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Cautions Because of possible device risks, such as perforation of the uterus, Mirena use is generally avoided, but not prohibited: Within six weeks of delivery of a baby Before the uterus has returned to normal following pregnancy When a uterus is oriented backward rather than forward (retroverted uterus) Because of possible complications during the insertion procedure, healthcare providers may take extra measures performing an insertion in people with: Seizure disorders Slow heartbeat A history of fainting Bleeding problems Because of possible adverse effects, healthcare providers may need to monitor women who have: A history of ectopic pregnancy Blood clots or a history of blood clots Risk factors for blood clots such as: Severe arterial diseases such as stroke or heart attack High blood pressure High cholesterol Lupus Smoking Diabetes Migraines or severe headaches Weakened immune system Abuse The Mirena IUD is not subject to abuse, nor does it cause physical dependence

Modern high-wattage devices operate at significantly higher temperatures than earlier models, producing up to 15 times more formaldehyde in high-power settings

Pictorial cigarette warnings increase the likelihood that consumers will read, recall, and understand the warnings