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mirena coils
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203 Posts

Posted:  16-Jan-2013 17:42
I had a 49 year old lady come in today who has had her Mirena coil for 5 years-she came for a smear. She was asking me when the coil comes out. I explained that it would stay until after the menopause but she said when would she know what this had finished since she is not having periods though she has had a bit of spotting now that the progesterone is running out. I said I would find out. She had been told it would stay in forever!!!

331 Posts

Posted:  16-Jan-2013 20:46
Not  FP trained but was told that if a mirena was put in over aged 45 then it could stay in for as long as needed ie over 50 or forever. I don't like the sound of forever though. Will get mine removed once I'm 55 safely in menopause territory.


1126 Posts

Posted:  16-Jan-2013 21:14 Log in to like this post
Look at faculty guidelines, not forever but until menopause established either with two bloods in the post men range or 55

3266 Posts

Posted:  17-Jan-2013 17:16
Agree with speedfreak that if IUS inserted over age of 45 then it can remain in place indefinitely. So in your patients case she does really need it replacing. As for menopause, she is likely to have some idea when she is going through it and if not then she she should be very happy and grateful! The mirena will most likely reduce the risk of heavy bleeding at this time. Why do so many women fret over menopause?

1126 Posts

Posted:  18-Jan-2013 08:15
I am puzzled that people seem to be saying forever.......indefinitely needs some clarification as I have not heard any Fp expert say leave forever just that timing is variable and person specific, surly if You had a sixty year old with a mirena still in you would remove it, or have I missed something. That is not to say it would be harmful left just an unnecessary f.b which could be confusing if any post menopause bleeding or pelvic pain occurred. Interesting thread.

638 Posts

Posted:  21-Jan-2013 13:50 Log in to like this post
If a mirena is inserted after age 45, it can remain in situ for 10 yrs. If a lady is amenorrhoeic, it may be either menopause or perhaps because of the mirena, progesterone-only contraception etc you should confirm status with an FSH before abandoning contraception.

43 Posts

Posted:  22-Jan-2013 12:32
If Mirena is inserted at or after the age of 45 years and they are happy with their bleeding control then it can remain in until after the menopause (upto 7 years for contraception)(FSRH guidelines) Women should have a method of contraception until 12 months after their LMP if over 50, or 2 years after LMP if under 50. So basically if not bleeding then out at 55.

1 Posts

Posted:  23-Mar-2013 13:34
[xx(]I am interested in what Bagpuss1 had to say about this topic. I am 57 this year and had the marina coil in for 9 years and most of that time ive been on anti-depressants. I thought i was told the marina coil would just stay in forever but since reading up on it and other peoples opinions on it i now think that maybe my depression could be down to this amongst a whole lot of other health issues i have. So would the general advice from this page be for me to have the coil removed. Oh and i have had no bleeding for about 8 and a half years so i think i can safely say my chances of getting pregnant now are very slim to say the least.

1126 Posts

Posted:  24-Mar-2013 17:35
I would have the ius removed, however I doubt it is affecting your mood as there must be very little if any hormone activity now.

1025 Posts

Posted:  24-Mar-2013 20:17
I  had Mirena inserted nearly 5 yrs ago for heavy periods- had a lovely few yrs when amenorrhoeic- then came back - not heavy but got used to not having them so didn't want them xx talked my Pn into changing it early - then  nothing! am now nearly 49.. have decided to leave it alone- am experiencing monthly symptoms - coulod be hormonal - could be menopause - who knows.. would you just leave it in?

2 Posts

Posted:  08-Apr-2013 21:44
i got the marina coil in 5 years ago, i went to get it removed but was told that i didnt have to get it out and it could stay there forever but it wouldnt work as a contraceptive and i would need to take the pill or some other type of precaution, is it safe/ok to leave it in forever?

1156 Posts

Posted:  09-Apr-2013 07:55
If she is under 50 she will still need some contraception unless mirena in for bleeding probs and say her partner has had a vasectomy. She could have another one fitted to see her past the menopause or opt for another method of contracecption.Also remember to be vigilent for other reasons for break through bleeding. It may not be because the hormone is running out although this may be the case.If mirena in for bleding probs, her bleeding prob may well return if opts not to have and she is not menopausal.
If she is getting other sx of the menopause , she could always have a FSH b/t to confirm.
I am FP trained

72 Posts

Posted:  07-May-2013 18:37 Log in to like this post
How reliable is the FSH test ?

and how do you analyse the results if people already have mirena / OCP / HRT ?

1156 Posts

Posted:  08-May-2013 08:13
According to professor John Guillibaud ,guru of family planning, the fsh should be repeated 1 month later to confirm.As far as leaving it in forever,I disagree with this!Infection would be a risk,severe actinomycosis for exmaple. Also would be much more difficult to remove in old lady with vaginitis!!
Rememeber to always investigate irregular bleeding to exclude uteine cancers in patients over age of 50.

75 Posts

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Posted:  18-Jun-2013 20:46

I'm sure the Mirena is ok for 7 years if inserted over 45yrs old, def not forever [:)]!!

Sarah xx

187 Posts

Posted:  18-Jun-2013 21:01
I recently read if Mirena inserted under 35yrs then change at 5yrs.  If over 35 - unlicensed use for up to 7yrs and If inserted after age 45yrs - I would leave it to carry through menopause up til age 55yrs and then would remove it as long as pt happy. 

2 Posts

Posted:  19-Jun-2013 09:31
i am 28 ive had to coil 5 years and was told it doesnt ever have to come out, so ive left it in and gone on the pill

862 Posts

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Posted:  19-Jun-2013 13:10 Log in to like this post
This sounds unusual advice mega2011.
It is not common practice to advise leaving a coil in situ when it has expired as it is a foreign body and a possible source of infection. Maybe you should query this as I have never heard experts recommending this practice and I work in the FP enviroment.


862 Posts

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Posted:  19-Jun-2013 14:59
....and of course it would cause no end of problems if you were to get pregnant with the coil in situ...yes, def get it taken out!


28 Posts

Posted:  06-Jul-2013 09:56
This page won't let me post this link but there is very clear guidelines on the fsrh website. Google fsrh.org and then search for coil.
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