Can I use the Mirena coil contraceptive if I have had cancer?
The Mirena coil is a method of contraception for women. It is an intrauterine system (IUS). And although it is similar to a contraceptive coil (IUD) it works in a different way.
You have the Mirena coil put into your womb like the contraceptive coil. But unlike the contraceptive coil, it releases a small amount of a man made hormone into your womb every day. This is levonorgestrel – a man made version of the hormone progesterone. It helps to prevent pregnancy in 2 ways
- By thickening the mucus at the neck of the womb making it difficult for sperm to enter the womb
- By stopping the womb lining from thickening making it difficult for fertilised eggs to settle in the womb
Because the lining of the womb doesn’t thicken, you may have much lighter periods. Or your periods may stop completely. In fact, some women have this type of coil put in to help make heavy periods lighter.
The manufacturers of the Mirena coil say that women shouldn’t use it if they have had
- Cervical cancer or womb cancer
- Liver cancer
- Hormone dependent cancers, including breast cancer
- Blood cancers, including leukaemia
- Gestational trophoblastic tumours, such as molar pregnancy
A side effect of the Mirena coil is spotting. This is light bleeding that happens at any time of the month, not just during your period. Spotting can mask the symptoms of cancer, which is why the manufacturers recommend that you shouldn’t use Mirena if you have or have had womb or cervical cancer. The manufacturers also recommend that you do not use the Mirena coil if you have abnormal cervical cells (cervical dysplasia).
There is no evidence that the Mirena coil causes these cancers. In fact, some women have the Mirena coil if they are taking oestrogen only hormone replacement therapy (HRT). This is because your womb will thicken if you take oestrogen alone, which can increase your chance of developing womb cancer.
The Mirena coil has been used to treat womb cancer in certain cases where women are too unwell to have normal recommended treatments. Doctors are also looking at using it to treat some very early womb cancers in young women. And the PROTEC1 study is looking at using the Mirena coil in obese women to see whether it reduces their risk of developing womb cancer.
The Mirena coil may affect how your liver works. If you have had liver cancer or any type of liver disease, you should not use the Mirena coil.
Although the Mirena coil only releases a small amount of levonorgestrel, we are not sure how much of it, if any, goes to other parts of the body. Currently, there is no strong evidence to show whether or not the Mirena coil could cause cancers that depend on hormones to grow.
Although a couple of studies have found a link between this type of coil and breast cancer, they had flaws. For example, they did not account for factors that we know are linked to a woman's risk of breast cancer such as weight and family history. Overall there does not appear to be a link between using an IUS device and breast cancer. But if you are concerned you can talk to your GP or specialist about what contraception is best for you.
If you have a blood cancer such as leukaemia and have a Mirena coil, any bleeding caused by the coil would be much heavier. This is because you may not have enough platelets to help your blood clot normally.
The manufacturers of the Mirena coil say it may be used with caution if your leukaemia is in remission.
The manufacturers recommend that you do not use the Mirena coil if you have recently been diagnosed with a gestational trophoblastic tumour (GTT), such as a molar pregnancy or choriocarcinoma. They say you should not use this type of coil while your HCG levels are still raised. Your specialist will advise you about this.
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