Mirena IUD and Bleeding

MirenaMirena is an intrauterine device (IUD) that is fitted by a doctor and inserted into the womb, where it can remain for up to five years. Mirena is ultimately recommended for women who have already had at least one child. Mirena prevents pregnancy by continually releasing specific hormone levels at a rate of 20 micrograms per day.

Bleeding due to Mirena is the most common side effect among those implanted with the Mirena device. Manufacturers of Mirena note that bleeding and spotting may increase during the first three to six months following insertion. Patients may continue to experience the irregular periods and Mirena bleeding after the first three to six months. Mirena bleeding can sometimes be so severe that women must undergo surgeries to remove the device. Injuries that lead to Mirena bleeding can also result in infertility.

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Mirena can alter a women’s bleeding pattern resulting in:

  • Spotting
  • Irregular bleeding
  • Heavy bleeding
  • Oligomenorrhea, or infrequent menstruation resulting in only four to nine periods a year
  • Amenorrhea, or the absence of menstruation in a women of reproductive age

Mirena Bleeding Complications

The U.S. Food and Drug Administration has received over 45,000 reports of women suffering from IUD bleeding complications, ranging from minor to life-threatening. Oligomenorrhea, or infrequent menstruation, should be monitored for the first year after an IUD is implanted to ensure it does not result in pregnancy. Typically, Amenorrhea develops in approximately 20 percent of Mirena users by their first year of use.

Bleeding complications from Mirena include:

  • Inflammation
  • Infection
  • Device shifting into the abdomen
  • Perforation (puncturing) of the intestinal wall
  • Embedding in the uterine wall
  • Ovarian cysts
  • Pregnancy resulting in a miscarriage

Mirena Bleeding Caused by Perforation

In some cases, Mirena can be pushed through the uterine wall during the insertion procedure. This is known as Mirena perforation and can cause moderate to severe bleeding. The risk of Mirena perforation during insertion typically depends on the practitioner’s specific level of skill.

Doctors that are more experienced in Mirena insertion on average have one perforation per 1,000 insertions, although sometimes this rate can be less. The exact statistics of doctors who are unfamiliar with Mirena insertion protocol are not currently known. Mirena perforation during postpartum insertions is more likely.

It is recommended that patients wait at least six to eight weeks following the birthing process to begin using Mirena. Mirena bleeding caused by perforation can damage internal organs. In some cases surgery is required to remove the Mirena device. Penetration of the uterine wall or even the cervix can also occur within Mirena users. Mirena uterine wall penetration may not be detected until sometime after insertion.

Delayed Mirena Perforation Diagnosis

Delayed detection of Mirena perforation can lead to several complications including:

  • Migration outside the uterus
  • Adhesions (internal scar tissue)
  • Peritonitis (inflammation of the abdominal walls)
  • Perforation of the intestines
  • Intestinal obstruction
  • Abscesses
  • Erosion of adjacent bladder

Mirena users are encouraged to monitor any bleeding or spotting that occurs following insertion of the Mirena device. Mirena bleeding could be an indication of serious complications. Serious Mirena complications can signify that the device is not working properly, which places the patient at increased risk of pregnancy.

Show Sources
  1. "MedWatch The FDA Safety Information and Adverse Event Reporting Program." U.S. Food and Drug Administration. 19 06 2009. Web. 21 Apr 2013. http://www.fda.gov/Safety/MedWatch/SafetyInformation/Safety-RelatedDrugLabelingChanges/ucm121936.htm
  2. "Mirena Data Sheet ." Bayer NZ. Bayer Health Care , 11 12 2009. Web. 21 Apr 2013. http://www.bayerresources.com.au/resources/uploads/DataSheet/file9503.pdf
  3. World Health Organization (1987), Mechanisms of action, safety and efficacy of intrauterine devices: technical report series 753., Geneva.