<s>[INST] I just had a Mirena placed a week ago and Im experiencing cramps, usually starting in the afternoon and lasting into the night. Theyre usually gone in the morning.  Ive also been spotting since then which Ive read is normal, but today the bleeding is heavier, similar to the beginnings of a period. Is this normal?  Can I use a tampon after just one week of it being inserted?  Is it also okay to have sex by now?  I was halfway through my cycle when I had it inserted.  Thanks [/INST] Hi, thank you for your query. Yes it is normal to have cramping and spotting after insertion of IRENA.it's the bodies of adjusting to the foreign body placed inside.you'll mostly have these symptoms for one cycle. Yes you can use tampons during your periods as you used to.I would suggest you to wait till ten days after IRENA has been placed to resume sex to be on the safer side. Thank you, wishing you good health </s>