Mirena is a brand-name hormone-releasing intrauterine device (IUD) that’s prescribed as a form of birth control. Mirena contains the active drug levonorgestrel and belongs to the progestin drug class.

Mirena is an IUD (sometimes called a coil) that’s placed inside your uterus by a healthcare professional. Mirena is approved by the Food and Drug Administration (FDA) to:

  • help prevent pregnancy for up to 8 years
  • treat heavy menstrual bleeding for up to 5 years in people who want to use an IUD for birth control

Mirena can be used in adults and adolescents who have started their periods.

Drug details

Mirena is a small, plastic, T-shaped device that releases the hormone levonorgestrel. Levonorgestrel is a synthetic version of the female* sex hormone progesterone.

Mirena releases levonorgestrel steadily into your uterus for up to 8 years. If needed, your healthcare professional can remove Mirena at any time.

* Sex and gender exist on spectrums. Use of the term “female” in this article refers to sex assigned at birth.

Effectiveness

For information about the effectiveness of Mirena, see the “Mirena uses” section below.

Mirena is available only as a brand-name medication. It’s not currently available in generic form.

A generic drug is an exact copy of the active drug in a brand-name medication. Generics typically cost less than brand-name drugs.

Mirena can cause mild or serious side effects. The following lists contain some of the key side effects that may occur while using Mirena. These lists do not include all possible side effects from this form of birth control.

For more information about the possible side effects of Mirena, talk with your doctor or pharmacist. They can give you tips on how to manage any side effects that may be concerning or bothersome.

Note: The Food and Drug Administration (FDA) tracks side effects of drugs it has approved. If you would like to notify the FDA about a side effect you’ve had with Mirena, you can do so through MedWatch.

Mild side effects

Below is a partial list of mild side effects of Mirena. To learn about other mild side effects, talk with your doctor or pharmacist, or view Mirena’s prescribing information.

Mild side effects of Mirena can include:

Most of these side effects may go away within a few days to a couple of weeks. However, if they become more severe or don’t go away, talk with your doctor or pharmacist.

* For more information about allergic reaction and Mirena, see “Allergic reaction” below.

Serious side effects

Serious side effects from Mirena aren’t common. However, they can occur. Call your doctor right away if you have serious side effects. Call 911 or your local emergency number if your symptoms feel life threatening or if you think you’re having a medical emergency.

Serious side effects and their symptoms can include:

  • Severe infection after Mirena is inserted (this can be life threatening). Symptoms can include:
    • severe pain or fever shortly after Mirena is inserted
  • Ovarian cysts. Symptoms can include:
    • pain during sex
  • Pelvic inflammatory disease. Symptoms can include:
    • heavy or prolonged vaginal bleeding
    • unusual or foul-smelling vaginal discharge
    • lower abdominal or pelvic pain
    • fever or chills
    • pain during sex
  • Perforation (Mirena getting embedded in the wall of your uterus or cervix, or piercing through it). You won’t be protected from pregnancy if this happens. Symptoms can include:
    • excessive pain or bleeding when Mirena is inserted
    • worsening pain or bleeding after Mirena is inserted
    • not being able to feel the threads of Mirena
  • Expulsion (Mirena partially or fully coming out of your uterus on its own). You won’t be protected from pregnancy if this happens. Symptoms can include:
    • pain or bleeding after Mirena is inserted
    • not being able to feel the threads of Mirena
  • Severe allergic reaction.*

For more details, you can refer to this article about Mirena’s side effects.

* For details about allergic reaction and Mirena, see “Allergic reaction” below.

ALLERGIC REACTION

As with most drugs, some people can have an allergic reaction after Mirena insertion. This side effect wasn’t reported in clinical trials of this drug. However, it has occurred since the drug was approved.

Symptoms of a mild allergic reaction can include:

A more severe allergic reaction is rare. However, it is possible. Symptoms of a severe allergic reaction can include:

  • swelling under your skin, typically in your eyelids, lips, hands, or feet
  • swelling of your tongue, mouth, or throat
  • trouble breathing

Call your doctor right away if you have an allergic reaction to Mirena, as the reaction could become severe. Call 911 or your local emergency number if your symptoms feel life threatening or if you think you’re having a medical emergency.

The Food and Drug Administration (FDA) approves prescription drugs such as Mirena to treat certain conditions. Mirena may also be used off-label for other conditions. Off-label drug use is when an FDA-approved drug is prescribed for a purpose other than what it’s approved for.

For more information about Mirena’s other uses, see the “Other uses for Mirena” section below.

Mirena is a hormone-releasing intrauterine device (IUD). It’s a form of contraception (birth control) that’s placed inside your uterus by a healthcare professional. An IUD is sometimes called a coil.

Mirena is FDA-approved to help prevent pregnancy for up to 8 years. For continued protection against pregnancy, it should be replaced after 8 years. However, your healthcare professional can remove Mirena at any time if needed.

Mirena can be used in adults and adolescents who have started their periods.

Effectiveness for helping to prevent pregnancy

Mirena is considered a highly effective form of birth control in recommendations for contraceptive use from the Centers for Disease Control and Prevention (CDC).

Clinical trials show Mirena is more than 99% effective at helping to prevent pregnancy. This means fewer than one pregnancy occurs in every 100 people who use Mirena each year. For more information on how Mirena performed in clinical trials, see the drug’s prescribing information.

Mirena and children

Mirena can be used for birth control in adolescents under age 18 years who have started their periods.

To learn more about birth control options and sexual health, see our sexual health hub.

The Food and Drug Administration (FDA) approves prescription drugs such as Mirena to treat certain conditions. Mirena may also be used off-label for other conditions. Off-label drug use is when an FDA-approved drug is prescribed for a purpose other than what it’s approved for.

For more information about Mirena for helping to prevent pregnancy, see the “Mirena for birth control” section above.

Mirena for heavy menstrual bleeding

Mirena is a hormone-releasing intrauterine device (IUD). It’s a form of contraception (birth control) that’s placed inside your uterus by a healthcare professional.

In addition to its use for birth control, Mirena is also FDA-approved to treat heavy menstrual bleeding. For this use, it can be used for up to 5 years in people who want to use an IUD for birth control.

For continued treatment of heavy menstrual bleeding, Mirena should be replaced after 5 years. However, your healthcare professional can remove Mirena at any time if needed.

Mirena can be used in adults and adolescents who have started their periods.

Heavy menstrual bleeding explained

With heavy menstrual bleeding (also called menorrhagia), you have unusually heavy or prolonged periods. For example, you may:

  • have periods that last longer than 7 days
  • have bleeding that soaks through one or more tampons or pads every hour for several hours in a row
  • pass large blood clots
  • need to use more than one period product at a time
  • need to change your protection during the night
  • have long lasting period pain

Heavy periods can interfere with your daily life and emotional well-being. They can also raise your risk of anemia (low red blood cell count). Anemia can cause weakness, fatigue, and shortness of breath.

To learn more about women’s health, see our women’s health hub.

Effectiveness for heavy menstrual bleeding

Mirena is an effective treatment for heavy periods. It typically reduces menstrual blood loss after the device has been in place for about 3 to 6 months. It can make your periods lighter, shorter, or even stop altogether. For information on how Mirena performed in clinical trials, see the drug’s prescribing information.

According to the manufacturer, several guidelines recommend a levonorgestrel-releasing IUD, such as Mirena, as a treatment option for heavy menstrual bleeding.

Mirena and children

Mirena can be used to treat heavy menstrual bleeding in adolescents under age 18 years who have started their periods.

To learn more about your periods and birth control options, see our women’s health hub.

Other drugs and devices are available that can be used to help prevent pregnancy or treat heavy periods. Some may be a better fit for you than others. If you’re interested in finding an alternative to Mirena, talk with your doctor. They can tell you about other medications that may work well for you.

Note: Some of the drugs and devices listed here are used off-label to treat these specific conditions. Off-label drug use is when a drug that’s approved by the Food and Drug Administration (FDA) is prescribed for a purpose other than what it’s approved for.

Alternatives for helping to prevent pregnancy

Examples of other forms of birth control include:

  • other intrauterine devices (IUDs) that release levonorgestrel, such as Skyla, Kyleena, Liletta
  • the copper IUD (Paragard)
  • medroxyprogesterone injection (Depo-Provera)
  • etonogestrel implant (Nexplanon)
  • vaginal rings, such as:
    • ethinyl estradiol/etonogestrel vaginal ring (NuvaRing, Haloette, Eluryng)
    • ethinyl estradiol/segesterone acetate vaginal ring (Annovera)
  • patches, such as:
    • ethinyl estradiol/norelgestromin (Xulane)
    • ethinyl estradiol/levonorgestrel (Twirla)
  • combination pills (containing estrogen and progestogen), such as:
    • ethinyl estradiol/norethindrone (Junel, Nylia, others)
    • ethinyl estradiol/drospirenone (Yaz, Loryna, Nikki, others)
    • ethinyl estradiol/levonorgestrel (Altavera, Daysee, Seasonique, others)
  • progestogen-only pills, such as:
    • norethindrone (Camila, Errin, Nor-QD, others)

Alternatives for heavy menstrual bleeding

Examples of other drugs that may be used to treat heavy periods include:

  • birth control pills containing estrogen and progestogen, such as:
    • ethinyl estradiol/norethindrone (Junel, Nylia, others)
    • ethinyl estradiol/drospirenone (Yaz, Loryna, Nikki, others)
    • ethinyl estradiol/levonorgestrel (Altavera, Daysee, Seasonique, others)
  • progestogen tablets, such as norethindrone
  • nonsteroidal anti-inflammatory drugs, such as:
  • tranexamic acid (Lysteda)

Mirena is a hormone-releasing intrauterine device (IUD). It’s placed inside your uterus by a healthcare professional. Mirena is used to help prevent pregnancy and treat heavy menstrual bleeding.

Mirena works by steadily releasing a hormone called levonorgestrel into your uterus. Levonorgestrel is a synthetic form of the female* sex hormone progesterone.

Levonorgestrel released in your uterus has three main effects:

  • it thickens the mucus in your cervix, which makes it harder for sperm to enter your uterus
  • it thins the lining of the uterus, which:
    • makes it harder for a fertilized egg to implant there
    • makes your periods lighter (or, in some cases, stop altogether)
  • it makes sperm less able to move, survive, and fertilize an egg

Levonorgestrel is absorbed into the bloodstream in small amounts from the uterus. In some people, this may prevent ovulation (the release of an egg from the ovary).

All of Mirena’s effects help prevent pregnancy. Its effect on the uterus lining can also help reduce heavy menstrual bleeding.

* Sex and gender exist on spectrums. Use of the term “female” in this article refers to sex assigned at birth.

How long does it take to work?

Mirena starts working to help prevent pregnancy right after you have the device inserted. However, it typically takes about 3 to 6 months for periods to become lighter.

Mirena is a form of birth control used to help prevent pregnancy. Your doctor will not insert Mirena if you are or could be pregnant.

It’s very unlikely that you’ll become pregnant with Mirena in place. However, no form of birth control is 100% effective. There’s a very small risk that you could become pregnant while using Mirena.

If you do become pregnant with Mirena in place, there is a risk of the pregnancy being ectopic. With an ectopic pregnancy, the fertilized egg implants outside your uterus, often in one of your fallopian tubes. This pregnancy can’t continue as it typically would. Emergency medical treatment will be needed to help prevent your fallopian tube from bursting.

Contact your doctor right away if you think you could be pregnant while you have Mirena in place, or if you have symptoms of an ectopic pregnancy. These may include missing a period, unusual vaginal bleeding, or abdominal pain.

If you’re pregnant, your doctor will likely recommend that you have Mirena removed, even though this could cause pregnancy loss.

There are several risks if the pregnancy continues with Mirena still in your uterus. These risks include:

  • severe infection and sepsis (a life threatening immune response to infection)
  • pregnancy loss
  • premature labor and delivery
  • a female* fetus developing male* characteristics

If Mirena can’t be removed, talk with your doctor about the risks of continuing with the pregnancy.

* Sex and gender exist on spectrums. Use of the terms “female” and “male” in this article refers to sex assigned at birth.

Mirena and fertility

Mirena isn’t known to affect your fertility (ability to become pregnant). After you have Mirena removed, your ability to become pregnant should quickly return to how it was before Mirena.

Mirena is highly effective at helping prevent pregnancy. You shouldn’t need to use another form of birth control while you’re using Mirena.

However, Mirena doesn’t protect you against sexually transmitted infections (STIs). You should use condoms to help prevent STIs while using Mirena. If you get an STI while using Mirena, this can raise your risk of developing pelvic inflammatory disease.

Talk with your doctor if you have questions about using other birth control methods while using Mirena.

Mirena is generally considered safe to use while breastfeeding. Levonorgestrel, the hormone that Mirena releases, may pass into breast milk in small amounts. However, it’s not known to cause side effects in a child who is breastfed.

Mirena doesn’t typically affect breast milk production. However, isolated cases of decreased milk production have been reported.

If you’re breastfeeding, you may have a raised risk of perforation when Mirena is inserted. With perforation, Mirena may get embedded in the wall of your uterus or cervix, or pierce through it.

If you have excessive pain or bleeding during or after Mirena insertion, or you’re not able to feel the threads of Mirena, contact your doctor right away. These could be symptoms of perforation.

If you’re breastfeeding, talk with your doctor about the risks and benefits of using Mirena.

Here are answers to some frequently asked questions about Mirena.

Does removing Mirena cause certain side effects?

It’s possible. However, any side effects are typically mild.

Your healthcare professional will remove Mirena by gently pulling on the threads using forceps. Some people may have mild pain, cramping, bleeding, or dizziness during this procedure. To help prevent pain when Mirena is removed, your healthcare professional may recommend taking a pain reliever such as acetaminophen (Tylenol) just before removal.

If your healthcare professional can’t easily pull Mirena out through your cervix, this could be a sign that Mirena has become embedded in your uterus. In this case, your healthcare professional may use a hysteroscope (a thin camera with a light) to look inside your uterus. This can help them find Mirena and remove it.

If this procedure is needed to remove Mirena, your healthcare professional will give you pain medication or an anesthetic to make it more comfortable.

You may have mild pain or bleeding for a few days after having Mirena removed. If this continues, talk with your doctor.

Can Mirena be used for endometriosis?

The Food and Drug Administration (FDA) hasn’t approved Mirena to treat endometriosis. However, doctors sometimes prescribe Mirena off-label for this use. (With off-label use, a drug is prescribed for a purpose other than what it’s approved for.)

With endometriosis, tissue similar to the lining of the uterus grows outside your uterus, typically in your pelvic area. This tissue responds to female* sex hormones the same way the lining of your uterus does.

Mirena releases a hormone that thins the lining of your uterus. It may also reduce the growth of endometrial tissue. According to the American College of Obstetrics and Gynecology, Mirena can reduce pelvic pain associated with endometriosis.

If you’re interested in using Mirena for endometriosis, talk with your doctor. They can recommend whether this is a good option for you.

* Sex and gender exist on spectrums. Use of the term “female” in this article refers to sex assigned at birth.

Will I not have a period while using Mirena?

Possibly. Mirena thins the lining of your uterus, so it can make your periods lighter. And some people (though not everyone) find their periods stop altogether while they’re using Mirena.

However, these changes don’t happen right away. To begin with, you may have irregular periods, spotting between periods, or sometimes heavier or longer periods. Then after 3 to 6 months, any spotting is likely to stop, and most people will have lighter, shorter, or sometimes no periods.

If you have questions about your period and Mirena use, talk with your doctor.

How much does it hurt to get Mirena inserted?

You may have some discomfort, cramping, or pain when Mirena is inserted and for a short time afterward. However, this is typically mild. It can often be eased with an over-the-counter pain reliever such as acetaminophen (Tylenol).

To help prevent pain when Mirena is inserted, your healthcare professional may recommend taking a pain reliever just before your appointment. In some cases, your healthcare professional can also numb your cervix with a local anesthetic before inserting Mirena.

Tell your healthcare professional right away if you have excessive pain when Mirena is inserted. This could suggest that Mirena hasn’t been placed correctly. In addition, talk with your doctor if you have worsening pain or bleeding after Mirena is inserted. These could be signs of perforation or expulsion.

With perforation, Mirena becomes embedded in the wall of your uterus or cervix, or pierces through it. With expulsion, Mirena comes out of your uterus by itself, either partially or fully. In both of these cases, you won’t be protected from pregnancy. Your healthcare professional will check to see if Mirena needs removing or replacing.

If you have questions about Mirena insertion, talk with your doctor.

You may wonder how Mirena compares with other medications that are prescribed for similar uses. To find out how Mirena compares with Kyleena, see this article.

You may wonder how Mirena compares with other medications that are prescribed for similar uses. To find out how Mirena compares with Skyla, see this article.

As with all medications, the cost of Mirena can vary. The actual price you’ll pay depends on your insurance plan and your location.

Before approving coverage for Mirena, your insurance company may require you to get prior authorization. This means that your doctor and insurance company will need to communicate about your prescription before the insurance company will cover the drug. The insurance company will review the prior authorization request and decide whether the drug will be covered.

If you’re not sure whether you’ll need to get prior authorization for Mirena, contact your insurance company.

Financial and insurance assistance

If you need financial support to pay for Mirena, or if you need help understanding your insurance coverage, help is available.

A copay savings program is available for Mirena. For more information and to find out whether you’re eligible for support, visit the program website. Bayer, the drug manufacturer, also has a US Patient Assistance Program that may help with the cost of Mirena. Visit the program website or call 866-228-7723 for details.

To learn more about saving money on prescriptions, check out this article.

Generic version

Mirena is not available in a generic form. A generic drug is an exact copy of the active drug in a brand-name medication. Generics tend to cost less than brand-name drugs.

Below is some information on Mirena’s dosage. Mirena is only available in one strength. Everyone who uses it will receive the same dosage.

Drug forms and strengths

Mirena is hormone-releasing intrauterine device (IUD). It’s placed inside your uterus by a healthcare professional. An IUD is sometimes called a coil.

Each Mirena IUD contains 52 milligrams (mg) of the active drug levonorgestrel.

Mirena releases 21 micrograms of levonorgestrel per day (mcg/day) to begin with. Over time, the amount of levonorgestrel Mirena releases gradually decreases. After 5 years, Mirena releases 11 mcg/day. After 8 years, it releases 7 mcg/day.

Dosage for helping to prevent pregnancy

Mirena is inserted by a healthcare professional once every 8 years. It’s effective for helping prevent pregnancy for up to 8 years. For continued protection against pregnancy, it should be replaced every 8 years.

If needed, you can have Mirena removed by a healthcare professional at any time.

Dosage for heavy periods

Mirena is inserted by a healthcare professional once every 5 years. It’s effective for reducing heavy bleeding for up to 5 years. For continued treatment of heavy periods, it should be replaced every 5 years.

If needed, you can have Mirena removed by a healthcare professional at any time.

Children’s dosage

Adolescents under age 18 years can be prescribed Mirena after they have started their periods. The recommended dosage is the same for adults using Mirena. This is described above.

Will I need to use this drug long term?

Mirena is meant to be used as long-term birth control. If you and your doctor determine that Mirena is safe and effective for you, you can use it long term.

Mirena isn’t known to interact with alcohol. It’s typically safe to drink alcohol while using Mirena.

If you drink alcohol, talk with your doctor about how much is safe to drink while using Mirena.

Mirena is not known to interact with other medications, herbs, supplements, or foods. The manufacturer of Mirena didn’t look at interactions in clinical trials of the drug. Mirena works locally in your uterus, so it’s unlikely to be affected by other medications, herbs, supplements, or foods.

However, this doesn’t mean that interactions won’t be recognized in the future. For example, new drugs could be approved that interact with Mirena.

Before getting Mirena, talk with your doctor and pharmacist. Tell them about all prescription, over-the-counter, and other drugs you take. Also, tell them about any vitamins, herbs, and supplements you take. Sharing this information can help you avoid potential interactions.

If you have questions about drug interactions that may affect you, talk with your doctor or pharmacist. You can also refer to this article for details about potential interactions and when to avoid Mirena.

Mirena is an intrauterine device (IUD) that is inserted and removed by a doctor or another healthcare professional. They will do this at an office visit.

How Mirena is inserted

First, your healthcare professional will do a pelvic exam to find the position, size, and shape of your uterus. Then they’ll cleanse your vagina and cervix with an antiseptic solution. Next, they’ll slide a thin plastic tube that contains Mirena through your cervix into your uterus.

Once Mirena is in place, your healthcare professional will remove the plastic tube, leaving Mirena in your uterus. Then they’ll cut the threads of Mirena to the correct length. They may show you how to feel for the threads so you can check Mirena is still in place. You should do this about once a month.

If you can’t feel the threads, or you can feel more than just the threads, you may not be protected from pregnancy. If this happens, make an appointment with your healthcare professional to check that Mirena is still in the right place. In the meantime, use a barrier form of birth control such as condoms, or avoid having sex.

When to have Mirena inserted

Various factors affect when you should have Mirena inserted. These include:

  • whether or not you’re currently using another form of birth control
  • if you’re switching to Mirena from another hormonal form of birth control, such as the pill, patch, injection, or implant
  • if you’ve recently given birth or had pregnancy loss or an abortion

Your doctor will tell you when you should have Mirena inserted, based on your personal circumstances and menstrual cycle.

How Mirena is removed

You should never try to remove Mirena yourself.

Your healthcare professional will remove Mirena by gently pulling on the threads using forceps.

If your healthcare professional can’t easily pull Mirena out through your cervix, it may have become embedded in your uterus. In this case, your healthcare professional may use a hysteroscope (a thin camera with a light) to look inside your uterus. This can help them find the device and remove it.

If this procedure is needed to remove Mirena, your healthcare professional will give you pain medication or an anesthetic to make you more comfortable.

When to have Mirena removed

Mirena stops working to help prevent pregnancy after 8 years. It stops working to treat heavy periods after 5 years. So you should have Mirena removed after 5 or 8 years, depending on the reason for using it. If you want to keep using Mirena, a new device can be inserted right after the old one is removed in the same appointment. Mirena can also be removed at any time before this if you want to stop using it.

Sometimes, your doctor may recommend having Mirena removed if you develop certain side effects. For example, if you have a uterine or pelvic infection that’s severe, doesn’t get better with treatment, or keeps coming back, they’ll likely recommend removing Mirena.

This drug comes with several precautions. These are known as drug-condition interactions.

Before having Mirena inserted, talk with your doctor about your health history. Mirena may not be right for you if you have certain medical conditions or other factors affecting your health. These include:

  • Allergic reaction. If you’ve had an allergic reaction to Mirena or any of its ingredients, your doctor will likely not prescribe Mirena. Ask your doctor what other forms of birth control may be better options for you.
  • Pelvic or genital infections. Mirena can raise your risk of pelvic and genital infections. Your doctor will typically not prescribe Mirena if you have:
    • a pelvic infection called pelvic inflammatory disease or have had one in the past (unless you’ve had a routine pregnancy since the infection cleared up)
    • had a pelvic infection after a pregnancy in the last 3 months
    • an untreated genital infection, such as bacterial vaginosis, vaginitis, or cervicitis, until the infection has cleared up
    • a high risk of pelvic or genital infections, for example, if you have a weak immune system, misuse or have misused IV drugs, or you or your partner have unprotected sex with multiple partners

      Talk with your doctor if you have or have had a pelvic or genital infection before you start treatment with Mirena. They can help determine the best birth control option for you.
  • Uterine bleeding. If you have uterine bleeding and your doctor hasn’t diagnosed the cause, they’ll likely not prescribe Mirena. Inserting Mirena may worsen your condition, and if the condition has not been diagnosed, the effects of Mirena are unknown. Ask your doctor what other forms of birth control may be better options for you.
  • Unusual uterus shape. If you have a condition that makes your uterus an unusual shape, such as fibroids, your doctor will likely not prescribe Mirena. This condition may affect how effectively Mirena works and possibly cause an increased risk of side effects. Ask your doctor what other forms of birth control may be better options for you.
  • Cancer of the uterus or cervix. If you have uterine or cervical cancer, or your doctor suspects you might have either, they will likely not prescribe Mirena. Mirena is not recommended for use in people with this condition. Ask your doctor what other forms of birth control may be better options for you.
  • Breast cancer or other cancer sensitive to progestogens. If you’ve ever had breast canceror another progestogen-sensitive cancer, or your doctor suspects you might have this type of cancer, they’ll likely not prescribe Mirena. Mirena contains levonorgestrel, which is a synthetic type of progestogen that can increase your risk of breast cancer and breast cancer complications. Talk with your doctor about what other forms of birth control may be better options for you.
  • Liver disease or liver cancer. If you have liver disease or liver cancer, your doctor will likely not prescribe Mirena. Contraceptives containing hormones, such as Mirena, may cause severe liver issues and may worsen your condition. Ask your doctor what other forms of birth control may be better options for you.
  • Risk of blood clots. Mirena may cause blood clots and stroke. If you have a blood disorder that raises your risk of blood clots, or you take an anticoagulant medication (blood thinner), talk with your doctor. They can recommend whether Mirena is safe for you.
  • Past heart attack or stroke. Mirena may cause blood clots and stroke. If you’ve had a heart attack or stroke, talk with your doctor. They can recommend whether Mirena is safe for you.
  • High blood pressure. Mirena can increase blood pressure. If you have high blood pressure, talk with your doctor. They can recommend whether Mirena is safe for you.
  • Migraine. If you have a history of migraine, talk with your doctor. They can recommend whether Mirena is safe for you.
  • Pregnancy. Mirena is used to help prevent pregnancy, and your doctor will not insert Mirena if you are or could be pregnant. Mirena should not be used as emergency contraception (birth control). If you become pregnant with Mirena in place, this may lead to risks for you and a developing fetus. For more information, see the “Mirena and pregnancy” section above.

    If you’ve recently been pregnant, you may have a raised risk of perforation* when Mirena is inserted. You may also have a raised risk of expulsion (Mirena coming out of your uterus on its own). Talk with your doctor about these risks if you have Mirena inserted within 6 weeks of giving birth or having an abortion.
  • Breastfeeding. It’s typically safe to use Mirena while breastfeeding. However, if you’re breastfeeding, you may have a raised risk of perforation* when Mirena is inserted. For more information, see the “Mirena and breastfeeding” section above.

* With perforation, Mirena may get embedded in the wall of your uterus or cervix, or pierce through it.

Note: For more information about the potential negative effects of Mirena, see the “Mirena side effects” section above.

Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.