Unprotected sex after second mirena insertion.
June 5, 2015 7:35 PM   Subscribe

My doctor didn't know the answer to this, looked at me deadpan, and said "you can wait". Obviously. I'm just curious though, having immediately replaced one mirena with another, is there still the prerequisite seven day alternative contraceptive wait time?
posted by Marinara to Health & Fitness (12 answers total) 1 user marked this as a favorite

I would probably give it a bit of time to let my cervix glue itself shut again. I wouldn't worry about risk of pregnancy so much as risk of infection in this case.
posted by asperity at 7:43 PM on June 5, 2015

Mine said there was no reason to wait.
posted by katieinshoes at 8:04 PM on June 5, 2015 [1 favorite]

Unless you and your doctor are really tight pals (which it doesn't sound like) I would contact the doctor's office and say something like "I was in earlier to have a Mirena inserted and when I asked about when I could safely have unprotected sexual contact the doctor laughed off my question. I find this completely inappropriate and would like to know: when can I safely have unprotected sexual contact?"

"You can wait" is TOTALLY out of line as a response from a medical professional. Holy shit, is this some sort of throwback reference to women-as-sexually-insatiable-beings or something? You were a PATIENT seeing your DOCTOR for a MEDICAL PROCEDURE and he laughed off your legitimate question about post-procedure care? I'd be livid.
posted by Lexica at 8:27 PM on June 5, 2015 [32 favorites]

Response by poster: She. My doctor was a woman.

This was after a long frustrating weekend of being told that I shouldn't even have one because of being nulliparous and shamed for not using secondary contraceptives during the duration of my first IUD because the Mirena is not 100% effective and if I don't want kids I should also use condoms or not have sex. I've been blown away by the ignorance and lack of compassion when dealing with doctors for gynecological purposes here.

I was only asking because she said I was not allowed sex without backup protection until after seven days of insertion. This was weird because when I had my first IUD done (in Olympia, WA, thank heavens) it was during my menstrual cycle and my doctor gave the go ahead immediately. I just was curious because it didn't seem like there would be any gap in hormones since I went from one mirena to another. No practical reason, I'm cramping like crazy and bleeding like I haven't in five years, I was just curious about the actual reason. And yeah. Definitely livid.

Sorry to threadsit, just residual feelings of resentment and frustration. Anyway, you guys are awesome as always.
posted by Marinara at 9:11 PM on June 5, 2015 [4 favorites]

I don't know the answer but Planned Parenthood has a great chat service (plannedparenthoodchat.org) that can give you a definitive answer for free. They go live at 9am ET 6am PT on Saturdays. You could also call your local branch as soon as they open and you can consult a nurse.
I'm sorry you were treated that way. That's an embarrassing way for a medical professional to act.
posted by rubster at 9:38 PM on June 5, 2015 [6 favorites]

shamed for not using secondary contraceptives during the duration of my first IUD because the Mirena is not 100% effective

What. The. Hell.

I didn't think to ask my gyn when I had my Mirena round 2 inserted (and my first was stuck when we went to remove it, so I was on x days no sex for other reasons), but if this is the nonsense your doctor is feeding you, I wouldn't trust anything she had to say about anything. Seriously. The whole point Of the Mirena is that you don't have to use backup protection.

I sometimes wonder whether metafilter is too fast to leap to DTMFDA, but in this case, if you've got another option...I'd take it. 'Cause that's bullshit.
posted by leahwrenn at 9:39 PM on June 5, 2015 [12 favorites]

I went to see a doctor about birth control options once and she said doctors didn't handle that and that I needed to call a 1-800 number, which she pointed at on a poster, if I needed that info. I was a scared university student and didn't have the nerve to ask anyone about birth control again for years. It's only recently that I realized she was totally out of line.

Your doctor did not handle your question appropriately. She could have said that she didn't know, but that she would look into it and that you should continue to use a back-up method in the meantime. And then she should have looked into it.
posted by Chaussette and the Pussy Cats at 10:50 PM on June 5, 2015

This page from Planned Parenthood (in the "How Soon After Getting an IUD Can I Have Sex?" section) says:

"You can have sex as soon as you like after the IUD is inserted....Hormonal IUDs are effective immediately if inserted within seven days after the start of your period. If you have Mirena or Skyla inserted at any other time during your menstrual cycle, use another method of birth control like a condom, female condom, or spermicide if you have vaginal intercourse during the first week after insertion. Protection will begin after seven days."
posted by needs more cowbell at 11:57 PM on June 5, 2015 [1 favorite]

Sorry, just realized that does not answer the specific question. The following (an archived drug label) implies that one would have continuous coverage if the Mirena is removed and then immediately replaced, but it doesn't exactly flat-out say that:


If Mirena is removed mid-cycle and the woman has had intercourse within the preceding week, she is at a risk of pregnancy unless a new Mirena is inserted immediately following removal.

5. Continuation of Contraception After Removal

You may insert a new Mirena immediately following removal.
If a patient with regular cycles wants to start a different birth control method, remove Mirena during the first 7 days of the menstrual cycle and start the new method.
If a patient with irregular cycles or amenorrhea wants to start a different birth control method, or if you remove Mirena after the seventh day of the menstrual cycle, start the new method at least 7 days before removal."
posted by needs more cowbell at 12:36 AM on June 6, 2015 [1 favorite]

When I asked my doctor how soon it was safe to have otherwise unprotected sex after she'd put in my FIRST Mirena, she said "Well, I'd prefer it if you waited until after you left the office." (I was postpartum and my period hadn't yet returned.)
posted by KathrynT at 12:37 AM on June 6, 2015 [31 favorites]

The heavy cramping and bleeding on top of the doctor's attitude are worrisome. Is there a Planned Parenthood clinic in your area? Call them or get on the PP chat mentioned above and ask abut these symptoms. Trust what you know about your own body, if the last Mirena didn't do this to you then this one shouldn't either.

And find a new doc!
posted by mareli at 3:36 AM on June 6, 2015 [3 favorites]

A Mirena has a lower failure rate than being STERILISED (tubes tied or vasectomy).

Condoms for STIs, yes, but it kind of already IS two forms of contraceptive, IUD and hormones, which is what makes it so effective.

From a contraceptive point of view, you should be good to go. There is a slightly higher risk of getting an infection or pelvic infections being carried to uterus immediately after placement, so if that is a concern, that would be the only reason to use condoms.

I am so glad that you won't have to deal with this Doctor for a few more years, because that is bullshit.
If there is an FPA in your area, I find them more experienced in contraceptive options, and placing IUDs etc.

[Fellow nulliparous, Mirena user]
posted by Elysum at 5:54 AM on June 6, 2015 [2 favorites]

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