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Mirena Removal

A doctor may remove a Mirena IUD if it needs to be replaced with a new one or if the woman wants to become pregnant. 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. To avoid possible complications, Bayer doesn’t recommend women remove their own Mirena.

A doctor or health care provider performs Mirena intrauterine device (IUD) removal in a medical office. Most insurance plans cover Mirena IUD removal. The procedure should only take a few minutes.

There are several reasons why a doctor will remove Mirena. Usually, the doctor will replace an old IUD so it remains effective. Another reason is because a woman wishes to have a baby.

Did You Know?
A doctor should remove and replace Mirena after five years for it to remain effective.
Source: Mirena prescribing information

If a woman does not want to have a baby, she should have Mirena removed within seven days of the start of her period. If a woman removes the IUD within eleven days of having sex during any other time of the month, pregnancy may happen.

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

Sometimes, removal might be more complicated if there have been side effects with Mirena. These include serious side effects such as perforation of the uterus, pregnancy outside the uterus (ectopic pregnancy) or infection.

Complications can occur during insertion, while Mirena is in the uterus and during removal. Women who have suffered complications such as uterine perforation or ectopic pregnancy have filed Mirena lawsuits against Bayer.

Reasons for Mirena Removal

Usually, doctors remove Mirena to replace it or because women want to become pregnant. But, some women’s health conditions or Mirena side effects may require removing the IUD.

Reasons to remove Mirena may include:
  • Severe bleeding that could lead to anemia
  • Sexually transmitted disease
  • Pelvic infection or endometriosis
  • Pregnancy
  • Pain during sex
  • Cervical cancer
  • Uterine perforation
  • Severe migraines
  • Increased blood pressure
  • Arterial disease or stroke

What to Expect During Mirena Removal

IUD removal only takes a few minutes. The doctor will simply pull on the strings with forceps. The arms of the IUD will fold, and it will simply slide out.

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

Source: Dr. Antonio Pizarro, OB/GYN told SELF

Sometimes, the strings are missing. The doctor should rule out pregnancy and then use a sonogram or X-ray to locate the Mirena and then remove it with narrow forceps. He or she may need to dilate the cervical canal.

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

In some cases, doctors may need to surgically remove the IUD. This can happen if the Mirena perforated the uterus or moved from the uterus.

In the case of infections, doctors may have to treat the infection with antibiotics before removing the device.

Uterine perforation is more likely to occur during Mirena insertion rather than removal.

Mirena Removal Pain

Mirena removal pain is usually minor. It should only last a few moments. Women should expect cramping as the device comes out.

What to Expect After Mirena Removal

After a routine Mirena removal, there should be no symptoms or pain. Some light spotting can occur. If women experience severe pain, fevers or excessive bleeding after removal, they should contact their doctor.

How Long After Mirena Removal Will I Get My Period?

It may take a few months for a woman’s period to be regular again. A woman’s period should return to the way it was before Mirena implantation.

How Does Mirena Removal Affect Fertility?

Most women’s fertility will go back to normal after Mirena removal, and they can get pregnant quickly. If a woman does not want to get pregnant after having an IUD removed, she should use another form of birth control.

“We found no difference in 12-month pregnancy rates or time to pregnancy between former IUD users and users of other contraceptive methods. However, there was a clinically and statistically significant reduction in fertility in African American women.”

Source: European Journal of Contraception and Reproductive Health Care

Mirena Removal Side Effects

While most women do not experience issues after Mirena removal, some side effects may occur.

For example, if a woman gets pregnant while on Mirena, removing the IUD may result in pregnancy loss.

Some women refer to the Mirena removal side effects as the “Mirena crash,” according to an article in Refinery29. But, there are no scientific studies about the crash.

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

Removing Mirena at Home

Bayer and most doctors do not recommend removing Mirena at home because of possible complications.

Some doctors feel educating women on how to remove the device themselves might encourage more women to use it.

For instance, a study in the journal Contraception found 25 percent of women questioned would be more willing to try an IUD if they could remove it themselves.

However, another study by Advancing New Standards in Reproductive Health found only one out of five women who tried self-removal did so successfully.

“When I needed my own IUD removed I did not do it myself. Even though I have inserted and removed thousands I went to a gynecologist.”

Source: Dr. Jen Gunter, OB/GYN

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

Michelle Llamas, Senior Content Writer
Written By Michelle Llamas Senior Writer

Michelle Llamas has been writing articles and producing podcasts about drugs, medical devices and the FDA for nearly a decade. She focuses on various medical conditions, health policy, COVID-19, LGBTQ health, mental health and women’s health issues. Michelle collaborates with experts, including board-certified doctors, patients and advocates, to provide trusted health information to the public. Some of her qualifications include:

  • Member of American Medical Writers Association (AMWA) and former Engage Committee and Membership Committee member
  • Centers for Disease Control and Prevention (CDC) Health Literacy certificates
  • Original works published or cited in The Lancet, British Journal of Clinical Pharmacology and the Journal for Palliative Medicine
Edited By
Emily Miller
Emily Miller Managing Editor
Medically Reviewed By
Dr. John A. Daller
Dr. John A. Daller American Board of Surgery

10 Cited Research Articles writers follow rigorous sourcing guidelines and cite only trustworthy sources of information, including peer-reviewed journals, court records, academic organizations, highly regarded nonprofit organizations, government reports and interviews with qualified experts. Review our editorial policy to learn more about our process for producing accurate, current and balanced content.

  1. Mirena. (n.d.). Questions and answers about Mirena. Retrieved from
  2. Planned Parenthood. (n.d.) How does IUD removal work? Retrieved from
  3. Barnes, Z. (2017, December 29). What to Expect After IUD Removal: Ob/Gyn Experts Explain. Retrieved from
  4. FDA. (n.d.). Mirena. Retrieved from
  5. Advancing New Standards in Reproductive Health. (n.d.). IUD Self-Removal. Retrieved from
  6. Foster, D.G. et al. (2012). Interest in using intrauterine contraception when the option of self-removal is provided. Retrieved from
  7. Health Research Funding. (2014, April 19). Mirena Crash Symptoms. Retrieved from
  8. Stieg, C. (2017, May 8). What happens after you get your IUD out? Retrieved from
  9. Gunter, J. (2016, June 4). Don’t remove your own IUD. Here’s why. Retrieved from
View All Sources
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