I keep hearing women who have never had kids will find it difficult to find a doctor agree to insert Mirena due to higher chance of infection (and the pain/difficulty issue during insertion) due to multiple partners. Why is this? Are they assuming that condoms aren't used WITH Mirena if there is no long term monogamous relationship? Is infection risk less if condoms are used too?
The FDA has not approved Mirena for insertion in women who have never had children. As Kaismama mentioned, the cervix is smaller in nulliparous women (women who have never been pregnant) but also that there is a much higher chance of PID (pelvic inflammatory disease) which can cause scarring in the uterus. there is also an increased chance of ectopic pregnancy which can destroy a fallopian tube and can lead to infertility. when the FDA doesnt approve something, it is hard to find a doctor who will go against that for legal reasons. OB-GYNs carry the highest malpractice insurance there is because they are sued more often than any other Dr. and therefore will be most likely to not risk their livlihood by going against FDA recommendation. It is just legal fodder! Have you thought about Depo-Provera or Implanon? They may be options for you.
It isn't. The best available research shows that the only increased infection risk with an IUD insertion is if you have an active STD at the time of insertion. After the first 20 days, there is no increase in infection rates, and in fact the mechanism of action for the Mirena (thickening the cervical mucus) may block the passage of pathogens into the uterus. IUDs including Mirena are now recommended for teens, for women without children, for women with multiple partners, and even for women who are HIV positive. When today's IUDs first became available, the medical establishment was very wary, partly because of bad technology in the 1970's. It has taken a while for many doctors to catch up on the latest research and recommendations by regulatory boards.
- Mirena Information for Consumers
- Mirena Information for Healthcare Professionals (includes dosage details)
- Side Effects of Mirena (detailed)
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