How long before Mirena starts working for contraception?

When insertion takes place within seven days from the start of a period, contraception starts straight away. For insertions at other times, additional precautions are usually advised for a short period. Dr Mohamed will confirm timings for your situation.

How long before bleeding improves?

Heavy bleeding often starts to reduce over three to six months. Some patients notice lighter periods earlier, others take longer. Persistent heavy or painful bleeding needs review to rule out other causes.

What happens when Mirena comes out?

Once removed, Mirena no longer provides contraception or endometrial protection. Fertility returns quickly for most women. If pregnancy is not desired, another method should be in place before or immediately after removal.

Does Mirena cause weight gain?

Evidence does not show a consistent strong link between Mirena use and significant weight gain across large groups of women. Individual experiences differ, so weight and other symptoms are reviewed at follow up.

Mirena Coil (Levonorgestrel Intrauterine System) in Norwich

Contraception, heavy bleeding and HRT support in one device

Doctor & Nurse Led Clinic

Long Term Hormone Control

Evidence Based Device

Menstrual Bleeding Management

Part of Menopause Care

Mirena is a small T shaped intrauterine system placed inside the womb. The device slowly releases levonorgestrel, a progestogen, directly into the lining of the uterus. This local hormone delivery provides long term contraception, treatment for heavy menstrual bleeding and protection for the womb lining when you use oestrogen as part of hormone replacement therapy.

At The Doctors Laser Clinic in Norwich, Dr Mohamed offers Mirena fitting and follow up as part of a wider approach to women’s health, perimenopause and menopause care.

What Mirena Is And How It Works?

Mirena contains 52 mg of levonorgestrel. The device sits inside the uterine cavity and releases a steady, low dose of hormone over several years.

Levonorgestrel acts mainly on the womb lining and cervical mucus.

The lining becomes thin and less likely to build up and shed heavily
Cervical mucus becomes thicker, which reduces sperm movement
In some women ovulation reduces in frequency

Because hormone release is mainly local to the uterus, overall hormone exposure in the bloodstream stays lower than with many tablet or injection methods.

Who Mirena suits?

Mirena is suitable for many patients who want:

Reliable, low maintenance contraception
Treatment of heavy menstrual bleeding
Endometrial protection as part of HRT
Support through perimenopause with both contraception and control of bleeding

Suitability always depends on your medical history, examination findings and any existing conditions. Dr Mohamed will review these in detail before recommending the device.

Mirena for contraception

Mirena is a long acting reversible contraceptive with effectiveness above 99 percent when in place. ¹

Regulatory updates in the UK now support Mirena use for up to eight years for contraception ². Current guidance includes:

Up to 8 years of use for contraception after insertion, provided the device remains in the correct position and you have no new medical issues
Insertion from age 45 or later, with some guidance supporting use through to age 55 for contraception only, subject to individual assessment ³.

For many women, this removes the need to remember daily pills or frequent injections. One fitting then provides long term pregnancy prevention, with fertility returning after removal for most patients.

Mirena for heavy menstrual bleeding

Heavy menstrual bleeding affects quality of life, energy levels and iron stores. National guidance from NICE places levonorgestrel intrauterine systems such as Mirena as a first line treatment for heavy menstrual bleeding in appropriate patients. ⁴

Evidence shows:

Mirena reduces menstrual blood loss by around 80 to 90 percent after six months of use in many women ⁵
Health related quality of life often improves more than with several alternative treatments ⁶

Some patients experience:

Much lighter periods
Shorter periods
No bleeding after several months

Irregular spotting is frequent in the first three to six months and often settles gradually. You receive clear advice on what to expect and when to seek review.

Mirena as part of HRT

Oestrogen in HRT thickens the womb lining if used alone. Endometrial protection is therefore needed for anyone with a uterus who uses systemic oestrogen, in order to reduce the risk of endometrial hyperplasia and cancer. ⁷

Mirena provides this protective progestogen effect directly to the uterine lining.

Licensing and duration in HRT

In the UK:

Mirena holds a licence for four years of endometrial protection when used with oestrogen as part of HRT ⁷
British Menopause Society and Faculty of Sexual and Reproductive Healthcare support use of Mirena and other 52 mg levonorgestrel systems for up to five years for this purpose, based on study data showing adequate endometrial protection over this time ⁷.

Your doctor will discuss licensing, current evidence and your individual risk profile. Some patients, for example those with a higher BMI or additional risk factors, might be advised to replace at four years rather than five.

Mirena in perimenopause

Perimenopause often brings:

Heavy or erratic bleeding
Contraceptive needs
Menopausal symptoms such as hot flushes and mood change

Mirena offers a practical base for:

Reliable contraception
Bleeding control
Endometrial protection when you start oestrogen HRT patches, gel or tablets

In practice, many perimenopausal women use Mirena as a “progestogen backbone” while oestrogen dose is adjusted over time. This reduces tablet load and removes the need for separate progestogen courses.

Who should not have Mirena?

Mirena is not suitable for everyone. Situations where alternative options are needed include:

Current pregnancy
Unexplained vaginal bleeding awaiting investigation
Known or suspected breast cancer or endometrial cancer
Acute pelvic infection
Uterine cavity distortion from large fibroids or congenital anomalies
Allergy to any component of the device

Dr Mohamed will review your history, medicines and previous investigations to decide whether Mirena is appropriate or whether a different option fits better.

Mirena fitting process at The Doctors Laser Clinic

1. Consultation and assessment

Your first visit focuses on:

Medical, gynaecological and contraceptive history
Period pattern, bleeding severity and any previous treatments
Menopausal symptoms and HRT history where relevant
Discussion of aims, concerns and alternative options

If Mirena suits your needs, Dr Mohamed explains benefits, limitations and possible side effects in clear, practical terms. The timing of insertion is planned, often within the first half of the cycle, or at a time that suits HRT planning or contraception changeover.

2. Before your appointment

You receive written advice on:

Whether a pregnancy test is needed before insertion
Whether screening tests for infections or a smear test are due
What pain relief to take in advance, if appropriate
Whether someone should accompany you home

Any required ultrasound or blood tests are arranged through your GP or local services if needed for safe fitting.

3. Fitting the Mirena coil

A Mirena fitting is an outpatient procedure.

Typical steps include:

Positioning on the examination couch
Pelvic examination and speculum insertion
Cleaning of the cervix
Use of a local anaesthetic around the cervix in selected cases
Gentle measurement of the uterine cavity
Placement of the device through a thin tube into the womb
Trimming of the device threads in the vagina

Most fittings take several minutes. Cramping during and shortly after the procedure is frequent. You are encouraged to rest for a short period before leaving.

4. Aftercare

Normal short term effects include:

Crampy discomfort for a few hours
Light bleeding or spotting
Tiredness after the appointment

You receive clear written aftercare instructions about:

Simple pain relief
When to expect changes in bleeding
When to avoid intercourse or tampons in the first days if advised
How to feel for the threads once any soreness settles
When to contact the clinic or urgent care

A follow up check is usually arranged after a few weeks or earlier if you have concerns.

5. Follow up, removal and replacement

Mirena can stay in place for:

Up to 8 years for contraception in current UK guidance
5 years when used for heavy menstrual bleeding
4 to 5 years for endometrial protection with HRT, depending on individual risk review

Removal is usually simple and involves gently pulling on the threads in clinic. A new device is often inserted in the same appointment when continued treatment is needed.

Side effects and risks

Most patients tolerate Mirena well, yet no medical device is risk free.

Frequent short term effects:

Irregular bleeding or spotting in the first three to six months
Cramping, especially in the first weeks
Breast tenderness, headaches, mood change or acne in some women

Less frequent but important risks:

Expulsion, where the device moves or falls out, especially in the first months
Uterine perforation during insertion, an uncommon complication that is usually recognised at or soon after the procedure
Pelvic infection, mainly in the first few weeks after insertion, especially when there is an untreated sexually transmitted infection present

Any new pain, fever, offensive discharge, sudden change in bleeding or loss of threads needs prompt review. Dr Mohamed will explain red flag symptoms in detail.

Mirena, HRT and breast health

Discussion of HRT and breast cancer risk is part of any menopause consultation. Mirena does not remove the need for this discussion, but using local progestogen in the womb lining may reduce the need for systemic progestogen tablets in some regimens.

Screening and breast awareness should continue in line with national guidance. Any new breast symptom requires assessment.

Patient Feedback

Absolutely fantastic experience all-round. This was the second time I’ve used the clinic for their Hyperhidrosis treatment, which is a sensitive issue for me, but I must say I was put at ease from the moment I arrived. The service provided by Dr Willis and his team was superb, and it has once again solved this sensitive problem. Total life changer - thank you all!

Hyperhydrosis Patient

Frequently asked questions

Why choose The Doctors Laser Clinic for Mirena

At The Doctors Laser Clinic in Norwich you receive:

• Doctor led counselling and assessment
• Integration of Mirena within a broader HRT or perimenopause plan
• Clear written information and realistic expectations
• Access to follow up support and review

Next steps

If you are considering Mirena for contraception, heavy periods or as part of HRT, a structured consultation helps you decide whether this approach fits your needs. Contact The Doctors Laser Clinic in Norwich to arrange an appointment with Dr Mohamed.

This page provides general information and does not replace individual medical advice. Decisions about contraception, heavy menstrual bleeding treatment and HRT always require personal assessment with a qualified healthcare professional.

Doctors and Nurses with a Special Interest in Skin

All of our team have a special interest in skin and are happy to discuss your problem with you. We use only the best equipment on the market.

book an mirena coil appointment

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All treatments start with an initial consultation with one of our team. During your consultation we learn about your areas of concern and treatment goals.

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