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Anon. asked...

Which is more effective at stopping periods - the implant or the Mirena coil? And which has the least side effects? The background is that I have pelvic girdle pain (my "baby" is 3 years old!) which gives me constant pain. The pain increases the week before my period, peaks whilst I'm on my period and takes a week to get back to a normal pain level. The pain when bleeding in the same however much it is, spotting hurts just as much as a period. My pain relief is codeine and when I'm on my period the pain is so bad that I have to be off work sick. I'm having physio but can only do exercises on good days. I've tried the mini pill which gave me two periods a month, and the combined pill which gave me very bad stomach cramps. As the pain goes up and down over the month I'm guessing it's hormone driven? Thank you for your time.

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The Answer

There are distinct advantages and disadvantages to using the implant and the Mirena coil.

Advantages of using the Mirena coil include:

• Once the Mirena coil is fitted, it normally works straight away and can possibly last for up to 5 years or until it's removed.

• It normally doesn't interfere with sex.

• Your normal fertility returns as soon as the coil is taken out.

• It's not affected by other medicines.

• It’s known to help heavy or painful periods in the long term making periods shorter and lighter, with the result of them possibly stopping completely after one year of use.

• It's one of the most effective forms of contraception available in the UK.

Disadvantages of using the Mirena coil include:

• Some women experience changes in mood and libido.

• Your periods may become heavier or more painful but this may improve after a few months.

• Can affect compliance due to vaginal bleeding and pain.

• Irregular bleeding/spotting are common in the first six months after having the Mirena coil fitted. This normally decreases with time.

• Some women experience headaches, acne and breast tenderness after having the coil fitted.

• An uncommon side effect of the coil is the appearance of small fluid-filled cysts on the ovaries, which usually disappear without treatment.

Risks of using the Mirena coil include:

• Damage to the womb.

• Pelvic infections.

• Rejection of coil by the womb.

• Ectopic pregnancy.

Advantages of the implant include:

• It normally works for three years.

• the implant does not interfere with sex.

• you do not have to remember to take it everyday like the pill.

• Fertility normally returns to normal as soon as the implant is removed.

• the implant can also reduce heavy or painful periods after the first year of use.

Disadvantages of the implant include:

• Your periods may change significantly while using a contraceptive implant eg no bleeding, infrequent or prolonged bleeding. These bleeding patterns are likely to remain irregular, however they normally settle down after the first year.

• Side effects that some women report include: headaches ,acne ,nausea, breast tenderness, changes in mood, loss of sex drive. These normally stop after a few months.

• Some medicines can reduce the implant's effectiveness. These include complementary remedies, such as St John's Wort

• Risks of using the implant include the area of skin where the implant has been fitted can become infected.

In answer to your question which is more effective, it will be a case of trial and error depending on what suits you best as every woman reacts differently to different contraception methods. We would suggest you visit your doctor to discuss alternative pain relief as long term codeine can cause constipation. With regard to the pain going up and down over the month, it may be due to fluctuations in hormones but again your nurse/doctor will discuss this further.

Answered by the Health at Hand nurses  

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