Hormone administration before exchanging the Mirena coil?
March 21, 2011 | 12,00 EUR | answered by Dr. med. Ralf Berg
I am 42 years old and have been living problem-free with the Mirena coil for 5 years. Now I want to have it replaced with a new one, and usually this is done during menstruation when the cervix is dilated. Since my menstruation (as is often the case with Mirena) has been absent for several years, my gynecologist has prescribed me the pill Microgynon 30, which I should take for 3 weeks to induce a menstruation so that the coil can be inserted more easily. I live in the United Arab Emirates and my impression is that medications are used more quickly here than in Germany. My question: does a bleeding really facilitate the exchange to the extent that this intervention in my hormonal balance is justified? Is this also common in Germany? (By the way, I have already had 2 births)
Dear patient,
After a (non-representative) quick survey among "my" gynecologists, you are probably right that medication is given to you more quickly. At least here in Southern Baden, this approach is not common. It is not primarily about the bleeding, but rather about the fact that the cervix is "softer" during menstruation (under the influence of estrogen) making removal easier. However, this is not mandatory and is generally not practiced here.
Your second question, regarding the impact on your hormone balance, is of course "sophisticated". Wearing the coil itself surely represents a greater intervention in your natural hormone balance. Essentially, the body is tricked into thinking it is pregnant by the release of progestin hormones from the coil. With the addition of estrogen through the pill, the ratio of progestin and estrogen changes, leading to a withdrawal bleeding. This is not necessarily harmful.
What to do? A. Either have the coil removed in BadenWürttemberg.
B. Perhaps take Microgynon instead, so that the local gynecologists can more easily remove the coil for you. From here, I cannot assess whether the colleagues in the United Arab Emirates simply have little experience with the procedure and this measure will make the removal easier for you.
With best regards from the Black Forest Dr. R. Berg
