Spiral Mirena with endometriosis
As you know, one of the reasons for the development and aggravation of endometriosis is abortion. Therefore, for women suffering from this disease, it is important not only quality treatment, but also reliable contraception.
Spiral Mirena successfully solves these two tasks: protects against unwanted pregnancy and has a therapeutic effect. The high efficiency of the spiral for endometriosis is beyond doubt, therefore, gynecologists use it quite often in their practice.
Content:
- The mechanism of action of the spiral
- What is the Mirena spiral?
- Who is the installation of the Mirena spiral shown to?
- Contraindications to the use of the Mirena spiral
- Pros of using Mirena
- Side effects from using Mirena
- Can I get pregnant after removing the coil?
- Important recommendations
The mechanism of action of the spiral
Mirena is a hormonal contraceptive that works topically. The coil contains small doses of levonorgestrel. This substance belongs to the group of gestagens.
Levonorgestrel enters a woman's body in a metered dose and has the following types of therapeutic and contraceptive effects on it:
- Suppression of estrogenic activity against the background of endometriosis, due to which a pronounced antiproliferative effect is achieved.
- Suspension of the ovulation process while maintaining ovarian function and normal levels of estradiol in the blood.
- Suppression of the function of the corpus luteum.
- Deterioration of blood flow in the endometrium.
- Thickening of mucus in the cervical canal.
- Changes in the structure of the inner uterine wall, which leads to the appearance of abundant menstruation or their absolute absence.
Mirena not only treats endometriosis, but also prevents a woman from getting pregnant. Therefore, the coil is an excellent solution for those patients with endometriosis who wish to protect themselves from conception.
The spiral is installed for 5 years, which allows you to get rid of the need to take oral contraceptives and use barrier methods of contraception for a sufficiently long period. This is very convenient for women who are not planning a pregnancy. However, it should be understood that Mirena is not just a spiral, but also a drug, moreover, of a hormonal group. Therefore, you should not make your own decision about its installation. It is necessary to consult with a doctor and find out if there is a need to introduce such a drug into the body. It is important to assess all possible risks and complications from using Mirena.
What is the Mirena spiral?
In appearance, the spiral resembles the letter "T". It is placed in the conductor tube. The hormone-containing core is white. An opaque membrane controls the consumption of levonorgestrel. There is a loop on one side of the spiral, which is necessary for its extraction. On the other hand, the design is equipped with shoulders, with which the spiral is fixed in the uterus.
Who is the installation of the Mirena spiral shown to?
Spiral Mirena is well suited for women who are diagnosed with endometriosis at an early stage. Pathological foci of inflammation under the influence of a hormonal drug will gradually fade away and will reverse development.
It is not recommended to put the Mirena spiral on those women who are planning to conceive a child in the near future.
The spiral can be installed both in patients of reproductive age and in postmenopausal women suffering from endometriosis. Wearing Mirena is possible against the background of a woman undergoing hormonal treatment, but provided that the scheme does not contain gestagens. The spiral is set for up to five years.
Experts recommend this spiral to women after undergoing surgery to remove foci of endometriosis (provided that there is no contraindication to its introduction).
Research and analysis before installing the spiral:
- General examination by a therapist.
- Examination on a gynecological chair.
- Ultrasound of the pelvic organs.
- Ultrasound of the mammary glands.
- Examination of a smear from the cervix.
- LHC smear analysis.
- Exclusion of the presence of genital infections in a woman.
Installation of the spiral. Mirena should be administered by a doctor who has experience in installing intrauterine devices. The doctor is obliged to open the package only before the direct introduction of the device into the woman's body. The entire procedure must be performed under sterile conditions. The spiral is inserted into the uterine cavity. The whole procedure is almost lightning fast and does not take more than 30 seconds.
It is allowed to install the spiral immediately after the abortion, or 6 weeks after the birth of the child.
Removing the spiral. The doctor should remove Mirena from the body. To do this, the doctor gently pulls it out by the threads, using special forceps for this purpose. When the threads are not visible due to their presence in the uterine cavity, a special traction hook is used to remove the spiral. If necessary, the cervical canal is expanded.
Contraindications to the use of the Mirena spiral
Before deciding to install a spiral, a woman must undergo a comprehensive examination. This will minimize the risks of developing side effects from the use of a contraceptive.
Contraindications to the use of Mirena are:
- Pregnancy.
- Inflammatory processes in the pelvic organs.
- Infectious diseases of the genitourinary system.
- Endometritis that develops after childbirth.
- Postponed septic abortion and cervicitis (not earlier than 3 months).
- Dysplasia of the cervix.
- Malignant tumors of the uterus and cervix.
- Breast cancer, the presence of hormone-dependent tumors in the body.
- Vaginal bleeding that has an unexplained cause.
- Fibroids.
- Liver disease in the acute stage.
It is quite logical that Mirena is not prescribed for women with individual intolerance to levonorgestrel.
Pros of using Mirena
- Elimination of painful and heavy bleeding during menstruation. During the period of using the spiral, women note that menstruation becomes scanty, or stops altogether. This happens under the influence of a medicinal substance that Mirena secretes. This effect should be regarded as positive, because by suppressing ovulation, it will be possible to get rid of the growth of new foci of endometriosis and provoke atrophy of existing proliferations. By the end of the third month of using the coil, the volume of menstrual bleeding is reduced by 88%.
- Due to a pronounced decrease in blood loss, women manage to get rid of iron deficiency anemia.
- The severity of dysmenorrhea when wearing Mirena decreases.
- During the use of the spiral, a woman will be able to forget about what menstrual pains are. They will become less and less intense every month. After a while, the painful sensations will cease to bother at all. In parallel, the pains provoked by overgrown foci of endometriosis will go away.
- The advantages of using the Mirena spiral for the treatment of endometriosis are obvious. After all, a woman does not have to take pills every day, trying not to miss the next dose of the drug.
- The spiral has only a local effect on the body. The drug hits "right on target", so a very small amount is required. In this regard, you can not be afraid of the high risk of developing side effects such as excess weight gain or problems with veins. Achieving high concentrations of levonorgestrel in the uterine cavity makes its endometrium immune to estradiol.
- A woman does not have to spend money on expensive contraceptive drugs.
- Coil installation is very simple and takes a few minutes.
- Drug overdose is excluded, since levonorgestrel is released from the capsule in continuous small portions.
Side effects from using Mirena
The most common side effect of using an intrauterine device is the appearance of spotting bleeding in the middle of the cycle. They are observed in 10% of all patients, but disappear 3 months after the installation of the device. It is also possible to form benign ovarian cysts, which over time tend to self-resolve.
Some women report a decrease in libido, deterioration of mood, increased nervousness, headaches, nausea, and back pain. Acne, breast tenderness and weight gain may occur. However, after stabilization of the hormonal background, these side effects disappear.
Can I get pregnant after removing the coil?
It has been proven that the use of Mirena does not affect fertility after its extraction. Studies have shown that after the removal of the spiral, 80% of women were able to become pregnant within a year. Therefore, one should not worry about the fact that Mirena affects the further reproductive abilities of a woman. While wearing the coil, the risk of conception is extremely low. The total pregnancy rate per year does not exceed 0.16 per 100 women.
Important recommendations
Although the use of the coil is quite well tolerated by women, nevertheless, one should not forget about its presence in the body.
If the following conditions occur, you should seek the advice of a doctor:
- Migraine-type headaches that have not previously bothered a woman.
- Deterioration of vision.
- Yellowing of the skin.
- Significant increase in blood pressure.
- Hematopoietic dysfunction. The use of the spiral must be abandoned in the event of a stroke or heart attack.
- If a woman becomes pregnant while using the coil, the device must be removed as soon as possible. Otherwise, it can lead to miscarriage. If it is impossible to accurately extract the spiral, there is a reason to consider the issue of artificial abortion.
- 1-3 months after the introduction of the spiral, a woman must visit a doctor and undergo an examination. In the future, annual observation by a gynecologist is shown.
- If, after removing the coil, a woman wants to continue using it, then the introduction of a new device is possible immediately.
- It should be remembered that the use of the Mirena spiral does not reduce the risk of contracting sexually transmitted infections.
- The spiral is not suitable for the treatment of endometriosis in an advanced stage, since its use will not bring the desired effect.
The author of the article: Lapikova Valentina Vladimirovna | Gynecologist, reproductologist
Education: Diploma in Obstetrics and Gynecology received at the Russian State Medical University of the Federal Agency for Healthcare and Social Development (2010). In 2013 completed postgraduate studies at N. N. N. I. Pirogova.
