Mirena IUD for heavy periods: what to know

Mirena releases a progestogen inside the womb. This can make the lining thinner, so there is less tissue to shed during a period. It may be considered when heavy periods interfere with daily life, cause pain, or contribute to low iron. A clinician first considers why the bleeding is heavy. Fibroids, adenomyosis, endometrial polyps, endometrial hyperplasia, polycystic ovary syndrome, and perimenopause can all change menstrual flow.

The adjustment period may include spotting, cramps, or unpredictable bleeding before a clearer pattern develops. Some people continue to have troublesome bleeding or have a reason the device is unsuitable, so a personalised discussion matters.

Tell the clinician about pregnancy possibility, pelvic pain, unusual discharge, previous womb or cervical problems, medicines, and your typical bleeding pattern. Ask how insertion will be performed and what follow-up is planned. After insertion, record flow and cramps, and learn how to check the threads if advised. Keep your follow-up appointment even if bleeding improves, because persistent symptoms may need another explanation or treatment.

Get urgent medical advice for severe or worsening pain, fever, offensive discharge, faintness, very heavy bleeding, suspected pregnancy, or a device that seems to have moved. Do not pull on the threads or try to remove the device yourself.

Ask whether the likely cause of your heavy periods has been assessed, how long an adjustment pattern may last, and which changes should prompt a call. Discuss iron testing, alternatives, and what happens if Mirena does not suit you.