Hello and welcome, I understand your query. Irregular bleeding is common after use of hormone containing IUD s and it tends to settle after a few months. The mirena provides many other advantages like protection from endometrial cancer in addition to contraception. So please wait for some more time before thinking of removal. Try using drugs like tranexamic acid twice daily to stop the bleeding. If you have decided to get it removed, you may request a general anesthesia. However if you are able to tolerate a vaginal examination, removal is much easier and faster than insertion and can be done very easily in a few minutes in the out patient clinic itself. There is no need to hold the cervix while removal. Discuss this with your doctor and then decide. Hope this satisfies your query. Thanks for using HCM. Feel free to ask any more questions that you may have. Dr Madhuri Bagde Consultant Obstetrician and Gynecologist