Bleeding patterns in Mirena users

Abstract

22 Mirena IUDs have been inserted at Central Nottinghamshire Healthcare (NHS) Trust family planning clinics. Except for prolonged heavy bleeding in 2 women, observed bleeding patterns and other side effects have been as expected, that is, lighter bleeding, usually pain free, with some irregular spotting. After hysteroscopy and laparoscopy showed a normal uterus in August 1996, a Mirena was inserted in another area in a 30-year-old para 2 woman who had heavy bleeding on COC. The patient presented in January 1997 after 1 month of heavy bleeding. Upon inspection, the device's threads were protruding through the cervix and the woman removed it easily herself. The other case, a 29-year-old para 2 woman, had the Mirena inserted in October 1996. She had a history of heavy painful periods and recurrent vaginal thrush on COC. The device was checked after routine sound to verify its proper placement. The woman had bled constantly since fitting at check-up 5 weeks later, but the blood flow was painless and getting lighter. All was normal upon examination, but the threads were trimmed because they appeared to be long. No problems were reported at check-up 5 months later. However, seen 10 weeks later and complaining of heavy, constant, painful bleeding, it was decided to remove the Mirena, which was almost certainly sitting in the cervical canal at the time.