4) UNBOXING Mirena & Kyleena! (Talking IUC with Dr. Dervaitis)

IMPORTANT 2023 UPDATE re: IUD DURATION OF USE- US FDA now approves 52mg levonorgestrel IUD (Mirena, Liletta) for 8 YEARS use for contraception. When treatment of heavy menstrual bleeding is the primary indication, best results are usually seen in the first 5 years. Kyleena (19.5mg) is still 5 years. See video #35 for info on copper IUD extended use.
**********
Dr. Kristina Dervaitis, an OB/Gyn in Newmarket, Ontario, answers your IUD questions: Why is that box so big and what’s in it?!? (Mirena & Kyleena “unboxing”).
Please note: this channel is provided as a volunteer public health education initiative (not for profit, no industry support, the channel is not monetized with ads). Dr. Dervaitis received her MD in 2000 and completed her OB/Gyn residency training in 2005 at Western University.
For additional information on contraception and sexual health, I recommend the Society of Obstetricians & Gynaecologists of Canada official website: www.sexandu.ca

[@amandagoulard3900]

Thank you for providing women with the education to feel empowered. Much appreciated 💜

[@Aska_the_Strange]

Very informative. Thank you!!

[@chelseycleemoff5572]

This is awesome! Thank you so much for the information and helping me decide on my next move towards an IUD.

[@dr.kristinadervaitis789]

There are several different brands of copper IUD. Some examples: FlexiT, Liberte, Mona Lisa, Nova T, Paragard. -Dr. D

[@jades7312]

Is it true that Jaydess is no longer available in Canada?

[@dr.kristinadervaitis789]

Yes- Jaydess has been replaced by Kyleena (which is the same slightly smaller size as Jaydess, but an even better option because it lasts up to 5 years instead of 3)👍. -Dr. Dervaitis

[@jades7312]

@@dr.kristinadervaitis789 Thank you for your reply. What you're doing to educate the public is wonderful. Could the Skyla be special ordered to Canada since it is technically the Jaydess? It worked really well for me. I'm concerned the increased dose in Kyleena may not be ideal for me in terms of side effects. I did have minor side effects with the Jaydess.

[@casebeth]

so sad that the US only offers us Paraguard :/ at this point I'd go across the border in a heartbeat for the infinitely better standard of care.

[@kylahutchins8735]

I’ve had the kyleena for almost a month now and I haven’t stopped randomly bleeding since

[@dr.kristinadervaitis789]

This channel is not intended to provide personalized medical advice. Please see video #7 for more (general) information on what bleeding to expect after IUD insertion. If you are concerned about bleeding, see your doctor. -Dr. Dervaitis

[@random_girl1787]

Hi, I really love your videos about iuds, they have helped a lot! I was wondering if the kyleena is less effective because it contains les hormones (and if so how much less effective). I'm not sure if you have mentioned it before.

[@dr.kristinadervaitis789]

Kyleena is equally effective as Mirena (both 2/1000 chance of pregnancy) and slightly MORE effective than the copper IUD (which has a 6-8/1000 chance of pregnancy). -Dr. Dervaitis

[@thePhoenixxx1983]

Thanks Dr. Dervaitis for making this video, it's quite informative and I appreciate that. Can you advise how long the Mirena string is before it's cut?

[@dr.kristinadervaitis789]

Glad you found the video helpful! The Mirena strings are usually cut about 2-3 centimetres beyond the opening of the cervix. -Dr. Dervaitis

[@notetoselfimissyouxx]

Hi Dr Dervaitis. Will hirsutism induced by Kyleena resolve itself after removal?

[@dr.kristinadervaitis789]

No evidence to support a link between hirsuitism and the hormonal IUD.

[@shreddder999]

Decisions, decisions.

[@Pr1ncessYak]

I'm seeing so many people say that the kyleena iud caused terrible acne. What's the mechanism behind the iud causing acne? I thought there'd be less hormonal side effects because less of the hormones enter the blood stream

[@dr.kristinadervaitis789]

Hi Kay- Yes, acne can be a side effect of the levonorgestrel IUD. Although the amount of hormone that gets into the bloodstream is very low, it’s not “zero”, and so some patients experience side effects. Levonorgestrel has some mild androgenic properties, and some women’s skin might be more sensitive to this than others. It is still a low percentage of women who experience acne as a side effect. If it is a bothersome problem, the IUD can be removed at any time, and there are other options (including the non-hormonal copper IUD). -Dr. Dervaitis

[@Pr1ncessYak]

@@dr.kristinadervaitis789 thanks so much. My options are limited because I have endomoitrosis. I would like to get a iud but I'm concerned.that an iud may just add inflammation to my already inflamed pelvis and abdomen. Do iuds increase the likelihood of infections and inflammation?

[@dr.kristinadervaitis789]

Kay - sorry that I missed seeing this subsequent question from you. The levonorgestrel IUD is actually one of the first line treatment options for endometriosis (progesterone helps to diminish endometrial tissue, including endometriosis implants outside the uterus, it does NOT “inflame” or infect them...) -Dr. Dervaitis

[@charlayib]

Do both cause acne or just the kyleena?

[@theresakas]

Is ultrasound necessary or is it pretty accurate inserting the IUD without an ultrasound?

[@dr.kristinadervaitis789]

Hi Theresa- Generally speaking, it is not necessary to have an ultrasound before or during an IUD insertion. The health care provider performing the insertion would always do a physical exam prior to any insertion. If there were any concerns or possible abnormalities based on the physical exam (or patient medical history) one might then consider doing an ultrasound prior to insertion. Everyone’s anatomy is unique, and if an IUD insertion is proving to be challenging, some providers may then decide to go to an ultrasound guided procedure instead (but this is rarely necessary). Similarly, ultrasound is not mandatory after an IUD insert, but in some situations, the health care provider may decide to do an ultrasound afterwards to check IUD position (or to check on any other issue that might warrant imaging...) -Dr. Dervaitis

[@theresakas]

Dr. Kristina Dervaitis thank you so much for the info. I had the ParaGard for 3 years and it dislodged on Friday. I just switched to the Kyleena on Monday and have been having cramping here and there. I’m assuming that’s normal?

[@charlayib]

Would the copper that is in Kyleena cause an adverse reaction for someone who could not tolerate a copper IUD?

[@dr.kristinadervaitis789]

There is NO copper in Kyleena (or any of the hormonal IUD’s)! -Dr. Dervaitis

[@specialoccasions6553]

@@dr.kristinadervaitis789 thank you. I thought it had a bit of copper that is wrapped on it. Said so online. Hmm

[@dr.kristinadervaitis789]

Special Occasions For further information, please see the Bayer product monograph (also available online).

[@frangipani5379]

Is it ok for someone who had PCOS before to use a hormonal IUD? If not what might be the best contraception option? Thank you!

[@dr.kristinadervaitis789]

The hormonal IUD is ideal for patients with PCOS (it provides them with the progesterone that they need, but aren’t making due to less frequent ovulation). Any contraception option that provides progesterone is important for PCOS patients (thus I would not recommend a copper IUD for PCOS patients). -Dr. Dervaitis

[@parasto5851]

Hi Doc and thank you for taking the time to do these videos. I have endometriosis and will get a Mirena in a few days. I have never had children, will the Mirena be bothersome for me rather than the Kyleena? i think my question is; will the actual size of the IUD affect my experience living with the IUD? Many thanks

[@dr.kristinadervaitis789]

Hello- Mirena tends to be recommended over Kyleena for treatment of endometriosis (the higher level of levonorgestrel makes it more effective at endometrial suppression, although there is still some of this benefit with the lower dose as well). For years, before Kyleena /Jaydess/Skyla were available, we were using Mirena for all patients (regardless of whether they have had children) and I certainly continue to use Mirena to help patients of all ages with their menstrual problems (even if they haven’t had children). Once inserted, the size of the IUD won’t have an effect on the experience (the difference in size is very minimal- KYLEENA: 28 mm x 30 mm, 3.8 mm diameter, vs. MIRENA: 32mm x 32 mm, 4.4 mm diameter). -Dr. Dervaitis

[@potatogal4739]

With the iuds, Kyleena and Mirena had a variation in the amount of hormones- which do you think would be better for a younger person?

[@dr.kristinadervaitis789]

Generally speaking, if the patient suffers from painful and/or heavy periods, I will often prescribe the higher dose (52mg) Mirena. Otherwise, the Kyleena (19.5 mg) is typically what is prescribed for younger patients who have but yet had children (because the insertion device is a bit smaller). -Dr. Dervaitis

[@potatogal4739]

Oh okay thank you. One more question, can the difference in hormones affect how well or how it works for people in comparison? Like can it cause more or less side effects depending on which one you use?

[@dr.kristinadervaitis789]

Theoretically, if an individual’s system was more sensitive to the hormones, the lower dose might have fewer side effects (but keep in mind that the “side effect” of less heavy and less painful periods tends to be more pronounced with the higher dose... although both generally have a beneficial effect on menses). -Dr. Dervaitis

[@potatogal4739]

Dr. Kristina Dervaitis okay thanks so much!!

[@potatogal4739]

I get my iud in on my next period, which is a couple weeks away and I’m pretty nervous but glad because it seems like a great option.

[@noelkilbert3093]

Dr. Kristini I have a skyla. What are your thoughts on this iud. I’m one of women in my mid 40s.

[@dr.kristinadervaitis789]

Hi Noel- Skyla is a hormonal IUD that is effective for up to 3 years. It has a lower dose of levonorgestrel compared to Kyleena and Mirena, but has similar beneficial menstrual cycle side effects. It is equally effective at preventing pregnancy compared to other IUD’s (

[@dr.kristinadervaitis789]

Theresa- Yes, some cramping on & off after an IUD is inserted is normal. -Dr. D

[@YagmurMasmas]

Hello, Is it normal to experience continuous and severe cramping for days after the insertion? I am used to heavy period cramps to the point where ibuprofen doesn't really help but naproxen does. However, these past days naproxen isn't lessening the cramp pains either. I'm lucky that I was able to work from home but even then I feel drained and unable to do much.

[@dr.kristinadervaitis789]

Hello- Unfortunately I can’t give personalized medical advice over the internet. If you are concerned about your cramping, I recommend that you see your doctor. -Dr. Dervaitis

[@YagmurMasmas]

@@dr.kristinadervaitis789 Hello, Thank you for your response and thank you for the videos. It was a very helpful resource before getting the IUD. Best wishes, Yagmur

[@jahliyasisohor9694]

Yagmur Masmas I am experiencing the same thing, I had Mirena inserted yesterday. Did the severe cramping subside?

[@YagmurMasmas]

@@jahliyasisohor9694 Yes it did. Right now I'm experiencing on and off cramping but by far not as severe as the first days. After 3 days I was able to gym (although tensing did make me cramp so I don't recommend it) and now I'm able to function similarly to a normal period (I am still bleeding). I am obviously not a doctor but for me anti spasmodic drugs did more than anti inflammatory (like naproxen, ibu): I heard from a friend about about dicyclomine and mefthal spas. I'm sorry you are experiencing such pain, it sucks! Get better soon.

[@rebelamyrlin]

so the way you demonstrated on the model uterus - the IUD wasn't straight. Looked like it was leaning to the side with the bottom touching the uterine wall. Is this a concern? Is this actually how it goes in, or is it just because it's a false, rigid anatomy model? The angle with which it is inserted makes me super nervous.

[@dr.kristinadervaitis789]

It’s just a model! (This should not be cause for concern). I have inserted thousands of IUD’s, this was intended for demonstration purposes only. A flat plastic model is very different from a (three dimensional) actual uterus. -Dr. Dervaitis

[@charlayib]

I tried jaydess and I had cramping on one side in my pelvis. I am wondering if a higher does would make it worse?

[@dr.kristinadervaitis789]

Dose of progesterone should not increase cramping (if anything, the higher the dose, the more of a chance there is to decrease menstrual bleeding and cramping). -Dr. Dervaitis

[@katechoi3223]

Dr Kristina, is it safe to take MRI with Mirena inserted in my uterus?

[@dr.kristinadervaitis789]

Yes. No restrictions on imaging with Mirena. -Dr. Dervaitis

[@babygirl36695]

I had the mirana but now during sex I feel like something is stabbing with a point on my right pelvic side. I made a doctor appointment but she check and said everything is in place. I can't figure out why intercorse is now painful with a stabbing feeling

[@dr.kristinadervaitis789]

This channel is not intended to provide personalized medical advice. Talk to your doctor.

[@shannonmcnally6969]

Do you pick up your own IUDs in Canada? I had a Kyleena inserted the US and the doctor already had it when I arrived for my appointment.

[@dr.kristinadervaitis789]

It varies from clinic to clinic. Most physicians write a prescription for the IUD and the patient then picks up the IUD at a pharmacy. In some clinics, they may have IUD’s available there in the clinic for purchase. -Dr. Dervaitis

[@AriannaGiselle999]

Hi Doctor! What is the longest amount of time you can leave an IUD inserted? A lot of videos say a few years and my OBGYN swears mine is good for 10! I am just scared of an accidental pregnancy or complications with my uterus.. Thanks in advance!

[@dr.kristinadervaitis789]

Please see video #35 for more information on this topic: kzbin.info/www/bejne/r5i6i4NonK1nn68

[@willah1779]

Why are some iuds different colors?

[@dr.kristinadervaitis789]

These are just IUD’s for demonstration purposes. All of the actual IUD’s are white (plus copper for the non-hormonal ones). String colour may vary depending on the type of IUD. -Dr. Dervaitis

[@AJ-wh4yl]

2 different physicians tried inserting the Mirena and couldn’t get it in. I took medicine to dilate my cervix and it only dilated a little, it didn’t help at all. I’ve never been pregnant before. I was disappointed because I have the worse experience with my menstrual. Heavy bleeding and extreme cramping. They suggested the smaller Kyleena. My purpose of getting the iud is to control the bleeding and cramping but if the Kyleena doesn’t help for this, should I consider having it placed? It was an overwhelming experience each time they tired.

[@dr.kristinadervaitis789]

Unfortunately I can’t give personalized medical advice over the internet. There are other options for management of menstrual disorders. Talk to your doctor about your options.

[@kristygarcia5011]

I got the Kyleena in February, and I’ve had a baby vaginally. Will it work the same or no?

[@biswajitdeb6405]

Madam my wife's Mirena was inserted cz of fibroid tumour 16months before.. Age 51 Today she had bleeding again but not heavy .. Does it happens? @Dr. Kristina Dervaitis

[@dr.kristinadervaitis789]

This channel is not intended to provide personalized medical advice. If your wife is concerned about her bleeding, she should see her doctor. -Dr. Dervaitis

[@zakarrahg5250]

Hi I'm getting mine kyleena IUD come nexplanon 2022 27 2020

[@dr.kristinadervaitis789]

Good luck Zakarrah! Thanks for watching! 👍 -Dr. Dervaitis

[@marygracelabordocanag7593]

Hello my name is mary,is it ok to drink norethistherone while on mirena just to stop my period for holiday,hope you response god bless doc.

[@dr.kristinadervaitis789]

Hi again Mary! (Sorry, I think I called you Rica in my last reply😊)- Short term concurrent oral progesterone (such as norethistherone) is considered safe in women who already have a Mirena in place, but only if there are no contraindications to the medication, and only with the supervision of your doctor. -Dr. Dervaitis

[@marygracelabordocanag7593]

@@dr.kristinadervaitis789 thanks doc god bless and more power

[@efuqua57]

Which IUD is made of copper ?

[@Radioactivesharkk]

Ms Fu paraguard

[@dr.kristinadervaitis789]

Hi- Sorry, realize now that I must have missed this question! There are many brands of copper IUD, including: Paragard, MonaLisa, Flexi-T, Liberté, NovaT... it depends on what country you live in and the brands available. -Dr. Dervaitis