Mysterious Mirena migration
July 31, 2014 1:47 PM   Subscribe

After a year and a half of trusty service, my Mirena IUD seems to have been sucked into unknown parts of my uterus, taking its strings with it and leaving me with dull cramps 24/7. Has this happened to you or anyone you know?

I went to my OB/GYN this morning, and they saw a glimpse of the strings but couldn't grab them to take the IUD out. Now I have to wait until next Tuesday to be seen for an ultrasound to figure out if it's embedded/crushed/twisted in my uterus or elsewhere. Then who knows what will happen. Googling results in a million horror stories, so I thought I'd ask here, as this is a pretty pro-Mirena group of ladies. If it did happen to you, what was the process to get your IUD removed? How long did it take from initial doctor appointment to resolution?

The longer I have these cramps and insane abdominal bloating (I look 5 months pregnant), the more anxiety I have about this piece of metal jabbing through my uterus and escaping to the great beyond. Please talk me down, Mefites! I had no other Mirena side effects until now.
posted by Maarika to Health & Fitness (14 answers total) 1 user marked this as a favorite
This happened to my friend last summer. She unfortunately had to have surgery to have it removed. I don't remember where it had embedded itself, but the surgery went well and she is completely fine now.
posted by roomthreeseventeen at 1:56 PM on July 31, 2014

I have had two Mirena problems relevant to your question. At one point, the strings vanished up into my uterus. The doctor made sure it was still set properly, and having confirmed that, just left it there and told me we didn't need to sweat it until I wanted it out. When I wanted it gone to have a a baby, though... that was horrible. They tried to fish it out with a thing called an IUD hook with no anesthesia, which winds up being the most singularly awful experiences I have ever had in my life, and if they propose to do this to you, throw a bloody fit.

Ultimately they took it out via a scheduled hysteroscopy procedure under general anesthesia. It was a quick thing, in at 7am, home by lunchtime, no long-term discomfort or anything.

I have *also* had a perforated Mirena -- my second one. It was set about seven weeks after I had that baby, and about a week after that we were in a fairly mild car accident. Annnnnd the strings vanished again. As best we can figure, my uterus was still soft enough postpartum that the seat belt pushed the IUD through the wall of the uterus. This is when I got cramping in my back, though I didn't have bloating or anything.

It was a three-month process to figure out what happened to it -- they tried ultrasounds, x-rays, at one point they were working under the theory it had been expelled, but of course it hadn't been. Eventually they located it (from the x-ray) and fished it out via laparoscopic surgery. While I was recovering from anesthesia, the doctor showed me another x-ray they took in the operating room because they couldn't find it again -- the thing had migrated to someplace just under my ribcage. I still went home the same day.

But no internal bleeding even with the thing not in the right spot for a few months, and recovery after the surgery was eh, a couple of slightly rough weeks, I guess. It was not the most horrible thing that could ever happen to you, and you'll probably be just fine.

I'm not getting another IUD, though. I still advocate for them for other people, but it seems like my body doesn't like 'em so much. Bad luck, I enjoyed not having periods.
posted by Andrhia at 2:09 PM on July 31, 2014 [1 favorite]

If it comforts you, about 15 months in, I started to get random cramping from my Mirena too -- all the time, not just at specific points in my cycle. But it's right where it should be. I know, because I finally demanded another ultrasound just to make sure.

So, yes, there may be bad news next week -- or it may just be that the effect of the Mirena has changed in ways that aren't acceptable to you, but are not in any way injurious OR indicative that you're in for trouble at removal.

(I should add, after about 3 months of the random annoying constant cramping, it settled back down again. I didn't experience such extreme bloating, though.)
posted by artemisia at 3:23 PM on July 31, 2014

When I got my IUD, they told me that perforations are way more likely to happen when a woman has recently given birth - in its usual resting state, the uterus has a thick muscular wall around it that thins when it stretches around a baby. Hopefully your Mirena has just shifted a bit and will be easy to remedy.
posted by momus_window at 3:26 PM on July 31, 2014 [1 favorite]

My Paragard lost its strings and the midwife could not find it using ... Manual tools. But! At the ultrasound it was right where it was supposed to be, just the strings got retracted somehow. There is a good chance this will not suck.
posted by chesty_a_arthur at 3:29 PM on July 31, 2014

Sometimes the strings slither on up there (it's a uterus; it's supposed to be a comfy place). This has happened to a few my girlfriends with IUDs, and so far all that's happened is:

Step 1) Lady visits doctor. Doctor says, "It could be badnews badnews thing! Or maybe not. Why don't you spend a week in anxiety until you get the ultrasound?"
Step 2) Lady gets stressed out at the Doctor's recommendation, then gets the ultrasound a week later.
Step 3) Ultrasound tech says, "Looks normal to me! Continue on your merry way!"
Step 4) Lady proceeds with same IUD for the course of its efficacy.

No guarantees, but this has happened to at least 3 of my friends.
posted by samthemander at 4:54 PM on July 31, 2014 [1 favorite]

My Paragard's strings also disappeared. My regular Dr couldn't retrieve it so she ordered an X-ray which showed it was still in place. It was almost due to be removed so I went to my OB/Gyn who removed it relatively easily & quickly in the office. I had slight cramping and a little spotting, but not much worse than my regular period.
I was a little freaked out at first though, when my regular Dr couldn't find the strings and I thought I might have expelled it without knowing!
posted by Ochre,Hugh at 4:56 PM on July 31, 2014

My experience with something similar was the same as samthemander's friends' experiences: My doctor couldn't see or feel the strings, and an ultrasound revealed that the IUD was where it was supposed to be even if the strings were not.

My mirena came out along with a hysterectomy (for unrelated reasons) a couple of years later, so I can't advise about removing a mirena whose strings have migrated or disappeared.
posted by ImproviseOrDie at 5:11 PM on July 31, 2014

My Mirena's strings were cut short to begin with and then curled up into no-man's land -- when i wanted to get pregnant, they got it out (after a couple of tries and having to go get some sort of long salad-tong like device) and it wasn't really bad at all. Way easier than having it inserted, without a doubt.

So don't flip out -- if they could see the stings, it's fine. If they can't see the strings, it's also fine. Really, you'll be a-ok. It's in there and it won't end up in your lungs or anything. Also, your Mirena is plastic, if that makes you feel better. I got to keep mine as a souvenir! When I get my current one out, I'm going to make a sweet pair of earrings!
posted by danielle the bee at 5:13 PM on July 31, 2014 [1 favorite]

Went for my annual last year, they couldn't find my strings. Also at that appointment I discussed removing it with my doctor. Week later I had my ultrasound to figure out what was going on down there. Week after that I had another appointment to check results and they found it. The strings had curled up.

I had decided I wanted it removed (for a variety of reasons). Scheduled it a week after the other appointment. My doctor described it as procedures A, B, and on attempt C she extracted it. If it had gone to D, I think it would have involved what Andrhia described in her first experience. Doctor, nurse and I were relieved it didn't get that far. I took a ton of ibuprofen an hour before the appointment and was totally fine that evening. Putting it in was much more painful for me.
posted by paradeofblimps at 7:28 PM on July 31, 2014

I recently had some weird issues with cramping and spotting, and got my IUD checked. I have a Paraguard, the copper, non-hormonal one, and had to get an ultrasound to confirm it was still in the right spot. Which it was.

But my gyno also said I had BV, which was probably responsible for the issues. I took some antibiotics, and it's been fine for the last 3 weeks. So you might want to get tested for BV before you freak yourself out too much. It's common for IUD users and can contribute to bloating and cramping and often has no other symptoms. Fun stuff.

IUDs rarely 'travel' these days. I had the same fears, and my gyno said f it was poking something important it wouldn't be dull cramps and spotting, I would be bleeding, like, a LOT.

I hope everything works out for you!
posted by ananci at 8:06 PM on July 31, 2014

My mirena was stuck when I went to have it swapped out. The doc fished around, his partner doc fished around, they looked with an ultrasound...i think they spent about 45 minutes fishing around. Comfy.

So then he said he'd better do a hysteroscopy and fish it out with an instrument that can pass through the camera. In the hospital, under what he called "conscious sedation". In case it has perforated the uterus or something.

So I said ok, we'd do that, and the procedure was totally painless and non-problematic, until we got to the bill, which was substantial. The hospital billed insurance $13000, of which I owed 20% plus the rest of my deductible, and I paid the doc $1300, plus some to the anesthesiologist. (Plus the cost of the new device, which was covered completely by insurance, but since the removal was a "complication" it was not covered---as the doc had expected---under the contraception benefit, but rather under general surgery.)

Yay US health care.
posted by leahwrenn at 9:13 PM on July 31, 2014

Response by poster: Thanks, everyone. I feel sufficiently relaxed to last until my ultrasound next week.
posted by Maarika at 6:01 PM on August 1, 2014

Response by poster: Ultimate follow-up - ultrasound showed that it hadn't shifted position at all, which was weird because I went from not feeling it for 18 months to feeling it poking me 24/7. One day the strings reappeared a little bit, so I made an appointment and got the IUD removed. No more poking.

Also, it was shocking how little and unfrighteningly plastic that thing looked once it was out.
posted by Maarika at 5:46 AM on October 6, 2014

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