This case involves a 32-year-old patient at our clinic

who had a Mirena® intrauterine device (IUD) inserted two years ago

due to severe menstrual cramps and heavy menstrual bleeding.

About three months after insertion,

her menstrual flow decreased significantly

and was well controlled for a period of time.

However, over the past six months,

she began experiencing persistent irregular bleeding,

which led her to return to the clinic for evaluation.

On ultrasound examination,

the Mirena® intrauterine device (IUD) was found to have shifted downward,

positioned toward the lower uterus and cervical canal.

These days, Mirena is known to be effective for up to 8 years

when used for contraception.

However, when bleeding resumes,

many patients naturally worry:

“Has the contraceptive effect decreased?”

“Could there be another problem?”

In such cases, simply pushing the IUD back into place

often does not result in stable positioning,

and the device is likely to migrate downward again.

Therefore, we generally recommend removing the existing IUD

and reinserting a new Mirena.

For this patient as well,

the previous device was removed

and a new Mirena IUD was inserted.

It is important to note that this patient

had not undergone routine follow-up examinations after insertion

and only returned to the clinic after experiencing bleeding for six months.

For patients with a Mirena IUD in place,

the following follow-up schedule is strongly recommended

to maintain safe and effective contraception:

▶ A follow-up visit within 2–3 months after insertion to confirm proper positioning

▶ Regular check-ups every 6–12 months thereafter

Following this schedule helps ensure

that the contraceptive effect is maintained safely and reliably.

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