Sudden heavy bleeding with Mirena after two years: what to know

A hormonal IUD often changes bleeding, but a new pattern after a stable period can have several explanations. The device may have shifted or may be nearing the end of its approved duration for your specific use. Fibroids, adenomyosis, endometriosis, endometrial polyps, or endometrial hyperplasia can also contribute to heavy bleeding. Perimenopause or polycystic ovary syndrome may alter cycles, and repeated blood loss can contribute to iron deficiency anaemia.

Check whether the strings feel different, missing, or longer than before, but do not pull them or try to reposition the device. Pregnancy is uncommon with an IUD but needs consideration if your period is unusual, especially with pain.

Arrange a clinician review rather than assuming Mirena caused the change. Tell them when the heavier bleeding began, whether you have cramps or discharge, and whether the strings have changed. They may check the device, perform a pregnancy test, examine the pelvis, arrange ultrasound, or test for anaemia.

Use pads to monitor flow and keep the device information available. Do not remove the IUD yourself or start extra hormones without medical advice.

Seek urgent help for rapidly increasing bleeding, faintness, severe or one-sided pain, fever, or feeling very unwell. Urgent assessment is also needed if pregnancy is possible and bleeding occurs with pain or dizziness.

Ask whether the IUD is in the right position and whether its duration or indication affects your options. Ask about ultrasound, anaemia testing, alternative causes, and what symptoms mean you should seek same-day care.