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Increasing demand for Mirena at Women’s Health Hub

At Women’s Health Hub there is an increasing demand for Mirena insertion. Many patients have noted the significant improvement in their quality of life after the insertion, and as a result most women are referred to us via word of mouth.

 

What is the Mirena?

A Mirena is a intrauterine device (IUD) which releases progesterone hormone.

 

What are the uses of Mirena?       

  • It is a long acting reversible contraceptive which lasts for 5 years.
  • The Mirena is used for control of heavy menstrual bleeding. It is the first line treatment recommended by the Royal Australian and New Zealand College of Obstetricians and Gynaecologists for heavy menstrual bleeding with no known or reversible causes.
  • It can be used as an adjunct for Hormone Replacement Therapy.

 

Who can have the Mirena?

  • Most women can have it. There are certain conditions where the Mirena is not recommended. Please discuss this with your doctor in further detail.
  • It does not matter if the woman has had children before.

 

What are the benefits of Mirena compared with the contraceptive pill?

  • It is more effective than the oral contraceptive pill. It is 99.8% effective as compared to the oral contraceptive pill which is 91% effective for typical use.
  • It is a long acting reversible contraception which lasts for 5 years. You can set and forget, without the need to remember to take a pill every day.
  • It is more cost effective in the long term.
  • There is minimal absorption of the progesterone hormone into the rest of the body.

 

What are the disadvantages of the Mirena?

  • There is some discomfort associated with the insertion process.
  • There are risks associated with the procedure.

 

What are the side effects of the Mirena?

  • Abdominal or pelvic pain. This is usually mild and intermittent.
  •  
  • Vaginal discharge.
  • Side effects are most significant during the initial period after insertion, then generally improve and subside.

 

What will happen to my menstrual cycle?

  • It is expected within the first 3 months of insertion, that there will be more frequent bleeding, averaging 30 days in the first 3 months. This improves with time.
  • 20% of women do not have menstrual bleeding after a year.
  • Women who have heavy menstrual bleeding can have blood flow reduced by 90%.
  • Your GP cannot accurately predict if periods will remain regular as it varies for all women.

 

Procedure

The insertion of a Mirena can be performed by a gynaecologist or a GP with extra training. Some General Practitioners at Women’s Health Hub have had extended training and are qualified to perform the Mirena insertion.

 

The starting point for a patient is to book an initial extended consultation with the GP which takes around 20 minutes. The GP will discuss the alternatives with the patient to determine the health issue at hand and whether the Mirena is the best solution for the patient.

 

We make sure that every single woman who has the procedure provides a prior urine sample to test for chlamydia or gonorrhoea. If suitable, the GP will provide a script for to buy the Mirena at the chemist.

 

On the day of the procedure, patients spend an hour in clinic, which includes performing certain checks done with our nurse before and after the procedure. The actual length of procedural time is no more than 15 minutes.

 

We strongly recommend panadol and neurofen around 30 minutes prior to the procedure to minimise discomfort.

 

What are the risks?

  • 1 in 100 risk of infection

We minimise this risk by doing a urine test for chlamydia and gonorrhoea at the initial consultation and by performing the procedure under sterile conditions

  • 5 in 100 risk of expulsion

In some women, the uterus contracts and expels the Mirena of its own accord. We recommend doing a monthly check for the presence of Mirena strings after insertion to minimise the chances of an undetected expulsion.

  • 1 in 400 risk of perforation

This occurs when the Mirena device extrudes from the uterus into the abdominal cavity. Every care is made by our doctors to minimise the risk of perforation thru various methods.

  • Ectopic pregnancy

As Mirena is effective at preventing 99.8% of all pregnancies. The chances are greatly reduced as compared to a woman who is not taking any form of contraception.

 

Cost

The Mirena device costs around $40 at the local chemist. The procedure costs $250, and around half is covered by Medicare so the out of pocket is $124.10

 

Next steps

 

Contact the Women’s Health Hub and make an extended consultation to determine if the Mirena is the right solution for you. For further information on the questions to discuss with your GP regarding a Mirena, please visit the Mirena website.

 

Dr Jean Ong | 31 October 2018

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