To think the Mirena IUD aid an amazing invention

[avocadochocolate]

Got my 3rd Mirena fitted today.

First one was so I did not have to set my alarm in the night to change my sanitary protection. I was bleeding for 7 days every 14 days. I went from that to no periods at all.

DM has the same problem in the 1980s and has to have a hysterectomy. I'm so happy to have avoided major surgery.

Now the Mirena is part of my HRT and it is the safest way to deliver the progesterone element.

Posting because I have seen a lot of posts from people who have not got on with it and I guess you are more likely to post if you are dissatisfied. The doctor I saw today inserts 400 a week!

You should know your options. Mirena are not made of miracles

Sure, SinkGirl, you can think that a few online bad experiences are representative. But actually the huge majority of success cases who don't talk about their IUD online should be a bigger selling point. Some people don't like the Pill, some people don't like condoms, some people don't like cheese. But MOST people who get the Mirena, according to statistics, love it and keep it, so yes, we are in the majority.

1. I never said that you weren’t the majority. I’m saying it’s not just a “few bad cases” and what “statistics” are you referring to? If they factor in retention of reported side effects then that can’t be trusted when these things are impacted by the actions of those prescribing it.

2. If there’s a chance that a medical treatment may cause you severe, life-impacting side effects and you may have a battle getting it removed, women should know that upfront. It’s not what they are told, however.

3. Women should also know that doctors are financially incentivised to prescribe them. This should be transparent.

I don’t really understand you’re attitude - I think it’s great that they work so well for some women, but I also think that women need to be aware of the potential side effects, and of the fact that doctors may refuse to remove it or be unable to remove it on request. Why wouldn’t you want women to have this information?

I had minera coil for 7 years and was only pissed that the doctors after years of asking for some relief from the extremely heavy periods took so long to advise me about it. I had to carry a change of clothes for a week every month. The coil worked for me I'm sorry it doesn't work for some but when it does its fantastic. I was told by my doctor to check it routinely when I checked my breasts to make sure it hadn't moved which I did and never had any problems.

Can't be bothered with a tiny minority of issues with a life-changing medication, sorry, just as I don't engage with anti-vaxxers.

I'm not aware of GPs being incentivised to provide Mirena, but I now live in USA where frankly anything goes. Is this actually a thing in the UK? And if it is - I'd like to see proof - I'd wonder if it's because the IUD is actually protective against other pregnancy-related issues, and therefore helpful overall to the NHS.

I love mine. I always had terribly heavy periods and 6 months after having it fitted, my periods stopped. Was a wonderful relief.

Absolutely awful for me but I know they do work for some people.

I'm on my third. First was fab. I have adenomyosis and the second stopped working for bleeding after about 18 months so now on third get heavy loss and excruciating pain so think my womb is just too resistant now

GPs do not get incentives to arrange Mirena. Of course if they do fit one they are paid for the procedure due to the training, time and costs involved, but often the GP will be salaried so that money will go to the practice, not to the individual GP.

Years ago offering Long Acting Reversible Contraception (coils, implants, injections) was included in the Quality and Outcomes Framework. If the practice recorded that they offered a certain percentage of patients on contraception LARC, the practice got extra money. Money paid to the practice, not an individual GP. And if the patient said "no thanks" the GP still recorded that they had offered it, and that counted towards the percentage. So the aim was to ensure women knew about LARC (which is more effective than preventing pregnancy than pills) rather then getting them to actually use it.

LARC is no longer in QOF so GP practices no longer get any extra money for offering LARC, however many still choose to offer it.

often the GP will be salaried
Most GPs are not salaried - 72% we’re not salaried as of 2015
spiral.imperial.ac.uk/bitstream/10044/1/48352/2/Salaried_GP.pdf

The QOF including LARC was absolutely linked to individual GP pay, with around 25% (if i remember rightly) of GP pay coming from performance pay linked to QOF

But even if it weren’t, financial benefits to the practice mean pressure on doctors to prescribe or advise a certain way. I’ve had this exact conversation with GPs through work many times.

What all these approaches to LARC a decade ago were referring to (like this: www.guidelinesinpractice.co.uk/womens-health/all-women-requiring-contraception-should-be-offered-larcs/309571.article) is forced compliance (eg. once you give a woman the injection or fit the IUD, she can’t choose to stop it in the short term).

When it comes to contraception I have a real issue with forced compliance, especially when doctors refuse to remove IUDs that are causing significant pain or other debilitating symptoms.

Can't be bothered with a tiny minority of issues with a life-changing medication, sorry, just as I don't engage with anti-vaxxers

How dare you compare women recounting their experiences of a medical treatment to anti-vaxxers? That’s despicable.

Nearly 100,000 complaints to the FDA about the Mirena from 2000-2018 (and that’s just america)

rewire.news/article/2018/12/04/hundreds-of-patients-are-claiming-the-mirena-iud-causes-a-neurological-disorder-but-experts-say-more-research-is-needed/

Mirena is also the IUD with the most complaints to the FDA. Since the FDA’s initial approval of Mirena in 2000, the federal agency has amassed 95,008 reports about the drug in its Adverse Events Reporting System, or FAERS. The number of complaints have risen as the IUD has gained popularity. Since 2007, complaints have increased tenfold. More than a third of the reports cite expulsion of the Mirena from the uterus (32,084) or dislocation of the device (10,793). Other complaints include genital or vaginal hemorrhaging (12,144) and pain (6,122). There were also reports of pregnancy using Mirena (3,971)

Study showing that Mirena is linked to a higher incidence of intracranial hypertension (ICH) but that more research is needed
www.ncbi.nlm.nih.gov/pmc/articles/PMC4519742/

As I said before, it’s great if it works for you, but I don’t know how anyone can be so dismissive - aren’t you concerned about it being handled correctly if you end up with a problem?

I think this sums up the issues pretty well
thefemedic.com/news/half-women-report-serious-trouble-contraception/

But the previous QOF incentive was to offer LARC, not to fit it. "Would you be interested in a coil or implant, which is more effective than your pill?" "No I want to stay on the pill". End of conversation, box ticked. If the GP said more to promote LARC, it wouldn't have been for any financial benefit for the practice. In any case, the LARC requirement has been removed from QOF now. Many GPs are critical of QOF (either the whole scheme, or some of the indicators incentivised through it).

If the GP gets paid to fit Mirena it must still be a massive saving to the NHS as a whole compared to the cost of hysterectomy which was the alternative for me and many others.

I love mine. Immediate drop from 3-4 migraines a month, down to 1 at ovulation.

No more horrible painful flooding periods. A bit of a twinge on e a month.

Life changing.

I have friends who swear by them. Me, nope. Hated it. Talked into it by several HCPs. Had one when I'd had my second child. Bled constantly and fairly heavily for 9 months (had it fitted 5 days after stopping a month of bleeding from giving birth) so pretty much 10 months of bleeding. Dr wouldn't take it out at the 4 month mark when I complained about the bleeding and the constant pain I was in "it takes time to settle down". At the 6 month mark where I was exhausted and felt drained and in pain it was to be expected as I had two children under 2. At the 8 month mark i went back and complained of all of this and demanded it be taken out they tried to tell me to give it a bit longer. I refused point blank. Blood tests showed I was quite anemic. Funny to think that 10 months bloid loss might do that to a person.

So...mirena coils that work and make you better, great. Excellent invention that should be used to help womens lives be better. BUT change the the aftercare. If a woman isnt happy with it just let her have it removed not cajole and persuade her to try for longer. I think that's one of the problems people have.

@TheFrenchLieutenantsMonkey That was my main bug bear, no medical practitioner wanted to listen to me, dismissed all my side effects, anything to avoid blaming it on the Mirena.

Never had acne on my back in my entire life until a couple of weeks after the mirena was fitted. Same goes for thick, coarse hair on my jawline, the greasy hair that I had to wash daily, the spots that appeared on my temple. The rapid weight gain too. All brushed aside and told 'it will settle down'.

Aftercare is one of the things that put me off having the copper coil after my experience with mirena, however as I wanted to avoid hormones after a lot of should searching I decided to have it fitted.

GP's ignore women's complaints, the number of times I went to the GP with excruciating migraines, anxiety, mood swings- I was told repeatedly it had nothing to do with the mirena. It was never noted or reported so I imagine the figures saying most women have no side effects are very, very wrong.

I had one removed on Monday after two months.

Sometimes I felt fine and thought, yeah this is good, I feel so in control. It also increased my sex drive.

Others I felt angry and ridiculously emotional. Apparently this dies down after three months. I didn’t like it.

I also put on some weight as I was hungrier!

What put me off though was a) my hair loss got worse and b) after a month I had the heaviest bleeding I have ever had, so heavy I bled through three sanitary towels in 15 minutes and took myself to a&e thinking my uterus had ruptured, to be told “oh that can happen”.

All I was told was that my periods would “probably stop”.

I wasn’t told about ovarian cyst risk either which, haven’t had one, would have put me off.

So, a mixed experience for me but I would not rule out getting one again if I had heavier periods or as part of HRT.

Totally agree with you OP! I had my first one 20 years ago,at the age of 35. After having suffered years of heavy,painful periods,it literally transformed my life. Within 3 months,I went from having 7 - 8 days of bleeding every month,accompanied by severe pain for 2 days before and for the first 5 or 6 days,to very light bleeding (so light that I went from using a super plus tampon AND a sanitary towel to just using a mini tampon) with no pain at all.
I had my second one 'installed' 6 years later,and apart from the initial bleeding for a couple of days after the fitting,again was only experiencing very light bleeding,and that wasn't even every month.
By the time I had my third one,6 years later at the age of 47,I had stopped having any bleeding at all. I still have that one,nearly 8 years later. My doctor said it could stay in place for 10 years,as I wasn't relying on it for contraception purposes now. I've not had any bleeding for 10 years now,and am assuming that I've gone through the menopause (I'm 55) but I've had no symptoms,apart from a few hot flushes about 3 years ago. I wonder if it has helped with having an easy menopause?

I wonder if it has helped with having an easy menopause?
i know lots of women who have kept it throughout the menopause, as I did. I had horrendous hot flushes but no other symptoms so perhaps it did help.

@Hortz

This is the main reason yes
They have tried it with me twice to avoid surgery. I’ve had ablation surgery and then a second Mirena which also failed so I have no options left

When it was working it was ok, I still had periods but the first one I had my partner at the time said I was less miserable when it fell out compared to when it was in 🤷🏻‍♀️

Yes GP’s get paid for fitting them

I had a horrific time which ended in a horrific womb infection and now permanently managed periods because of the damage. Horrendous! And they still tried to say it wasn’t the damn thing so I pulled it out myself!

I’m so glad I had my children before I tried it because I honestly don’t think my womb would habit them now