Patients often ask me what the best contraceptive method is. There is no right answer to this question as it depends entirely on you: how old you are, if you're a smoker, what medical conditions you have and when, or if, you would like to have a baby. But if the question is: what is the best contraceptive for my sex life? My answer is the Mirena...

What It Is...
The Mirena is a T-shaped intra-uterine system the size of a matchstick. When inserted into your uterus (in much the same way a pap smear is done), it delivers a small amount of progesterone into the uterus every day. If you haven't had children it can be a bit painful as the Mirena enters the cervix, but it is usually over in a few minutes. Ask for suitable pain relief prior to insertion.

Why It's Sex-Friendly
Unlike the Pill, which breaks down your testosterone and pushes up your SHBG (a scavenger molecule that binds to your natural testosterone), the Mirena does not interfere with your hormones. This is good news for your sex life because low levels of testosterone reduce your libido. For some women, the fear of falling pregnant causes anxiety during sex, which inhibits enjoyment. The Mirena is at least as effective as sterilization – less than one in a thousand women fall pregnant on it. It lasts for five years but can be removed at any time should you want to have a baby. It does not influence your fertility – you can fall pregnant immediately after removing it.

The Mirena is often prescribed for women who experience heavy bleeding and period pain both of which can be passion killers. The best medical treatment for heavy bleeding is only affective in 50% of cases and the Mirena has been proven to be superior to that. Studies also show that 80% of patients experience less period pain and 50% less PMS when using the Mirena. Do note that it can take a few months to settle and causes slightly more discomfort in the beginning.

Any Other Benefits?
The Mirena is safe to use while breastfeeding. The POP or 'mini pill' is usually prescribed, however this needs to be taken at exactly the same time every day to make sure you don't fall pregnant and women often experience spotting while on it. The Mirena is also useful as a hormone replacement therapy in post-menopausal women who have not had a hysterectomy. It provides progesterone to protect against the cancerous effects of oestrogen often taken to relieve menopausal symptoms.

Any Negative Side Effects?
Some women have reported headaches, lower abdominal pain, backache, skin disorders, vaginal discharge, breast tenderness, mood changes, nausea and fluid retention whilst using the Mirena. However on investigation these are usually found to be unrelated to the device.

Need To Know
Your partner should not feel the device during sex, it does not cause skin problems or weight gain associated with other forms of contraceptive and, bearing in mind it lasts for five years, is extremely cost effective. Expect to pay about R2000. Remember, the Mirena does not protect against HIV and other STIs. It must always be used in conjunction with a condom.