Mirena and a bicornuate uterus

A bicornuate uterus develops with a divided upper uterine shape, sometimes described as heart-shaped. The internal space may not be a single cavity, and the device is designed for placement in one uterine cavity. If the shape or cavity is not understood, placement may be difficult and the device may not provide dependable protection or bleeding control.

An ultrasound or pelvic MRI may help define the cavities and distinguish a bicornuate uterus from other uterine shapes. The decision depends on the anatomy, symptoms, contraception needs and clinician experience.

Tell your gynaecologist about previous imaging, pregnancy history, pelvic pain, bleeding and any prior device problems. Ask whether the device would sit fully within one cavity, whether another method is safer for your anatomy, and what follow-up imaging or examination is planned. Do not arrange insertion without an assessment of the uterine cavity.

After insertion, seek prompt advice for severe or persistent pain, heavy bleeding, fever, unusual discharge, pregnancy symptoms or concern that the device has shifted. These symptoms need examination because position cannot be confirmed from symptoms alone.

Ask which imaging best maps your uterus, whether both cavities communicate, where the device would be placed, how its position will be checked, and which non-intrauterine options could meet your goals.