‘Why Is My Gy­nae Push­ing the Mirena?’

Dr Lindi Mur­ray and Dr Ilana John­son are our COSMO gy­nae gu­rus. To­gether, these clued-up ladies own Lila, an ob/gyn prac­tice in Cape Town – and they’re here to an­swer your ques­tions

Cosmopolitan (South Africa) - - HEALTH -

I feel like my gy­nae is al­ways try­ing to get me to try the Mirena, even though I’m happy on the Pill. Is the Mirena a bet­ter op­tion?

The main ben­e­fit of us­ing the Mirena is that it qual­i­fies as a long-act­ing re­versible con­tra­cep­tive. This means that you can have it in­serted – and then for­get about con­tra­cep­tion for the next five years. When you want to fall preg­nant, it can sim­ply be re­moved. Most women will ex­pe­ri­ence no monthly bleed (this is per­fectly fine!) and hence no pe­riod pain. With the Pill, you have to re­mem­ber to take it ev­ery day to en­sure ef­fi­cacy. The Pill has other ben­e­fi­cial ef­fects, such as pro­tec­tion against ovar­ian and en­dome­trial cancer, as well as the woman be­ing com­pletely in con­trol of her cy­cle.

I have tried so many di€er­ent birth-con­trol meth­ods, but none of them seem to agree with me. What should I do?

There are many birth-con­trol op­tions out there. (See page 84.) Chat­ting to your gy­nae should help you to find one that is most suited to you. If the search has been ex­hausted and you can’t find a suit­able method, then con­doms are a good op­tion – bear­ing in mind that with typ­i­cal use, con­doms have a fail­ure rate of 13%. With the cor­rect use, that fig­ure can go as low as two per­cent, but con­doms are no­to­ri­ously dif­fi­cult to use con­sis­tently ev­ery sin­gle time.

I’ve been hear­ing about the arm im­plant. What are the bene…its of this method compared to the Pill or Mirena?

The im­plant is also a long-act­ing re­versible con­tra­cep­tive, and is sim­i­lar to the Mirena. The de­vice known as Im­planon lasts for three years (it can be re­moved be­fore then if preg­nancy is de­sired) and thus pro­vides longterm preg­nancy pro­tec­tion. They are ex­tremely ef­fec­tive, with only one preg­nancy per 1 000 women per year, so they are more ef­fec­tive than the Pill. For women who are un­com­fort­able with the idea of us­ing an in­trauter­ine de­vice, this could be a pos­si­ble longterm so­lu­tion. It’s also an op­tion for pa­tients who are not al­lowed to use the Pill for med­i­cal rea­sons, such as clot­ting ab­nor­mal­i­ties.

I’m on the Mirena and have re­cently started spot­ting. Is this a sign that some­thing may be wrong?

When you ex­pe­ri­ence un­sched­uled bleed­ing, it needs to be as­sessed by your gy­nae. Spot­ting can oc­cur for many rea­sons, which may have noth­ing to do with the Mirena. How­ever, it can be to­tally nor­mal if you’re in the fifth year of us­ing the de­vice. ■

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