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It it dangerous if I just leave my Mirena IUD in place after 6 years of use if I cannot afford to have it removed? #730/10

I have had my Mirena IUD for 5 years.  It's now time to remove it. I don't have health insurance and my heath department won't remove it. I called my doctor's office but they want $300 just to remove it.  I am unemployed and don't have the money.  Will it hurt my health if I don't get it removed? 

 

I have never had a problem with it the entire five years (no pain and no periods).  I don't want anymore children and only went with the IUD because my Ob/Gyn thought I was too young at 24, to make the choice of not having anymore children and refused to tie my tubes.

I am just wondering what danger I am in if I wait until I have the money or insurance. 

 

Thanks for your help!



Your Mirena IUD is effective for another 2 years.  It is safe and effective to leave in place for another 2 years.


You ought to be able to find a clinician who will remove your IUD.

 

Below is the answer to another person on the duration of effectiveness of the Mirena IUD:

 

Do you advise your patients to continue the Mirena IUD for 7 years?  Is there a timeline for FDA approval for 7 years?

My suggestions:

I tell people that my understanding is that the current Mirena IUD is effective for 7 years.

                                     

 

Here is the paragraph on this subject by Dr. David Grimes in the 19th edition of Contraceptive Technology:

 

 Intrauterine Devices (IUDs) by David A. Grimes, MD

 

EFFECTIVENESS

 

While contraceptive effectiveness is discussed in more detail in Chapter 27, a simple formula explains why today’s IUDs provide superior contraception (Figure 7-2). The effectiveness in the community of any contraceptive is related to a number of factors. These include the inherent ability of the method to prevent pregnancy (efficacy) and the user’s compliance (adherence to the regimen, such as pill taking) and continuation (ongoing use over time). Factors impairing effectiveness include a woman’s fecundability (reflecting age, body mass index, prior salpingitis, etc.) and frequency of coitus. Although combined oral contraceptives have excellent efficacy, compliance is only fair—as is continuation. Hence, the contraceptive effectiveness of combined oral contraceptives falls in the middle tier. In contrast, IUDs have excellent efficacy and users exhibit high compliance and high continuation rates (about 85% to 90% at one year). This translates into superior protection against unintended pregnancy.

 

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.

 

I would not discourage a woman using Mirena for a 6th and a 7th year from using a backup contraceptive.

 

This answer came for the most part from the 19th edition of Contraceptive Technology, a book that describes how all the contraceptives work, the advantages and disadvantages of each and much more!  The chapters are by nationally recognized experts.

 

Click here to see how to order this important reference book and other important books for clinicians, counselors and women and men wanting the latest contraceptive information.

www.managingcontraception.com

 

 

Key Words:  Mirena IUD, removed, insurance, expensive, unemployed, endanger health, pain, periods, tubal sterilization, danger, effectiveness, FDA approval, Contraceptive Technology, Dr. David A. Grimes, World Health Organization and Population Council, levonorgestrel system, cumulative failure rates, backup contraceptive


Reference:

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

Posted 8-11-2010, Updated 8-12-2010, Updated 8-19-2010

 

Robert A. Hatcher MD, MPH
Emeritus Professor of Gynecology and Obstetrics
Emory University School of Medicine
Atlanta, GA
---2010-08-19


Managing Contraception for Your Pocket 2013-2014
  


Managing Contraception for Your Pocket 2013-2014
  

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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