What are the risks and complications after a second IUD placement?

Question

Hello doctor,

I went to a doctor to change the Mirena coil. The coil was recommended by the attending gynecologist after surgery to remove an ovarian cyst and polyp. My diagnosis includes adenomyosis (before surgery, I complained of heavy, non-painful menstrual bleeding). The first coil lasted five years without problems. The gynecologist introduced a new IUD (intrauterine device) without first removing the old one. In connection with this situation, I have some questions. I would be grateful for your professional opinion.

Is it possible to correctly install the Mirena coil into the uterine cavity if the previous coil was not removed?
What side effects can be caused by the simultaneous presence of hormonal IUDs (two sterile foreign bodies) in the uterus? Could this cause health problems and harm to the patient?
How can one explain the symptoms that arose after the installation of the second Mirena, such as pain in the lower abdomen, and lower back and excessive menstrual bleeding?
Is the location of the coil at the internal os of the cervix (ultrasound) correct? If not, does this indicate improper placement of the IUD? What symptoms does this arrangement of the coil cause in the patient?
Are adenomyosis and endometriosis chronic diseases? Will symptoms such as heavy periods return after the Mirena IUD is removed?
What symptoms can be caused by increased levels of the hormone levonorgestrel in the body? With two Mirena coils in the uterus at the same time, could such an amount of the hormone levonorgestrel be released that could cause psychological anxiety and sleep disturbances in the patient?
Can the presence of two sterile foreign bodies in the uterine cavity cause harm to the patient’s health?
Does the presence of the Mirena IUD in the uterine cavity contribute to damage to the uterine mucosa, the formation of polyps, and uterine fibroids?
Can the IUD become dislodged or fall out (including partially) from the uterine cavity, what are the reasons for this? Could this be caused by the incorrect installation of the IUD by the gynecologist? What might be the patient's body reaction if the IUD slipped out of the uterine cavity, what objective and subjective indicators indicate that the IUD has slipped out of the uterine cavity?

Thank you.

Answer 1

Hello,

Thanks for trusting us with your health care.

Regarding your symptoms, no, it is not possible unless the previous one is removed. Yes, two IUDs (intrauterine devices) can be fatal as they may cause uterine perforation. There is no pain except that it sometimes causes bleeding via perforation. Yes, the internal os (orifice) is correct. If you have a pelvic mass, the period will be heavy even after the removal of the IUD. Mirena can cause irregular bleeding and may contribute to premenstrual syndrome. The IUD can be displaced and enter the abdomen, causing perforations and bleeding, which may be fatal. Schedule another appointment for follow-up via chat, phone, or video consultation.

Hope I have solved your query. I will be happy to help you further.

Thank you.