Doctor Discussion Guide
Could Mirena be right for you?
Here's a good conversation starter to bring on your next visit—and a helpful way to decide, together with your healthcare provider , if the time is right for Mirena.
1. I want effective birth control that lasts for as long as I want, for up to 5 years. YesNo
2. Some days are so hectic I forget to take my birth control. YesNo
3. I want an effective birth control method I don't have to think about taking every day. YesNo
4. I am interested in an estrogen-free form of birth control. YesNo
5. It is important for me to plan the length of time between children. YesNo
6. I want to keep my options open. I may want to have more children in the future, but not right now. YesNo
7. My partner and I are tired of using condoms. YesNo
8. I'd like to talk with my healthcare provider about intrauterine contraception. YesNo
9. I want birth control that treats my heavy periods. YesNo
Print out your answers and share them with your
healthcare provider at your next visit.








