Mirena is a hormonal intrauterine device (IUD), a T-shaped plastic frame placed in the uterus for long-term birth control. It releases a progestin hormone, levonorgestrel, which thickens cervical mucus, thins the uterine lining, and may partly suppress ovulation to prevent pregnancy for up to eight years. Beyond contraception, Mirena is FDA-approved to manage heavy menstrual bleeding for up to five years and can alleviate cramping and pain from conditions like endometriosis. Regular checks ensure its continued effectiveness.
How to Check Your Mirena
Begin by thoroughly washing your hands with soap and warm water, paying attention to cleaning under your fingernails, to minimize infection risk. Finding a comfortable position, such as squatting or sitting, can make it easier to reach your cervix.
Gently insert your index or middle finger into your vagina. Guide your finger upwards until you feel your cervix, which typically feels firm and slightly rubbery, similar to the tip of your nose. After locating your cervix, carefully sweep your finger around its surface to feel for the thin, thread-like strings. Do not pull on the strings during this process.
What to Expect When Checking
When you check your Mirena, the strings should feel like thin pieces of fishing line protruding slightly from your cervix. These strings are usually 1 to 2 inches (2.5 to 5 cm) long; consistent length indicates correct IUD position. The strings are typically trimmed to a specific length during insertion to rest high in the vaginal canal.
Feeling the strings confirms the Mirena is likely still in place. While you might not see the strings during a self-check, being able to feel them indicates proper placement. The strings are also essential for a healthcare provider to remove the device when needed.
When to Check and Why
Check your Mirena strings once a month. Many healthcare providers recommend performing this check after your menstrual period, as the cervix may sit lower, potentially making the strings easier to locate. Checking regularly helps you become familiar with how the strings normally feel.
Monthly checks are important because an IUD is most likely to shift or be expelled during menstruation, especially in the first few months. Regular checks can help identify any changes early, ensuring continuous protection against pregnancy. After the initial months, checking every few months may be sufficient.
Signs of an Issue and Next Steps
Signs of a potential Mirena issue require immediate attention. If you are unable to feel the strings at all, or if they feel significantly longer or shorter than usual, it could suggest the IUD has moved. If you can feel the hard plastic part of the IUD against your cervix, it has likely shifted.
Other concerning symptoms include new or worsening pelvic or abdominal pain, unusually heavy or prolonged bleeding after it had lightened, or abnormal vaginal discharge that is smelly or has an unusual color. If you experience any of these signs, contact your healthcare provider promptly. Until your provider can confirm the IUD’s placement, use an alternative non-hormonal birth control method, such as condoms, as the IUD may no longer be effective.