can install the Mirena intrauterine system.

Before installing the Mirena spiral, you should consult a gynecologist. and obtain information regarding all risks and possible adverse side effects.

Having decided to install the Mirena IUD, a woman must undergo a breast examination and mammography. as well as a gynecological examination, including examination of the pelvic organs and colposcopy (or at least a smear test from the cervix).

It is necessary to exclude oncological pathology of the female genital organs, pregnancy and sexually transmitted infections. All inflammatory gynecological diseases must be completely cured by the time of installation.

Before installing the Mirena spiral, it is extremely important to determine the location of the uterus in the pelvis, as well as the size and configuration of the uterine cavity. The correct placement of the IUD in the uterine cavity guarantees the effectiveness of the Mirena system and prevents its expulsion (expulsion).

For women of childbearing age, Mirena is prescribed in the first seven days of the menstrual cycle.

If there are no medical contraindications, the Mirena IUD can be installed immediately after an induced or spontaneous abortion in the first trimester of pregnancy.

After childbirth. in the case of normal uterine involution, installation of the Mirena spiral is permissible only after six weeks.

You can replace the IUD on any day of the monthly cycle.

If the Mirena therapeutic intrauterine system is installed to prevent endometrial hyperplasia during estrogen replacement therapy. then it is best to install the system on the eve of the onset of menstruation, and in women with established amenorrhea - on any day.

Precautionary measures

After installation of the Mirena spiral, the woman should be examined no later than 9-12 weeks later. Next, a gynecological examination should be carried out according to the usual rules (once a year) or more often (if certain complaints arise).

To date, there is no clinical data confirming the version of the occurrence of a tendency to thrombosis and varicose veins of the lower extremities when using the Mirena IUD. However, if symptoms of these diseases appear, in consultation with a specialist, you should decide on the advisability of removing the IUD, weighing the possible risks of thromboembolic complications and the benefits of using the drug.

Levonorgestrol, even in small doses, can negatively affect glucose tolerance. Therefore, in patients with diabetes mellitus, constant monitoring of plasma glucose levels is necessary.

In women with congenital and acquired valvular heart defects, installation and removal of the Mirena IUD is recommended under the cover of antibiotics. to avoid the development of septic endocarditis.

Complications that may occur when using the Mirena spiral

Perforation and penetration of the uterus

Perforation (perforation) and penetration (invasion into the wall) of the uterus are extremely rare (less than 1 time in 1000 cases of Mirena use). These complications usually arise during installation. Predisposing factors in this case are recent childbirth and lactation. atypical location of the uterus.

In case of penetration or perforation of the uterus, the system should be immediately removed, since in this position it is ineffective and conditions are created for the development of serious pathologies.

Ectopic pregnancy

Ectopic pregnancy is a rare complication (0.1% of cases per year), which is an indication for emergency surgery.

Ectopic pregnancy can be suspected when, against the background of signs of pregnancy (long delay of menstruation, if the cycle was relatively regular before, nausea, dizziness, etc.), sharp paroxysmal pain in the lower abdomen and symptoms of internal bleeding (pallor of the skin, sharp weakness, dizziness, rapid and weak pulse).

This complication is more common in women with a history of ectopic pregnancy, as well as in cases of severe infectious and inflammatory diseases of the pelvic organs.

Infectious and inflammatory diseases of the pelvic organs

Complications in the form of infectious and inflammatory diseases of the pelvic organs are relatively rare (1/1000 - 1/100 cases of IUD use).

The greatest likelihood of this kind of complications persists during the first month of using the Mirena spiral.

A significant risk factor is frequent changes of sexual partners.

In case of recurrent infectious and inflammatory diseases of the pelvic organs, as well as in case of a serious acute infection that is resistant to therapy for several days, the Mirena IUD should be removed.

Expulsion of the spiral

Expulsion (expulsion of the IUD from the uterine cavity) is a common complication. Therefore, women are advised to check the presence of Mirena threads in the vagina after each menstruation.

The fact is that it is during menstruation that the IUD can fall out unnoticed. Of course, when the IUD is expulsed, the contraceptive effect stops, so it is necessary to inspect pads and tampons after use so that Mirena falls out without going unnoticed.

Signs of the onset of expulsion in the middle of the cycle, as a rule, are pain and untimely bleeding. In such cases, the system must be removed, since disruption of the normal arrangement of the spiral negatively affects the contraceptive effect.

Development of functional ovarian cysts

Functional ovarian cysts occur in approximately 12% of women using the Mirena IUD. In most cases, they are asymptomatic, but sometimes there is a feeling of heaviness in the lower abdomen and pain during intercourse.

Most often, enlarged follicles return to normal without any medical intervention after two to three months of observation. If this does not happen, observation using ultrasound examination is indicated.

Surgery is extremely rarely resorted to.

Amenorrhea

Amenorrhea is a common complication of using the Mirena IUD. As a rule, it develops gradually during the first six months of using a contraceptive.

If menstrual bleeding disappears, pregnancy should be ruled out (perform a routine test). If the test is negative, you do not need to repeat it in the future. The normal menstrual cycle will resume after Mirena is removed.

Removing the spiral

After 5 years of use, the Mirena coil should be removed. In cases where, after removing the IUD, a woman intends to continue contraceptive measures, the Mirena coil should be removed at the beginning of the menstrual cycle. If the IUD is removed in the middle of the cycle, and before that there was unprotected sexual intercourse, then the woman is at real risk of becoming pregnant.

If a woman wishes to continue using the IUD, a new IUD can be inserted immediately after removal. In cases where, after removing the IUD, a new intrauterine contraceptive device is immediately installed, manipulations can be carried out at any period of the cycle.

After removing the Mirena IUD, you should check the integrity of the spiral, since if there are difficulties in removing the product, sometimes the substance slips into the uterine cavity.

Installation and removal of the Mirena coil may be accompanied by pain and bleeding of varying severity. In some cases, fainting may occur. In women suffering from epilepsy. insertion or removal of the IUD may cause a seizure.

Mirena intrauterine device and pregnancy

The drug is very effective. In cases where an unwanted pregnancy does occur, an ectopic pregnancy should first be excluded. During intrauterine pregnancy, the question of its termination is raised.

If a woman decides to keep the child, the IUD is carefully removed from the uterine cavity. In cases where it is not possible to remove the intrauterine system, the woman is warned about the possible risks of pregnancy with an IUD in the uterine cavity (spontaneous premature termination of pregnancy).

The possible adverse effects of the drug on fetal development should be taken into account. There are very few cases of carrying a child with the Mirena intrauterine system due to the high contraceptive properties of the drug. However, it is recommended that the woman be informed that there is no clinical data on the occurrence of fetal pathology under the influence of this drug.

Use during lactation

The active ingredient of the Mirena IUD penetrates into the blood plasma in small concentrations and can be released during lactation, so the content of levonorgestrel in breast milk is about 0.1% of the daily dose of the substance secreted by the system.

It is unlikely that such a dose would affect the general condition of the baby. Experts say that the use of Mirena during lactation six weeks after birth is completely safe for a breastfed baby.

FAQ

The cost of Mirena is quite high. I heard that using the IUD is accompanied by many unpleasant side effects. Is there any positive effect of the drug on the body?

The Mirena intrauterine hormonal system has the following therapeutic (not contraceptive) effects:

In addition, Mirena is widely used to normalize the condition of the endometrium during estrogen replacement therapy (such treatment is usually carried out during pathological menopause, or after bilateral ovarian removal).

Is it possible to use the Mirena coil for fibroids to treat the tumor?

The Mirena therapeutic system inhibits the growth of the fibroid tumor node. However, additional examination and consultation with a doctor is necessary. Much depends on the size of the nodes and their location. For example, submucosal fibroid nodes that change the configuration of the uterine cavity are an absolute contraindication for the use of the Mirena IUD.

Does the Mirena IUD help with endometriosis?

The intrauterine system releases a hormone into the uterine cavity. inhibiting endometrial proliferation - this is the basis for the ability of the Mirena spiral to prevent the development of endometriosis.

In recent years, studies have appeared indicating the therapeutic effect of the Mirena coil for endometriosis. Clinical data are quite contradictory. In addition, it should be noted that treatment of endometriosis with hormonal IUDs is not used in all countries.

From the standpoint of evidence-based medicine, the Mirena spiral for endometriosis, like any other hormonal therapy, can only give temporary results. The Russian National Guidelines for Gynecology recommend starting with surgical treatment as the most radical.

However, in each specific case, a thorough examination and consultation with doctors - a gynecologist, surgeon and endocrinologist - is necessary.

My periods stopped completely six months after the Mirena IUD was installed. This is fine? Will I be able to get pregnant after IUD removal?

Amenorrhea (cessation of menstruation) is a normal reaction of the body to the action of the Mirena hormonal system, which occurs in every fifth woman who uses the IUD. Typically, this condition develops gradually.

At the first disappearance of menstrual bleeding, pregnancy should be excluded. The effectiveness of the drug is very high, but experts still recommend getting tested. If the test result is negative, there is no need to worry in the future. After removing the Mirena coil, menstruation will be restored and a normal pregnancy can be expected.

Is pain, discharge or uterine bleeding possible after installing the Mirena IUD?

Immediately after Mirena installation, minor pain and spotting are possible. Severe pain and bleeding may indicate improper placement of the IUD. In this case, the Mirena coil must be removed.

Pain, discharge or uterine bleeding a significant time after installation of the Mirena coil may indicate the onset of expulsion (expulsion of the drug from the uterine cavity) or ectopic pregnancy. Therefore, if such symptoms appear, you should immediately consult a doctor.

Does Mirena affect weight? I really want to buy a Mirena intrauterine device, but I’m afraid of losing my shape (I have a tendency to be overweight).

Weight gain is a fairly common unpleasant side effect of the Mirena IUD. However, it should be taken into account that not everyone gets fat. According to clinical data, at least nine out of ten women do not notice even a slight weight gain after inserting an IUD.

In addition, weight gain is one of the side effects of Mirena, most pronounced in the first months after installation. As a rule, in the future the tendency to gain weight caused by the hormonal drug disappears.

Based on the existing tendency to be overweight, one cannot judge the possibility of weight gain after installing the Mirena spiral, since the occurrence of this side effect and the degree of its severity depends on the individual reaction to the hormonal drug.

I protected myself with hormonal drugs. There are no side effects, but I often forget to take pills. How can I best switch from tablets to Mirena?

If you take the pills irregularly, there is a possible risk of pregnancy, which should be excluded when prescribing the Mirena spiral.

In addition, it is necessary to undergo a full gynecological examination (pelvic examination, colposcopy) and check the condition of the mammary glands.

If there are no contraindications to the use of an IUD, the IUD is best inserted on the fourth to sixth day of the menstrual cycle. On the day of installation of the Mirena spiral, contraceptive pills are canceled.

When does pregnancy occur after Mirena removal?

Clinical data indicate that 80% of women who want to give birth to a child become pregnant in the first year after removing the Mirena coil. This is even slightly higher than the normal level of fertility (fecundity).

Of course, some time is needed to restore the normal state of the reproductive system, which is individual for each woman.

For patients for whom pregnancy is undesirable, doctors advise immediately after removing the Mirena coil to take measures to prevent conception. since for many women the likelihood of developing pregnancy appears immediately after the system stops working.

Where to buy Mirena spiral?

The Mirena intrauterine device can be purchased at a pharmacy. The drug is dispensed according to a doctor's prescription.

Mirena spiral price

The cost of the Mirena spiral depends mainly on the manufacturer, and ranges from 8,700 to 12,700 rubles.