A Mirena Intrauterine Device (IUD) is a contraceptive device which releases progesterone (Levonorgestrel) hormone gradually in the womb, to protect against pregnancy. It is also effective in reducing bleeding and pain that comes with menstrual periods. A Mirena IUD can be used for up to five years.
Why does a young person need a Mirena IUD?
A child or young person may need a Mirena IUD for management of heavy menstrual periods, painful periods or as a birth control measure.
What to expect with a Mirena IUD insertion
Before the procedure
The patient may need to fast (not have any food or drinks) before the procedure as they will likely be given a general anaesthetic (medicine that makes them go to sleep).
Some patients, including some females who are sexually active, may not require general anaesthetic. The procedure can be done under sedation in day medical unit for these patients.
If you are coming into hospital from home, the patient and/or the patient’s parents will be told when to stop eating and drinking.
Feel free to ask the doctor performing the test any questions you may have. The doctor will be from the Gynaecology Department and may not be the patient’s treating specialist.
A urine pregnancy test will also be completed prior to a Mirena IUD being inserted. This must occur before the IUD is inserted.
During the procedure
A parent or guardian may come in to the theatre area with the patient until they are asleep.
After the general anaesthetic is given, the patient will be positioned on their back, with their legs up.
The doctor will insert the Mirena IUD through the vagina into the uterus with the use of an inserter. This means no incisions (cuts) are needed on the outside of the skin or inside the vagina.
This procedure takes approximately 10 to 15 minutes, however if the patient is placed under general anaesthetic, they will be monitored for a few hours in post anaesthesia recovery room until the effects of general anaesthesia have subsided.
After the procedure
The patient may experience some strong period-like cramping for the next 48 hours after insertion, sometimes longer. If this does occur, you can continue to administer paracetamol, naproxen or ibuprofen, as directed by the doctor.
The patient may also experience irregular bleeding, spotting and some menstrual cramps in the first six months after a Mirena IUD insertion. This is very common and will usually progressively settle after the first six months.
If irregular bleeding, spotting and some menstrual cramps don’t subside after the first six months, please contact your clinician or GP.
If the patient was previously using other oral hormonal methods for heavy menstrual bleeding, it may help to continue these for two to three months after a Mirena IUD is inserted.
Following the procedure, the patient will be discharged home a few hours afterwards, once they are comfortable and recovered from anaesthesia.
What are the risks?
Every anaesthetic carries a very small risk of complication, which will be explained to you by the anaesthetist (doctor giving the anaesthetic).
The Mirena IUD insertion can sometimes cause minor cramping for two to four days after the procedure. Irregular periods and/or minor cramping may also occur for the first six months after the procedure. The risk of serious complications such as infection, bleeding, expulsion (the Mirena IUD coming out by itself) or damage to the uterus is low.
Care at home
Simple pain killers such as paracetamol, naproxen or ibuprofen can be given at home and the patient can return to normal activity from the next day.
If the patient experiences severe cramping pain which is not relieved by simple pain killers such as paracetamol, naproxen or ibuprofen, fever or severe bleeding or if you are worried for any reason, call the treating hospital, or 000 in an emergency.
Follow-up
The patient will usually be scheduled for a follow up appointment with their treating team after three to six months. However, there are any concerns before this, please make an appointment with your GP.
Key points to remember
- a Mirena IUD may need to be inserted for various reasons, not only for contraceptive use
- it is a very safe procedure
- it is usually done under general anaesthetic in children and adolescents
- ask your doctor any questions you may have
For more information
Common questions our doctors are asked
How long will it take for periods to become lighter?
It may take up six months for the patient’s periods to become lighter. Sometimes irregular bleeding can last for the first six months. If this continues, please consult with the treating team, or GP.
How long will it take to work as a contraceptive?
The Mirena IUD is effective in preventing pregnancies after seven days, alternative contraception must be used until then. Condoms should always be used to prevent the risk of sexually transmitted infection.
Will the procedure hurt?
The patient may experience some strong period-like cramping for the next 48 hours, sometimes longer, and you can continue to administer paracetamol, naproxen or ibuprofen, as directed by the doctor.
Developed by The Royal Children's Hospital Gynaecology department. We acknowledge the input of RCH consumers and carers.
Developed April 2021.
Kids Health Info is supported by The Royal Children’s Hospital Foundation. To donate, visit
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