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How long should a woman's first period last once a Mirena IUD is inserted? #917/8
How long is your first period supposed to last when you first have the Mirena inserted? I am curious to get the Mirena because my friend has one and she said her lasted for about a month when she first got the Mirena.

What your friend is experiencing is not unexpected.  The first few months after Mirena is inserted may bring many days of spotting to a women…unfortunately.  But by the end of the first year, she is losing 90-95% less blood than a person not having a Mirena IUD in her uterus.


If your friend is very concerned about wanting to stop the bleeding, and if she is a candidate for taking combined oral contraceptive pills (OCPs), they definitely might help her.  But it will stop on its own soon enough.  High-dose ibuprofen might also stop the bleeding.  Either approach or simply waiting it out would be appropriate.


Tell her good luck with this excellent contraceptive.


An IUD is a small device which is placed inside the uterus. The vertical arm of this IUD contains levonorgestrel. This hormone is a progestin much like the progesterone a woman’s ovaries produce each monthly cycle. Each week the levonorgestrel IUD gives off about the same amount of levonorgestrel as a woman gets when she takes one or two of the mini-pills called Ovrette. The levonorgestrel causes the cervical mucus to become thicker so sperm cannot reach the egg. Among typical couples who use this IUD, one in 1,000 will experience an accidental pregnancy in the first year.

Mirena is as effective in preventing pregnancy as tubal sterilization and lasts at least for five years. This method has been available for 10 years in Europe and has been used by approximately 2 million women worldwide. In Europe 10-25% of women use an IUD compared to 2% in the United States. Mirena is part of the reason for the popularity of the IUD in Europe.


  • It is the most effective reversible method ever developed!
  • It prevents ectopic pregnancies (15 times lower than non-contraceptors.
  •  It decreases menstrual cramping and dramatically decreases menstrual blood loss (a 97% reduction in menstrual blood loss in one study). Some women experience an absence of menstrual bleeding after one year (about 20%).
  • This IUD may be left in place for at least 5 years (probably effective for 8 or more years).
  • IUDs are safe, inexpensive over time, and provide extremely effective long-term contraception from a single decision.
  • One of the costs of any contraceptive is the cost to you should your contraceptive fail. Given the extremely low failure rate of Mirena, a person using this method is far less likely to have the emotional and financial expenses associated with an unintended pregnancy.
  • All you have to do is check for the strings each month.
  • May be used by postmenopausal women on estrogen therapy to protect the endometrium against endometrial cancer.
  • Once Mirena is removed, fertility returns rapidly. Approximately 8 out of every 10 women who want to become pregnant will become pregnant in the first year after Mirena is removed.  


  • Do NOT start this method of birth control unless you will find it acceptable to have your periods change.  They WILL change a lot.
  •  There may be more bleeding days than normal for the first few months and less than normal after 6 to 8 months. If your bleeding pattern is bothersome, contact your clinician. There are medications which can help you have a better pattern of bleeding.
  • The IUD does not provide protection against sexually transmitted infections. Use condoms if there is any risk.
  • There is a high initial cost of insertion.  

Key Words:  period, Mirena IUD, inserted, unpredictable, bleeding, spotting, combined oral contraceptive pills, ibuprofen, advantages, disadvantages


Robert A. Hatcher MD, MPH
Emeritus Professor of Gynecology and Obstetrics
Emory University School of Medicine
Atlanta, GA

The directors and owners of this website and any publications and information concerning health matters offered here advise a person with a particular problem to consult a primary-care clinician or a specialist in obstetrics, gynecology, or urology (depending on the problem or the contraceptive) as well as the product package insert and other references before diagnosing, managing, or treating the problem.
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