Hello,

Thanks for writing to us. I am happy to help you.

Mirena is a levonorgestrel containing IUD. Mirena is more than 99.5% effective at preventing unwanted pregnancy.

We have to rule out the possibilities of heavy bleeding with clots in this context. These include as follows:
1) Miscarriage due to failure of mirena- though rate is 0.2 HWY.
2) Uterine pathology like fibroid or polyp or pelvic infection (PID).
3) Sometimes abnormal uterine bleeding as a complication of itself.
4) Other- ectopic pregnancy,displaced IUD,thyroid disorder etc.

Complete physical examination including pelvic and speculum examination is needed to rule out underlying pathology.

Possibilities can be narrowed by several investigations like blood test for thyroid profile & clotting factor abnormality, Ultrasound scan (USG), vaginal swab test and endometrial biopsy (may be needed) etc.

Treatment depends on underlying etiology. So please consult with gynecologist for proper guidance through investigation, physical examination and medication with suggestive measures.

You may need to remove the mirena to get relief from this. Proper antibiotic therapy, hormonal medication and maintenance of genital hygiene are the mainstay of the treatment. Also you should take healthy diet with iron supplements.

Hope I have answered your query. If you have any further questions I will be happy to help.

Wish your good health & take care yourself.

Regards,
Dr Soumen.

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Hello,

Thanks for follow up query. I am trying to solve your problem accordingly.

First of all, according to your height (5 ft) ideal weight is 51-55 kg. Your body mass index is 27.34 and it indicates over weight.

Menstrual irregularity is basically due to hormonal imbalance, associated with overweight & ovarian cyst in co-existence of mirena IUD.

Painful sexual intercourse (dyspareunia) and mood swing are also due to effect of mirena IUD. To get relief from this, you may need to remove the mirena.

In this context, you may require to undergo several investigations as described on previous reply before planning to next line of management.

To combat anemia, you should take good hematinics or iron supplement with your diet. Here, complete hemogram (TC/ DC/ ESR/ Hb% etc ) is also required to check other blood parameters.

Follow some basic things to overcome the presenting problem:

1) Control body weight by regular exercise like jogging/ running/ treadmill
2) Drink plenty of fluids/water and eat leafy vegetables & fresh fruits.
3) Avoid stress by doing yoga/deep breathing regularly (20-30 times at a time)
4) Maintain genital hygiene and need proper sleeping in more relaxing way.
5) May use some lubricant to avoid painful sexual intercourse.

If you do not have any clarifications, you can close the discussion and rate the answer.

Be well and stay healthy.

Regards,
Dr Soumen

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