First published on Wednesday the 24th of April, 2019, this piece comes in at number 27 in the top 30 most read Villainesse stories of 2019.
The Mirena intrauterine system is one of the best forms of contraception in the world. Unfortunately, due to our country’s current funding restrictions, the Mirena is too expensive to be a realistic option for the majority of New Zealand women. But there is currently a petition started by Dr. Orna McGinn that you can sign requesting the House of Representatives to urge Pharmac to fully fund the Mirena for all women who request it. Fully funding the Mirena is an excellent decision that should have been made years ago, and here are 10 of the many reasons why:
1. The Mirena is one of the most effective forms of contraception in the world.
2. Unlike barrier forms of contraception and some hormonal contraceptive pills, the contraceptive efficacy of the Mirena is not dependent upon the user doing anything other than, well, having one in the first place (which is important given our country’s statistics around sexual violence, with 1 in 5 women estimated to experience serious sexual assault). So you don’t have to worry about forgetting to take the pill or using a condom*.
3. Once fitted, a Mirena lasts up to 5 years.
4. It has been available in Aotearoa for more than 20 years but unless you have a specific medical condition like heavy menstrual bleeding related iron deficiency anaemia it costs hundreds of dollars (up to $500 excluding cost of insertion) and is therefore unaffordable for the majority of women.
5. The fact that the Mirena is so expensive if you don’t meet the current criteria for funding further promotes health inequality in New Zealand.
6. Giving women the option to be prescribed a fully funded Mirena on request would reduce Aotearoa’s high rates of unplanned pregnancy, abortion, and miscarriage. We have one of the highest rates of teen pregnancy in the OECD, which is known to correlate strongly with child poverty. Making this effective contraception option financially accessible is therefore hugely important in reducing our unplanned pregnancy rates.
7. The Mirena reduces the risk of endometrial hyperplasia (endometrial changes that occur prior to endometrial cancer). When endometrial hyperplasia is detected, it requires invasive investigations and treatment - reducing our rates of endometrial hyperplasia by making the Mirena more readily available would result in significant savings to our healthcare system.
8. Making the Mirena fully funded is particularly beneficial to Māori and Pacific women. Obesity is a known risk factor for the development of endometrial cancer - having a BMI of 40 puts you at a nine-fold higher risk of endometrial cancer than a BMI of 22. Obesity disproportionately affects Māori and Pacific women and therefore puts many Māori and Pacific women in the high risk group for endometrial cancer - a group for whom surgical treatment can be challenging, costly, and associated with higher risk of complications. Encouraging women with high BMI to use the Mirena could therefore decrease rates of hyperplasia and cancer and prevent the complications that may occur with investigation/treatment.
9. Making the Mirena more accessible to women may decrease the working days lost due to heavy periods and pelvic pain. Over time, the Mirena makes periods lighter and some women find that their periods stop altogether.
10. Fully funding the Mirena gives Kiwi women more choice over their reproductive health and wellbeing.
*For contraception. The Mirena does not protect you from STIs - condoms are the most effective method of STI prevention.Support Villainesse