Does Mirena need removed for hysteroscopy?

[Charlock]

Just wondering how they can take samples/do hysteroscopy with a Mirena in situ. Do they take it out and put it back? Daft question perhaps.

Mine have usually been replaced there and then.

@Abra1t so they give you a new one? I've only had it 15 months.

If they need to remove it they will replace it unless there is a reason they can't.

I’d only had one of mine in for about six months when it came in.

But I was a bit of a hysteroscopy frequent flyer for a few years.

@Abra1t oh dear, that can't have been fun. Hope you're okay now. Any advice? I'm quite nervous about it. Always been okay with smears and coil insertions.

I have had six and they haven’t been fun but I can’t say they have been desperately painful. More lip-biting as the probe goes through cervix and then ok. I usually had a bit of local anaesthetic on the cervix. If you’ve been ok with the other procedures, you might find it the same: not the what you’d choose but bearable. I actually found having a couple with general anaesthetic more of a nuisance. But every woman is different! I found I could put myself into a kind of suspended animation, imagining myself on a beautiful beach, smelling the flowers, hearing the waves, etc, and distract myself.

eventually I had a total hysterectomy, and have done very well ever since, can’t fault my NHS treatment.

GOOD LUCK! I’m sure you’ll find the doctors and nurses are kind and sensitive.

They should have explained when the procedure was suggested.

When are you having it?

I think they could do a biopsy with a Mirena in place (I've had a biopsy on its own and that was really simple and quick, not in a theatre.)

But if they need to get the camera in I think the Mirena would come out and they'd fit a new one.

@JinglingSpringbells I'm scheduled for 22nd Feb. Looong story involving complaint to NHS, second opinion, Newson blah. I had consultant appointment in Nov, and I'd been having some bleeding/spotting since adjusting my dose, and it was agreed that if it didn't resolve after 3 months I would get investigations. It didn't fully so the referral was done via the secretary therefore no opportunity for explanations/questions. At the time she said a scan and samples because the Mirena casts a big shadow? So maybe the intention is that unless anything shows up in scan that would warrant hysteroscopy i.e. polyp, fibroid etc. Lurching between it's prob just combo of my HRT, the Mirena and peri fluctuations versus something scary. I never had breakthrough bleeding at all when I was on cyclical Utro but since Mirena 15 months ago little in the way of defined periods and more sort of unpredictable and light/spotting on and off. Think the expectation was Mirena would just stop everything but not with me it seems.

I’ve had 2 hysteroscopies and biopsies with a Mirena in.

I had mine inserted a year ago and I also have dramatically less bleeding but I still have days of spotting. I had hoped that the bleeding would stop completely but I will take this over the situation before where I went to sleep with towel on bed, pad and tampon.

@BoohooWoohoo thanks. I think if I knew it was just hormone/Mirena related I could accept it although it is annoying.

To reassure you @Charlock the stats for anything sinister for women on HRT who have spotting is tiny (far less than post meno women with bleeding.)
And the Mirena is used as a treatment for hyperplasia.

Have they checked the position of it? If it's dropped out or come down too far, you can get spotting with any coil.

They tend to leave small fibroids and polyps alone anyway as they can come back again. In women in peri they are rarely serious but they can tell a lot from a scan now.

Thanks very much @JinglingSpringbells this is all super helpful to know.

I had a routine smear test last summer and nothing was said about position. Could it have moved? At that time I wasn't bleeding. I've been quite aware of my threads sometimes recently, and when I've checked them they seem to me quite long but maybe that's normal. I've had to move them to the side sometimes to get more comfy. Is that normal?

Could having a retrofitted uterus be an issue? Though that doesn't make sense as I had a few months with no significant bleeding last summer. Who'd be a woman ... honestly.

I had a mirena fitted during a hysterscopy in Jan 2023.
I then had a follow up hysterscopy in Jul 2023, during which they also took a biopsy. They didn't remove the mirena to do this.