We are in a monogamous relationship and I have the Mirena IUD. Are condoms necessary? #411/14

I had the Mirena IUD inserted in October of 2013 due to problems with ovarian cysts and unexplained pain.  My boyfriend and I have recently been talking about not using condoms and relying on the Mirena as our only form of birth control.  Both of us are monogamous and have been tested for STDs (sexually transmitted diseases) and everything was negative.  I’m wondering if we should still use condoms as I know the Mirena is 99.8% effective and should I be worrying about unwanted pregnancies with it in place?


From an effectiveness standpoint and with regard to sexually tramsmitted infection, so long as you both remain monogamous, condoms are probably not necessary.


I want to explain to you what the published failure rates of Mirena, which are 0.2% in both perfect AND in typical users of mirena means.  First of all, it means that the success rate could be said to be 99.8%.  But back to the correct failure rate of 0.2%.  What does this mean?


Dr. Claude Burnett who heads up the health departments in and around Athens, GA posts a document called: “World’s Best Birth Control At Your Health Department” designed to eliminate the confusion of the desimal points and percentages. He posts the number of pregnancies experienced by women using 10 approaches to birth control.  Actually, if one counts women using no method of birth control , he tells us the number of pregnancies if  10,000 women are using 11 different approaches to contraception.  It is a brilliant idea.  Thank you, Claude!


Below are the numbers he posts in colorful posters in  clinic waiting rooms and exam rooms:



World’s Best Birth Control

At Your Health Department


Birth Control Effectiveness

In 10,000 Women


                                                          PREGNANCIES PER YEAR


Nexplanon         (the implant)                           5

Male Sterilization                                                 15

Mirena (the levonorgestrel IUD)                    20

Female Sterilization                                            50

ParaGard IUD (the copper T IUD)                 80


Depo Shots                                                         600

Minipills                                                                900

Combination Pills*                                              900

Condoms                                                            1,800

Withdrawal                                                          2,200

No Method                                                          8,500


Dr. Burnett gets these numbers from Professor James Trussell.  They are in the 20th edition of Contraceptive Technology (page 50), the 2013-2014 edition of Managing Contraception (page 35) and PERHAPS MOST IMPORTANTLY, in the package inserts for pills, IUDs, rings and most other contraceptives.  Thank you, James Trussell!


Please extend my congratulations to your boyfriend.  You are both doing just great. 



Today, June 16th, what did you decide to do about using condoms?


To learn more about the advantages and disadvantages of IUDs; go to: www.managingcontraception.com and click on Choices 2013 edition.  You can also order this wonderful new educational book from our website or by calling 404-875-5001.  Do you have your copy yet?  It is now available in English and Spanish.

Key Words:  Mirena IUD, problems, ovarian cysts, pain, condoms, birth control, monogamous, sexually transmitted disease, tests, negative, effective, pregnancies

Posted 4-2014, Updated 6-17-2014, Updated 6-29-2014, Updated 7-14-2014, Updated 8-7-2014, Updated 8-11-2014, Updated 8-26-2014


Posted on

August 26, 2014