17 November 2018
The Life Cycle of the Mirena
The IUD, also known as an intrauterine device, currently faces high demand from women health-care consumers due to its effectiveness and proclaimed safety. Women from all walks of life choose the IUD because they desire consistent and long-lasting pregnancy prevention (Planned Parenthood). The IUDs’ popularity also stems from its diverse applicability to women of all ages. IUDs are 99% effective, which is as effective as surgical sterilization. However, specific factors that set the IUD apart from other forms of birth control is its reversibility and convenience (Women’s Health Care). Women who currently use an IUD but want to begin a family can easy have the IUD removed. Also, many women choose the IUD over oral contraception because taking a physical pill can often be tedious or forgotten. Among the two most popular IUDs, one contains copper and the other contains hormones. In women’s health-care the leading hormonal IUD is known as the Mirena. Health-care professionals insert the Mirena into the woman’s uterus and after the insertion process the device prevents pregnancy up to 5 years. The Mirena is composed of two prominent materials which are pharmaceutical grade plastic and hormones; however, much more goes into the process of gaining, creating and forming these materials into the common IUD. Through research and analysis of the raw materials used in the production of the Mirena IUD, the healthcare consumer will gain knowledge regarding the environmental effects caused by this contraceptive device, beginning from when the materials are first extracted from the earth, leading into the material’s role in the manufacturing, distribution and waste management processes.
As health-care consumers research which IUD is the right fit for them, a frequently asked question is, “What is the Mirena made from?” The official Mirena website provides its readers with a simple, one sentence explanation. The website states, “Mirena is made of soft flexible plastic and contains the hormone levonorgestrel.” However, for women who want to be fully educated regarding their health and what environmental impact the IUD can cause, this is an extremely condensed explanation in regards to the complexity of the materials that are contained and used in Mirena’s life-cycle. To visualize what the Mirena looks like, the device is exactly 32 millimeters by 32 millimeters. At the very top of the device’s white plastic stem there are two slightly arched wings that make a t-shape. To understand the materials used in more depth, the t-shaped frame is made of polyethylene and is compounded with barium sulfate. The vertical stem of the Mirena contains a reservoir. Within this reservoir there is mixture of levonorgestrel and silicon. Moving downward to the very bottom of the device there is a small plastic loop that contains a thread. This thread is composed of a monofilament brown polyethylene containing iron oxide, which gives the thread its color (Rx List). All of these materials are at some point extracted from the earth or synthetically created in a lab. While discussing the materials and life-cycle of the Mirena it is important to understand the difference between primary and secondary materials. A primary raw material would be considered a material that is directly extracted from the earth. While a secondary raw material would be a primary material that has undergone a type of processing which changes it into a new form. The most prominent material used in the production in the IUD is polyethylene, a flexible synthetic plastic.
Polyethylene is an effective material for the Mirena IUD because of its resilience and elastic properties. The t-shaped polyethylene frame is compounded with barium sulfate; this is because barium sulfate is odorless and does not dissolve in water, meaning it would be able to withstand the moist environment of the uterus. Polyethylene is the highest demanded plastic in the world due its versatility. Polyethylene is “the simplest of all commercial polymers….nothing more than a long chain of carbon atoms, with two hydrogen atoms attached to each carbon atom” (Polymer Science Learning Center). Polyethylene can be produced by the purifying of ethylene, also known as “feedstock” (Paxon). The big question is, “where does ethylene come from?” This product is produced from steam or catalytic cracking of fractions “obtained from distillation of natural gas and oil.” The primary materials, more specifically, are are ethane gas, propane gas, and naphtha from crude oil (The Essential Chemical Industry). The process of “cracking” is when large molecules of hydrocarbon are broken down in size. These new molecules are more useful and profitable; this is an adequate example of turning a primary material into a secondary material through processing. After purifying the ethylene, the addition of benzyl peroxide, which is a synthesized molecule, acts as a polymerization initiator or, in other words, acts as a catalyst in the synthesis of polyethylene (ACS). However, the Mirena’s polyethylene is compounded with barium sulfate. Barium is produced from a naturally occuring mineral known as barite or baryte, while sulfate naturally occurs when leaves break down in streams or when water travels through soil or rock possessing the mineral gypsum. Barium by itself is highly poisonous to the human body, but when combined with a sulfate ion, it then becomes insoluble and safe to use in the Mirena (Office of Science Education). Also, the Mirena’s polyethylene stem contains a hormone known as levonorgestrel which is crucial to the functionality of the Mirena as a contraceptive.
Around the vertical stem of the Mirena is a reservoir; within this reservoir is a mixture of silicon and a progestin known as levonorgestrel. Silicon is the second most abundant element located on the earth’s crust. Silicon is naturally occurring and can be found in “rocks, [quartzite] sand, clays and soils, combined with either oxygen as silicon dioxide, or with oxygen and other elements as silicates. Silicon’s compounds are also found in water, in the atmosphere, in many plants, and even in certain animals” (madehow.com). The silicon located in the Mirena IUD is the “simplest member of the silicon polymer family” known as Polydimethylsiloxane (ACS). Regarding the hormones involved in the mixture, levonorgestrel is a synthetic progestin. According to CN Grant there is a particular synthesis of levonorgestrel by methoxydienone. More specifically, “The synthesis process of the levonorgestrel uses the methoxydienone as a raw material which reacts with an alkynyllithium ammine complex to prepare an acetylide, and then the acetylide is hydrolyzed to obtain the levonorgestrel” (Grant). Moving downward to the vertical stem of the Mirena IUD, there is a removal thread at the base.
Attached to the end of the vertical stem of the Mirena is a removal thread made of a monofilament brown polyethylene containing iron oxide which acts as a dye. The polyethylene monofilament is a man-made, plastic fiber. As discussed before, polyethylene is a simple polymer made up of bonded carbon and hydrogen atoms. The iron oxide contained in the Mirena is used as a “colorant” (Center for Drug Evaluation and Research 17). More specifically, “Natural iron oxides are derived from hematite, which is a red iron oxide mineral; limonites, which vary from yellow to brown, such as ochers, siennas, and umbers” (Podolsky and Keller 765, 772). After primary material collection and secondary material creation, there are materials used in the final production and distribution of the Mirena. Regarding, the manufacturing of the Mirena, there is no accessible information about the machines used in production; however, there is information about the transportation.
The Mirena is transported from Bayer Oy, the manufacturing site, located in Turku, Finland to the United States by a Finnish shipping company, known as Meriaura Ltd. Meriaura ships are 89.8 meters long by 13.6 meters wide and provide low-consumption transportation. (Modeva, 2018). The Meriaura shipping company openly expresses its concerns regarding climate change by stating, “Sea transport of energy and construction sites are a major opportunity to develop environmentally friendly and efficient equipment” (Shipping with Care, 10). Currently, the Meriaura company has been involved in biofuel development and have constructed a new vessel known as Meri. Meri is the first large cargo ship to run on 100% biofuels. The official Meriaura site provides biofuel information, by stating, “the raw material for biofuel comes from industry side streams, and therefore, is not competing against food production” (Meriaura Group). Regarding the materials, Biofuel can be produced from fish oil that are by-products of the food industry and vegetable waste oils. (Shipping with Care, 10). There is no current evidence that the Mirena is exclusively transported on these biofuel cargo ships. Meriaura cargo ships, like every other ship, require bunker fuel which in not sustainable fuel source. After the transportation of the Mirena is complete, the IUD reaches the consumer. The IUD’s recommended use, is up to 5 years and after its removal it will go through a waste management process.
The life-cycle of the Mirena does not repeat itself as the plastics in the IUD do not decompose and cannot be recycled. Instead, they undergo incineration or are compacted by machine and put into landfills (UNFPA 18). The unusable wastes of the Mirena IUD consist of, “the t-shaped plastic bodies, packaging materials and hormone derivatives,” which in Mirena’s case would be levonorgestrel (UNFPA 5). This contraceptive waste is first packed in aluminum foil and PVC blisters, also known as polyvinyl chloride. After the primary packaging, they are put into cartons made of paper board, which are finally packed in kraft paper shipping cartons (UNFPA 17). Overall, the life-cycle of the Mirena IUD is conclusive when it is send to landfill.
Through the evident research and analysis of the raw materials used in the production of the Mirena IUD, the healthcare consumer can make educated decisions and be aware of the IUDs’ unsustainability. Regarding production and transportation, the Mirena is destructive towards the environment and ecosystems by requiring the distillation of natural gases and oils. The Mirena is a medical device which is made from pharmaceutical grade plastics and cannot be recycled due sanitation laws. Additionally, the Mirena is inserted into a woman’s uterus and has to withstand fluids and moist environments; therefore, it cannot be composed of any materials that would disintegrate or be compostable. The Mirena is either disposed by incineration or compacted and sent to landfill where its life-cycle is completed.
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Grant, CN. “CN101982472B - Synthesis Process of Levonorgestrel by Methoxydienone.” Google Patents, Google, 17 Sept. 2010,
“Five Reasons You Should Consider an IUD.” Women's Health Care, PatientPop Inc., 27 Jan. 2018, www.chicagoobgyn.com/blog/5-reasons-you-should-consider-an-iud.
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“Mirena® (levonorgestrel-releasing intrauterine system).” Bayer HealthCare Pharmaceuticals Inc., 2008,
“Mirena Releasing Intrauterine System: Side Effects, Interactions, Warning & Uses.” RxList, www.rxlist.com/mirena-drug.htm#description.
Modeva, Svetlana. “VG-Shipping Acquires Two 4100 Dwt Vessels.” VesselFinder, 15 Oct. 2018, www.vesselfinder.com/news/13602-VG-Shipping-acquires-two-4100-dwt-vessels.
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Parenthood, Planned. “Hormonal IUDs.” Planned Parenthood, https://www.plannedparenthood.org/learn/birth-control/iud/hormonal-iuds.
Parenthood, Planned. “New Study Finds Women's Health Providers Use IUDs More Than Any Other Method of Birth Control.” Planned Parenthood, 2015, www.plannedparent
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Professor Cogdell, Tracy Corado
DES 040A, Section 5
6 December 2018
Embodied Energy of the Mirena IUD
The widespread use of the birth control pill in the 1960s allowed women to take charge and make their own decisions regarding their own bodies. Since the 1960’s, doctors have developed different forms of birth control in order to accommodate the large variety of women in the world. One of the most recent forms of contraception is the Intrauterine device also known as the IUD. The life-cycle of an IUD involves very few steps on the surface. However, as one dives deeper into this subject matter and focuses on the intricate processes of materials, extraction, production, and waste, it is confirmed that this process is not simple at all. There are a variety of smaller processes that deal with the chemistry and dosage of synthetic hormones and plastics. Of the three main IUDs, our sole focus is on Mirena IUD, a plastic based IUD that releases small doses of the progestin Levonorgestrel into a woman’s body. Throughout this project, it has become apparent that the machines and primary energy sources determine the unsustainability of the IUD. Through each of these divisions, one is able to truly gather how much energy is used in the lifecycle of an IUD. While one might assume that no energy is utilized by an IUD, the energy it takes to manufacture the IUD itself significantly impacts the planet.Through further research, there are four main parts to the embodied energy of the IUD: energy used in raw material extraction, production energy, transportation energy, and waste energy.
When discussing embodied energy, the first topic of interest is the raw materials. Normally, when one purchases products, they only think how they will directly apply or use the product. One does not take the time to think about how different elements are extracted from the earth and what energy is needed to form them into what the consumer sees. It is important to understand the amount of energy that is exerted to take or chemically combine these items. It directly leads to the conclusion of whether or not we can classify an item as sustainable or unsustainable. Through many resources, it was discovered that each individual item that is manufactured into Mirena is formed from various sources of energy. Although, there was trouble finding the exact processes that the Mirena company uses to extract their materials, it can be assumed that the materials are extracted the same way as the generic processes.
For instance, silicone is used in Mirena IUDs to make up the semi-opaque coat around the reservoir (RxList). In order to arrive at this stage, silica and coke must be weighed and then heated. The lid of the furnace it is heated in contains electrodes which allows an electric current to pass through the electrodes and form an arc. This arc then generates heat at a temperature of 2350 °C. This process, which takes about six to eight hours, results in the products of silicon (from sand and carbon) and carbon monoxide. In its molten state, the metal is treated with oxygen and air in order to reduce impurities. It is finally cooled and put into a cast to then be packaged and shipped (How Products Are Made). Electrical energy as well as thermal energy is being used here to create the final product of silicone. Electrical charges are being passed in order to generate heat. We now know what how the silicone is made and that it is combined with the synthetic hormone, yet the body of the IUD itself is also quite fascinating.
Mirena does not document its exact extraction process of the barium that they use to combine and create the radiopaque T-body shape (RxList). Yet, it is believed that in order to obtain the pure element of barium it must be separated from other elements that form naturally in barium compounds (Stoll). The separation of elements happens through the process of electrolysis, which is where an electric current is run through a liquid substrate that contains ions. The chemical decomposition of barium uses electricity, which means that the primary energy source is most likely fossil fuels.
The T-body shape of the IUD itself is composed of not only barium, but also polyethylene. Polyethylene is made differently depending on which end product one it forming. In the case of IUDs, it is unclear which is the most likely process to be used. Therefore, it is safe to assume that polyethylene uses a combination of pressure and heat to melt and mold this plastic (Lazonby). Varieties of plastics require different accommodations of temperature and the amount of pressure used. Due to the fact that Mirena does not specify the distinct operation, one cannot confidently say which temperature and pressure levels are used in the making of IUDs. However, Stanford University did a study that showed that about “3.6 x 1018 J of energy were diverted to polyethylene-based plastics in 2008”. To conclude the study, they said that, “the energy for plastic, including both hydrocarbon feedstock energy, energy used to refine feedstocks into base plastics, and the energy to manufacture plastic products, was between 2.5% and 4.0% of the total U.S. primary energy consumption in 2008” (Hammam). These percentages may not seem very large at first glance, yet when discussing it further, it is understood that this is just one type of plastic, out of the thousands, that is taking up this much energy.
Embedded in the body of the IUD is the most significant element of the product: the progestin Levonorgestrel. This hormone is distributed throughout the body over the span of about five years (the time that the IUD is in the body for). This synthetic hormone tricks the body into thinking that ovulation has already occurred at a critical point in the menstrual cycle by maintaining high levels of the Levonorgestrel. This prevents the eggs from being released from the ovaries (PubChem). There is a low bioavailability of progesterone which means that the body can only produce progesterone naturally. Because of this, doctors and scientists had to find a way to make a synthetic version of this hormone. This particular progestin is derived from testosterone and chemically rearranged to form the compound C21H28O2. It is not clear what type of energy is used to merge these elements together, yet due to the fact that Levonorgestrel is made in a laboratory, one can safely assume that chemical energy is needed.
We rarely ever think about how we extract items from the earth, yet a thought even more infrequent than this is what machines are used to combine each bare mineral or chemical composition into the form that consumers see it in. In order to determine how sustainable Mirena is, we must look at the kind of energy these machines use, whether it be thermal (heat-based), solar, or kinetic. Just as each element has its own extraction process, each element has different prime movers to power the machines. When calling to discuss this topic with the locations in Sweden and Finland, there was not much useful information relayed to me. By researching which machines Mirena uses, it can be concluded that they most likely use some type of assembly line and fossil fuel-powered machines to put each part together. There must also be some scientists on cite in order to measure the exact amount of Levonorgestrel that is positioned in the IUD.
Another section of embodied energy is the transportation systems used. Mirena is part of a larger company called Bayer, also known as Bayer Oy, a pharmaceutical company from Finland and Sweden. Bayer is responsible for the transportation of Mirena’s product. Starting in Finland, they use large cargo ships to transport the IUDs to the United States. Bayer’s ships come from the company Meriaura Group. This is a family company that started off small and, overtime, grew to become a larger establishment. This group states that they “believe that growth must be based on environmentally sustainable solutions and therefore also future investments will focus on reducing the overall impact on the environment” (Yurtoğlu). This company has partnered with a variety of individual eco-friendly companies to improve the sustainability of their company. While the shipping company itself is beginning to use biofuels (vegetable oil, fish oil, etc), we can not confidently conclude that the actual production process of Mirena IUDs are environmentally friendly.
The last section of embodied energy discusses the waste factor. Due to the fact that Mirena IUDs are considered contraceptives, once they are done serving their purpose, they are thrown into a “highly engineered sanitary landfill”. Subsequently, since the main priority is the preservation of the aquifer, each day’s waste is compacted with soil to maintain sanitary conditions. This is done with the intention of not contaminating the aquifer. After being properly managed in this specific landfill, it is incinerated at a temperature of about “1100-1400°C with filters to remove the particles as well as toxic gasses”(United Nations Population Fund). One can then conclude that the energy it takes to properly take care of contraceptives, after their usefulness has dissolved, is thermal (heat) energy.
Embodied energy of any product is one of the most important parts of a life-cycle, especially in today’s society where sustainability has such a large impact on consumerism. Yet, as significant as it may be, not many people pay enough attention to the amount of energy that goes into the creation of each product. Not only is the amount of energy important, but also the primary sources of energy that are used in the production of each part of the item is a significant factor of the sustainability determination. From the previous research, one can deduce that the creation of Mirena IUDs are not necessarily sustainable due to amount of energy each material uses on its own. We can also determine this from the fact that the most common primary energy source is fossil fuels, which as we have learned over the years, is extremely detrimental to our planet. Though Bayer and Meriaura have shared their attempt to change their energy sources, the process of extracting raw materials still takes up a large amount of fossil fuel energy. The raw materials extraction energy, production energy, transportation energy, and waste energy each contribute environmental devastation, therefore concluding that Mirena IUDs are unsustainable.
Energy of an IUD Bibliography
“About | Mirena® IUD.” Mirena US, Bayer, www.mirena-us.com/about-mirena/.
“CN101982472B - Synthesis Process of Levonorgestrel by Methoxydienone.” Google Patents,
Google, 17 Sept. 2010, https://patents.google.com/patent/CN101982472B/en.
Hammam, Curtis W. Energy for Plastic, Stanford University, 24 Oct. 2010,
L., Tyler. “Introduction of the Pill and Its Impact.” Contraception., U.S. National Library of
Medicine, Jan. 1999, www.ncbi.nlm.nih.gov/pubmed/10342090.
Lazonby, John. “Poly(Ethene) (Polyethylene).” The Essential Chemical Industry Online,
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Database, U.S. National Library of Medicine, https://pubchem.ncbi.nlm.nih.gov/compound/Levonorgestrel.
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11 Jan. 2018, www.mayoclinic.org/tests-procedures/mirena/about/pac-20391354.
“Mirena Releasing Intrauterine System: Side Effects, Interactions, Warning & Uses.” RxList,
Parenthood, Planned. “Hormonal IUDs.” Planned Parenthood,
“Safe Disposal and Management of Unused, Unwanted Contraceptives.” United Nations
Populations Fund, 2013, https://www.unfpa.org/sites/default/files/resource-pdf/Safe%20Disposal%20and%20Management%20of%20Unused%20Unwanted%20Contraceptives_2.pdf
“Silicon.” How Products Are Made, www.madehow.com/Volume-6/Silicon.html.
Stoll, Carol. “Facts About Barium.” LiveScience, Purch, 6 Nov. 2017,
Yurtoğlu, Nadir. “Mariaura.” History Studies International Journal of History, vol. 10, no.
7, 2018, pp. 241–264., doi:10.9737/hist.2018.658,
DES 40A Professor Cogdell 20 November 2018 Life Cycle of The Mirena Intrauterine Device Intrauterine Device(IUDs) are one of the most effective forms of reversible contraception to this day. An IUD is a small T-shaped device that is placed into a woman’s uterus through the cervix by a trained medical provider. Intrauterine Devices can be made with different materials and prevent pregnancies in various ways. Some IUD’s are wrapped in cooper and others are made from plastic. IUD’s that are wrapped in copper prevent pregnancy because copper is a natural spermicide. Plastic IUD’s, such as the Mirena, work differently than copper. Plastic versions administer low dosages of a hormone called progestogen to prevent ovulation and therefor prevent pregnancies. The Mirena IUD, manufactured by Bayer Healthcare Pharmaceuticals, was one of the first hormonal IUD to be on the market and one of the many IUDs that Bayer provides. Stated by Mirena US, Bayer, “Mirena is over 99% effective at preventing pregnancy.” With a low failure rate, as well as, effective for 5-12 years. During the time that Mirena is being used by its carrier it causes zero waste to the environment. Sadly, that doesn’t mean there is zero waste throughout the process of creating Mirena’s Intrauterine Device. After researching the topic’s waste lifecycle, it’s clear that Bayer makes a deliberate effort to produce their products as environmentally friendly as possible. Throughout this paper, I will examine the waste and emissions created throughout the lifecycle of making and disposing of the Mirena Intrauterine Device, including manufacturing, distributing, and recycling. The emissions and waste produced by Mirena, Intrauterine Device, doesn’t begin once an individual is done using the product but starts at the very beginning of its lifecycle; the releasing of greenhouse gas emissions and waste water. The production and manufacturing start’s in Finland at Bayer, a German multinational pharmaceutical and life sciences company, where different types of emission and waste are produced, such as air emission through greenhouse gases and wastew transports the Mirena IUD from a manufacturing site in Turku, Finland to the United States, through a Finnish shipping company called Meriaura. Meriaua’s is based in Northern Europe and specializes in demanding project cargo, transporting industrial bulk and raw materials. On Meriaura’s website they state, “We value flexibility and cost efficiency in our business. We want our customers to save money and time by providing them with good, swift and professional customer-driven service. We strive for longterm partnerships and believe that constant innovation is beneficial for us all. We are continually improving our services and want our customers to be a part of this process. We believe that marine transportation can be managed in an environmentally sustainable way and according to the needs of the customer.” (Meriaura) Meriaura, signed a contract with Dutch shipyard Royal Bodewes for two new ships that are designed to cause a considerably less amount of impact on the environment than conventional dry cargo vessels. The ships will provide dual fuel system that will be suitable for biofuel and MGO. The expanding and revitalizing of Meriaura’s ships is aimed towards lowering fuel consumption and Green House Gas emissions. The president of Meriaura group, Jussi Mälkiä, said, “Our goal is that in five years’ time at least 50% of our fleet consists of fuel efficient and low emission EcoCoasters that are run by biofuel produced of recycled oils. Designing of larger EcoCoaster is under process” (Jussi Mälkiä). After they are shipped to their destination it is then put into vehicles, this is where Bayer makes a conscious effort to be as eco-friendly as possible. Bayer stated, “In the future, we plan to focus more on reducing emissions in non-production areas. These include our vehicle fleet (Sustainable Fleet initiative), investigating the use of electric vehicles (electric mobility programs), optimizing logistics and further developing our information and communication technologies in terms of environmental aspects (Green IT)” (Bayer). Once the Mirena, Intrauterine Device is inserted into the women’s cervix, no emissions or waste is produced. When the Mirena is taken out of its carrier and disposed of, more waste is put out earth. While disposing of an Intrauterine Device, if done properly, the least amount of waste occurs, but when it is not disposed of in the right way it creates an immense amount of waste on earth. Although the plastics used in the Mirena Intrauterine device are effectively medical grade, they are not capable or permitted for reuse in medical devices, but they are still highly reusable in other applications. As far as disposal of the other parts of an IUD, according to UNFPA, “As with disposal of other contraceptives, the waste is taken to a designated site, where it is tipped, and from time to time, covered with a layer of soil. Typically, large depressions in the ground are filled. Eventually, the site will be closed for further tipping, and in some circumstances, it may be developed for industrial or residential uses.” This is the most frowned upon way and why countries, such as the United States of America, pricing of such disposal has increased to discourage overuse of scarce sources, such as landfills, by encouraging people to minimize environmental damage and encourage recycling. If an Intrauterine Device is disposed of in landfills, they should be shredded beforehand to prevent the selling and reusing of old IUD’s, as well as to help make them easier to biodegrade. According to Our Plastic Age, “Other concerns about usage and disposal are diverse and include accumulation of waste in landfills and in natural habitats, physical problems for wildlife resulting from ingestion or entanglement in plastic, the leaching of chemicals from plastic products and the potential for plastics to transfer chemicals to wildlife and humans. However, perhaps the most important overriding concern, which is implicit throughout this volume, is that our current usage is not sustainable.” With this being said our landfills are becoming full because of over using. There are accounts of unintentional pollution in soils with small plastic fragments that are contaminating compost that is prepared from municipal solid waste. This is causing plastic to be carried into streams, rivers, the ocean in the event of rain and floods. Degradation of these polymers in landfills is also likely to be slow and may create unwanted methane emissions in to the world. Plastics do not breakdown effectively in landfills and very little is known about how long it actually takes for plastics to degrade, let alone the effects they have on the earth all together.Though the use of a Mirena intrauterine device creates its fair share of waste, there are plenty of contraceptives that create far more. There are various forms of waste created throughout the lifecycle of Mirena’s Intrauterine Device. The emissions created by Intrauterine Device’s aren’t as significant, compared to the advantages you gain using them. By being the most effective form of reversible contraceptive, Mirena’s Intrauterine Device(IUDs) is also the most eco-friendly way to prevent unwanted pregnancies. As shown above, through the manufacturing, distribution and disposing, there are ways to make it more eco-friendly but as of now it is the most environmentally friendly type of contraceptive out there. Bibliography “About | Mirena® IUD.” Mirena US, Bayer, www.mirena-us.com/about-mirena/. Modeva, Svetlana. “VG-Shipping Acquires Two 4100 Dwt Vessels.” VesselFinder,15 Oct. 2018, www.vesselfinder.com/news/13602-VG-Shipping-acquires-two-4100-dwt-vessels. Frosch, Robert A., and Nicholas E. Gallopoulos. “Strategies for Manufacturing.” Scientific American, vol. 261, no. 3, 1989, pp. 144–153., www.jstor.org/stable/24987406. Richard C. Thompson, Charles J. Moore, Frederick S. vom Saal, Shanna H. Swan Phil. Trans. R. Soc. B 2009 364 2153-2166; DOI: 10.1098/rstb.2009.0053. Published 14 June 2009 L., Tyler. “Introduction of the Pill and Its Impact.” Contraception., U.S. National Library of Medicine, Jan. 1999, www.ncbi.nlm.nih.gov/pubmed/10342090. Bayer. “Bayer's Annual Report 2017.” Bayer's Annual Report 2017, 2017, www.annualreport2017 .bayer.com/management-report-annexes/about-the-group/safety-for-peopleand-the-environment/environmental-protection.html. Pescod, M.B. “Wastewater Treatment.” International Rice Commission Newsletter Vol. 48, FAO of the UN, 1992, www.fao.org/docrep/t0551e/t0551e05.htm. Bayer. “Bayer's Annual Report 2015.” Bayer's Annual Report 2015, 2015. http://www.annualreport2015. bayer.com/management-report-annexes/fundamental-information-about -the-group/environmental-protection/waste-and-recycling.html “Mirena (Hormonal IUD).” Mayo Clinic, Mayo Foundation for Medical Education and Research, 11 Jan. 2018, www.mayoclinic.org/tests-procedures/mirena/about/pac-20391354. “Mirena Releasing Intrauterine System: Side Effects, Interactions, Warning & Uses.” RxList, www.rxlist.com/mirena-drug.htm#description.