If you've been using an IUD as your method of birth control, then whether you are happy with it or not, at some point it must be removed. Should you decide you want to become pregnant, then obviously the Mirena IUD will need to be removed. Other reasons for an IUD removal include intolerable side effects, development of an infection, or even just that you may have decided you don't like it and want to try another birth control method. If you've had the Mirena IUD for five years, then you will also need to have it removed, and either replaced with another Mirena IUD, or settle on a different form of contraception. If you have gone through menopause while on the IUD your doctor will likely want you to wait to remove it until you have gone through an entire year following menopause. While some women feel the removal of the IUD is considerably less painful and faster than insertion, other women have suffered negative effects when having their Mirena IUD removed.
When to Have the Mirena IUD Removed
Some studies have indicated that having the IUD removed during menstruation can be a little easier since the cervix is naturally softer during this time, however the IUD can be removed at any time. The cervix may be wider and more "stretchy" during menstruation as well, however some women may feel uncomfortable having the IUD removed while they are on their period.
When you go in to have your Mirena IUD removed, your doctor will likely perform a routine gynecological exam to determine the uterus position. This consists of inserting fingers into the vagina while feeling the abdomen with the other hand, checking for tenderness or changes. During this exam, the physician will locate the IUD strings to confirm it is still in place. Should your physician be unable to locate the IUD string, he may perform an ultrasound to enable him to detect the location of the IUD. The doctor will then insert a speculum so he or she can see what they are doing, then will insert a special medical device to stabilize the uterus. Your doctor will grasp the IUD strings with a clamp or traditional forceps and gently pull it out of the uterus, In theory, as the IUD emerges, the arms retract, allowing it to slip out easily.
Problems during Removal
Sometimes the IUD does not come out easily, or does not appear to be moving. Your doctor may need to change the angle of the clamps, or may realize that the IUD has become embedded in the uterine wall. Should the IUD have become imbedded, you will probably be given an anesthetic so the doctor can dilate your cervix, insert the forceps into the uterus, grasp the IUD and remove it safely. Rarely, a surgical procedure may be necessary in order to dislodge an imbedded IUD.
What to Expect
You can expect a certain amount of discomfort during the procedure, and many women take aspirin or other mild analgesic prior to removal. In most cases, there will not be severe pain during the procedure, although some women experience much more than "discomfort." You will likely have a fair amount of bleeding following the Mirena removal, and often large clots are involved. Your cramping can range from mild to intense. Should you experience a level of pain which has you doubled over and crying, go to your emergency room or call your doctor immediately, as this could mean a tear or perforation.
Some doctors will recommend abstaining from sexual activity for five days prior to removal of the IUD since sperm can live for up to five days, resulting in a possible unintended pregnancy. Remember-though it may seem self-evident, never, ever remove an IUD on your own. You could cause severe damage to your body, including perforation of the uterus and internal bleeding. This is definitely not a do-it-yourself procedure, so call your doctor and make an appointment to have your IUD removed.