Is Mirena safe for those who have yet to give birth?

Dear Reader, 

It sounds like figuring out what birth control is right for you has been a literal headache—but rest assured it doesn’t have to be. In short, Mirena, and other intrauterine devices (IUDs), are safe to use for people who haven’t given birth. When IUDs initially became available, they were recommended only for those who have given birth. Though the guidance has long changed, many people (medical professionals included!) still believe they’re only for a limited group. Research has shown that its effects don’t differ between people who have and have not given birth.  

You also reference the contraceptive implant, Implanon. While this is no longer on the market, the implant called Nexplanon is widely available and may be helpful to consider. Stay tuned to learn more about various types of progestin-only birth control options, their potential side effects, and other options for contraception. 

What is Mirena? 

Mirena is an IUD that works by being inserted into the uterus. It prevents pregnancy for five to eight years by slowly releasing a progestin hormone called levonorgestrel. The hormone changes structures in the uterus and affects sperm survival and functioning.  

Some common side effects of Mirena include: 

• Changes in menstrual bleeding 
• Stomach or pelvic pain 
• Lack of periods 
• Headache or migraine 
• Vaginal discharge 
• Inflammation or infection of the outer parts of vagina 
• Ovarian cysts 

List adapted from WebMD 

Some risks of Mirena include it going through the uterine wall (perforation) or it coming out (expulsion). In general, Mirena shouldn’t be used by anyone who’s recently given birth or is breastfeeding as it increases your risk of perforation. Further, expulsion can increase the risk of pregnancy. Becoming pregnant while using Mirena heightens the risk of pregnancy-related problems, including miscarriage, infection, early labor, and ectopic pregnancy. 

How do people experience Mirena differently? 

Mirena is safe to use by anyone regardless of birth status. The most common concerns among those who are considering Mirena include: 

• Expulsion 
• Bleeding and pain 
• Perforation 
• Difficulties with inserting the device 

However, these conditions don’t differ between people who have and haven’t given birth. Instead, age might play a more impactful role in different individual experiences with Mirena. For example, expulsion is more common among adolescents than adults. Additionally, adolescents are more likely than adults to stop using Mirena for similar bleeding patterns. Within both populations, people who have and haven’t given birth experienced these conditions similarly.  

What is Nexplanon? 

Nexplanon is another long-acting reversible contraception (LARC) method that’s typically placed under the skin in the upper arm. Similar to IUDs, these implants also work by releasing hormones and prevent pregnancy by curbing ovulation and changing uterine structures.  

Nexplanon releases the hormones over time, allowing it to work for up to three years. Some people also report side effects, such as concerns with bleeding, headaches, changes in mood, and acne, among others.  

Are there other progestin-only birth control options? 

Besides hormonal IUDs and Nexplanon, another progestin-only birth control option is the minipill, or progestin-only pills (POPs). People can take the mini pill, regardless of whether or not they’ve given birth. These are taken as a daily pill and can be started at any time. When beginning to take the minipill, you may want to avoid sex or consider using a barrier method like condoms, for a short period, to reduce your chances of pregnancy while the medication reaches its full effects. Minipills may lead to similar side effects as Mirena and Nexplanon, along with breast tenderness, nausea, and depression. 

Are there other contraception options you could consider? 

Given that the progestin-only contraceptives also involve the risk of headaches and migraines, you may also want to explore lifestyle or surgical methods as an alternative form of contraception. 

Considering your conditions, doing a little birth control homework, and speaking with a health care provider may be a good step in finding your best contraceptive match!