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Once my Mirena IUD is inserted, when will it become effective? #1207/8
How long after Mirena is incerted should I wait to have PROTECTED sexual intercourse? I have no spotting and very mild cramping as of today and the Mirena was incerted yesterday afternoon (which was Tuesday).

When a woman is having menstrual cycles:

She can have a Mirena IUD inserted at any time within the first 7 days after the start of menstrual bleeding, at her convenience, not just during menstruation.  No additional contraceptive protection is needed.


She also can have a Mirena IUD inserted at any other time during the menstrual cycle, at her convenience, if it is reasonably certain that she is not pregnant.  If it has been more than 7 days since menstrual bleeding started, she will need to abstain from sex or use additional contraceptive protection for the next 7 days.

[World Health Organization's Selected Practive Recommendations]


Here is some more information about the effectiveness of Mirena:


Both of the intrauterine contraceptives in the United States rank in the top tier of contraceptive effectiveness (along with surgical sterilization, implants, and injectable contraceptives).  In combined World Health Organization and Population Council trials, the first-year discontinuation rate of the TCu 380A for accidental pregnancy was only 0.7 per 100 women, and even lower rates occurred in years two through ten. In World Health Organization trials, the cumulative 12-year failure rate with the TCu 380A was 2.2 pregnancies per 100 women.  In three trials conducted by Leiras, the Finnish manufacturer of the levonorgestrel system, the first-year cumulative failure rate was 0.14 per 100 women, and the cumulative five-year failure rate was only 0.71 per 100 women. In the Population Council’s randomized trial of the levonorgestrel intrauterine system vs. the TCu 380A, the seven-year cumulative failure rates were 1.1 and 1.4 per 100 women, respectively.  In contrast, the overall ten-year failure rate with all methods of tubal sterilization in the United States is 1.9 per 100 women.  Thus, contemporary intrauterine contraceptives rival the effectiveness of tubal sterilization. [D. Grimes-Contraceptive Technology 2008]


Key Words:  Mirena IUD, inserted, protected sexual intercourse, spotting, mild cramping, Dr. David Grimes, Contraceptive Technology 19th edition


Selected Practice Recommendations for Contraceptive use, second addition, section 11: World Health Organization, Geneva

Grimes DA. Intrauterine devices (IUDs) IN Hatcher RA, Trussell J, Nelson AL. et al Contraceptive Technology 19th edition: Page 119 & 120, Ardent Media Inc. 2008

Posted 12-12-2008, Updated 1-11-2009, Updated 1-24-2009


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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