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Mirena Removal

It’s recommended that a doctor perform your Mirena IUD removal, which is usually a quick procedure. During Mirena removal, the doctor will use forceps to pull on the strings of the IUD until it slides out. Light spotting may occur after removal.

Last Modified: September 5, 2023
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Reasons for Mirena IUD Removal

Women commonly choose to remove their Mirena IUD because they wish to become pregnant. Additionally, Mirena is most effective in preventing pregnancy for up to seven years and helps treat heavy periods for up to five years.

Sometimes, women’s health conditions necessitate the removal of the Mirena IUD. Women also sometimes choose a different method of birth control because of complications from their Mirena device.

A 2022 clinical study of 80 participants studied the effects of the Mirena IUD on endometrial thickness and curative effect in patients with perimenopausal abnormal uterine bleeding. The endometrial thickness and menstrual volume scores following three months of treatment were remarkably lower than those before treatment and were considerably lower than those of the control group.

Reasons for Mirena removal include:
  • Choosing to become pregnant
  • Sexually transmitted disease
  • Pelvic infection
  • Endometriosis
  • Mirena malposition within the uterus
  • Cervical cancer
  • Uterine perforation
  • Severe migraines
  • Increased blood pressure
  • Arterial disease or stroke
  • Severe bleeding leading to anemia

Although it is usually a quick and uncomplicated procedure, removal may be more complicated if there have been side effects with Mirena such as infection, perforation of the uterus or pregnancy outside the uterus (ectopic pregnancy).

What to Expect During Mirena IUD Removal

Typically, Mirena removal can be successfully completed in a few minutes. The doctor uses forceps to pull the IUD’s strings. The arms of the device should then fold, allowing for easy removal.

“The vast majority of the time, [IUD removal] simply involves doing a simple exam much like a Pap smear.”

Removal is usually less painful and quicker than inserting Mirena. It can be done at any time during your menstrual cycle. You may experience some cramping as the device is removed, but it should only last for a few moments.

Mirena Removal Illustration
During Mirena removal, a doctor uses forceps to tug on the IUD strings.

The doctor will use a speculum to hold the vagina open so they can see the IUD strings. If they cannot see the Mirena strings, the doctor may need to rule out pregnancy and then use a cytobrush device to find and pull them out.

Your healthcare provider may also open (dilate) your cervix to see it better. They may use a hysteroscope to examine the inside of the uterus. These procedures are usually not necessary, however.

On rare occasions, the Mirena device may have perforated the uterus, which would necessitate surgical removal of the device.

What to Expect After Mirena Removal

Once your health care provider has removed the Mirena IUD, you may experience mild pain and bleeding for a few days. If the doctor used a hysteroscope, you may have additional cramping and bloody discharge, which shouldn’t last longer than a few days. Contact your doctor if you notice your bleeding lasts more than a few days or is more than occasional spotting.

You should not experience heavy bleeding or severe pain after regular IUD removal. Call your doctor if you experience pain that isn’t relieved with over-the-counter medications like acetaminophen or ibuprofen.

If you have experienced complications with the removal and your doctor has prescribed antibiotics for an infection, take them as directed. Ensure you take the entire course.

Once your Mirena is removed, you can resume your regular activities as soon as you feel able to. Once Mirena is removed, you will not be protected from pregnancy unless you immediately begin another form of birth control. Be sure to discuss your birth control needs with your doctor before removal.

Mirena IUD Removal Side Effects

After removing your IUD, it is common to have some light bleeding or slight cramping. It may take a while for your menstrual cycle to return to normal after Mirena removal. You should be back to a regular cycle within three months.

Most women can become pregnant within a year after Mirena removal. Removing Mirena while pregnant, however, could possibly result in pregnancy loss.

Side effects are Mirena removal include:
  • Pain and cramping
  • Bleeding
  • Mood swings
  • Nausea
  • Breast tenderness
  • Passing blood clots
  • Fatigue
  • Depression
  • Weight gain

A cluster of side effects known as “Mirena Crash” are rare, but have been reported in a few cases after Mirena removal. In addition to the symptoms above, some of the symptoms include rapid changes in mood, anxiety and a reduced sex drive.

These symptoms are thought to be because of hormonal imbalance, but not all doctors agree that the symptoms are linked to the removal of the device.

Should You Remove Mirena Yourself?

Do not remove your IUD yourself. Doctors and Mirena manufacturer Bayer do not recommend removing it at home because of the risk of complications. These include bleeding, damage or perforation of the uterus or infection.

In trying to pull out the strings of the Mirena device, there is a risk that you may dislodge it instead of removing it. If your Mirena is dislodged, it may lead to pain and cramping

Diagram showing pelvic inflammatory disease
Pelvic inflammatory disease can happen if someone with an undiagnosed STI gets an IUD.

It’s also possible that the IUD may become embedded in the uterus tissue or that a piece of it may break off. This can lead to even more severe complications. 

Women who have suffered complications such as uterine perforation or ectopic pregnancy have filed Mirena lawsuits against Bayer.

Common Questions About Removing Mirena IUD

Mirena removal is usually a quick and painless process that should be performed in your doctor’s office. After removal, you can typically return to daily activities immediately. 

Here are answers to the most common questions about Mirena removal. 

When will my period return after Mirena removal?

It may take a while for your period to return to normal. With Mirena, if your periods became lighter and shorter, it may take up to three months for your period to return to what’s normal for you.

Even if your menstrual cycle has not stabilized, you can still get pregnant. 

How does Mirena removal affect fertility?

Once you remove Mirena, you can begin trying to get pregnant immediately. Researchers have found that 87% of women who wanted to get pregnant became pregnant within a year of removing their IUD. 

If six months have passed and you have not been able to become pregnant, contact your Ob/Gyn.

How will it feel to get my Mirena IUD removed?

Mirena removal is relatively painless, though you may feel cramping for a short time as the device is removed. In most cases, this lasts less than five minutes. 

When should I get my IUD removed?

You should replace your Mirena after seven years if you use it to prevent pregnancy. Bayer indicates you should replace it after five years if you are using it to treat heavy periods.

If you contract a sexually transmitted disease, have severe bleeding, have pain during sex, or suffer from severe migraines or increased blood pressure or arterial disease, you should see your doctor about having your IUD removed.

When should I call my doctor after IUD removal?

You should see your doctor if you have severe pain, cramping that doesn’t go away with over-the-counter medications, or bleeding that persists for several days. If you develop a fever or experience significant discharge, you should contact your health provider immediately.

How soon can I get pregnant after getting my IUD removed?

You can get pregnant immediately after getting your IUD removed. If you do not want to become pregnant, you should speak to your doctor about an alternative method of birth control before you get it removed. 

Please seek the advice of a medical professional before making health care decisions.