Mirena side effects can seriously disrupt your mood, your hormones, and your life. But all women don't have the same experience, in fact, some find this is the most reliable method with the least amount of side effects. In this article I am going to share with you what you should know before you place that IUD and what you should look out for if you already have a hormonal IUD. We're going to review the benefits and risks associated with hormonal IUDs, which is what we need to consider before starting any medical intervention.
Benefits of Mirena
While there are some serious side effects and complications associated with hormonal IUDs, there are also a few benefits worth noting. Before we dive into Mirena side effects to be in the know on, here are some of the reasons why women choose this IUD in the first place.
1. Daily Convenience
There is no pill to take, patch to place, or ring to insert. The Mirena can be placed and left for up to five years.
2. Highly Effective
The Mirena, like other IUDs, is more effective at preventing pregnancy than other common forms of birth control, like the pill or condoms.
How Does the Mirena Work?
The Mirena IUD, like all hormonal IUDs, contains a synthetic hormone called Levonorgestrel, a progestin, that it slowly releases in your body over time. While progestin sounds like progesterone, it is not, nor does it behave like progesterone in your body.
Instead, the progestin released thins the lining of your uterus, the endometrium, so a fertilized egg would be unable to implant. This is one way in which women have lighter or absent periods while using a hormonal IUD.
It is also designed to stop ovulation by suppressing the production of two brain hormones—Follicle Stimulating Hormone (FSH) and Luteinizing Hormone (LH). FSH and LH work together to mature an egg and trigger ovulation. They are also responsible for signaling the rise and fall of your hormones. It also thickens cervical secretions, making it difficult for sperm to make it to the egg in the event ovulation does occur.
Progestin Containing IUDs
The Mirena isn’t the only progestin containing IUD, but it does have the highest amount of hormones. Here is the list of hormonal IUDs commonly available in the United States.
The Mirena contains 52 mg of progestin and is estimated to release 20 micrograms daily. After 5 years the device will need to be removed.
This IUD contains the same amount of progestin (52 mg), but is estimated to release 18.6 micrograms of progestin daily, which is slightly lower than the Mirena. Liletta needs to be removed 4 years after having it placed.
Kyleena contains 19.5 mg progestin and is supposed to release 17.5 micrograms daily. Like the Mirena, this is approved for 5 years of use.
Skyla IUD has the lowest amount of total progestin (13.5 mg) and released progestin at 14 micrograms daily. It is only approved for 3 years of use.
Side Effects of Mirena
Perforation and expulsion are two of the scarier side effects associated with the Mirena and other IUDs. Perforation is when the IUD embeds in your uterus and expulsion is when the uterus pushes the IUD out. While scary, they are not very common. But you should still be aware this can happen and what to look for.
An IUD perforation occurs when the device either attaches to the uterus or punctures through. This can lead to scarring, damaged organs, infection, infertility and surgery.
Perforation more often occurs when the IUD is placed, rather than it migrating later. The solution? Get your IUD placed by a pro!
IUD Perforation Symptoms
- Severe pelvic or abdominal pain that does not go away
- Pain with intercourse
- Absent strings or shorter
What’s the risk of perforation?
The risk of perforation is low at about 1 in every 1,000 IUDs that are placed. Having an IUD placed by an experienced practitioner may lower this risk. If you’re feeling really concerned, talk to your doctor about the position of your uterus and any other individualized risk factors that could contribute.
Bleeding and pain come with the territory when you place an IUD in your uterus, but excessive pain, increased bleeding or not being able to feel the strings is a sign that a perforation may have occurred.
When it comes to IUDs, if you suspect anything is wrong, get to your doctor immediately. A quick ultrasound can help them see what is going on and at the least, give you peace of mind that everything is ok.
Expulsion—Your Uterus Kicks It OUT
Expulsion occurs after an IUD is placed and is your uterus pushing the device out. Hormonal IUDs, like the Mirena, come with a 3-6 percent expulsion rate in the first year. Comparatively, the copper IUD is associated with a 3-10 percent risk of expulsion in the first year.
Who is at risk of IUD expulsion?
Women with a history of heavy (menorrhagia) or incredibly painful periods (dysmenorrhea) are at higher risk of expulsion. Postpartum women may also be at higher risk for expulsion.
If you’ve already had IUD expulsion then it is estimated that your risk of another is about fourteen percent.
What are the symptoms of expulsion?
More than the usual cramping, either with your period or outside of menses, can be a sign of expulsion. If you experience a significant increase in bleeding, continuous spotting, new vaginal discharge then you’ll want to see your doctor and possibly have a transvaginal ultrasound to check out where your IUD is currently residing.
Hormonal IUD Side Effects
The progestin contained in the Mirena and other hormonal IUDs contribute to several side effects that can seriously interfere with your life. If you find yourself stuggling with any of these then it is a good time to chat with your doc and determine if this is really the best birth control for you.
If you need help transitioning off and getting your hormones back in balance then I invite you to check out my free resource: Post-Birth Control Quick Start Guide.
1. Missing Periods
A missing period occurs in about twenty percent of women with an IUD. It appears that the higher the progestin (remember, Mirena is the highest) then the higher the rate of amenorrhea (aka missing period). In my medical practice I have seen women lose their period within months of having the Mirena replaced and then struggle to get it back when they remove the IUD five years later.
2. Unpredictable or Just Plain Weird Periods
Other women don’t lose their period and instead experience unpredictable, long and intermittent periods.
Studies have shown that as many as fifty nine percent of women experience longer periods. As many as fifty two percent get their period at a random time and about thirty percent spot.
In my clinical practice, I’ve worked with patients who have spotted continuously for months after having their IUD placed. This warrants a trip to the doctor who placed it to make sure everything is ok, but this can be a side effect seen with hormonal IUDs.
And with progestin based contraceptives, you can still ovulate, which makes things even more complicated.
3. Breast Cancer Risk
A study in the New England Journal of Medicine that looked at 1.8 million women ages 15 to 49 years and found that hormonal contraceptives, including IUDs, were associated with an increased risk of breast cancer.
They found a twenty percent increased risk of breast cancer in women who used hormonal birth control compared to women using non-hormonal forms of contraception, like condoms, non-hormonal IUD, or FAM.
In my practice, if a woman has a family history or personal history of breast cancer we look to other options of birth control.
4. Mirena Side Effects Mood
I’ll never forget my first patient years ago who told me she felt “crazy” when her IUD was placed. She was having panic attacks that alternated with depression. Her gynecologist told her the only option was to begin several mood altering drugs. She came to me in hopes of fixing her mood for good.
But she already had the answer.
She had tracked her symptoms and it was so clear that her mood issues began with the IUD. We worked for three months together to try to get her relief because she did not want to have it removed.
At month four, she was done.
She had her IUD removed and followed my Post-Birth Control Syndrome Protocol diligently. Within weeks she felt like herself again and all of her mood symptoms were gone.
When she came back to my clinic she shared that her gynecologist dismissed the IUD had contributed in any way to her mood. “I felt unheard and like what I was saying didn’t matter to her at all. In her mind, I was the liar and the IUD was the perfect solution to every woman’s problems,” she shared.
Here’s the deal. These hormones can and do contribute to mood symptoms in women. Ask any woman who has lived through it and you’ll know how true that is. But there are also studies to support it!
Studies have shown young women who use hormonal contraceptives, including the IUD, have three times the risk of suicide compared to women who have never used hormonal birth control. Yikes!
Depression (and anxiety) are commonly reported with hormonal contraceptives, the hormonal IUD being no exception. If you have a history or family history of depression, you may want to consider non-hormonal alternatives.
Looking to support your body on or off hormonal birth control? Grab the Hormonal Birth Control Quick Start Guide
5. Pelvic Inflammatory Disease
It is estimated that about one percent of women who get the Mirena IUD placed will develop a serious infection known as Pelvic Inflammatory Disease (PID).
All hormonal birth control can cause nausea. And while the Mirena IUD tends to be lower compared to the pill, it is still a side effect you should know about.
7. Ovarian Cysts
There is an increased risk of developing ovarian cysts with the Mirena. This is estimated to occur in about twelve percent of women.
You may not notice you have a cyst and they may go away on their own. Or you may experience sharp pain on one side of your abdomen. If it’s the later, get to your doctor and get it checked out.
8. Headaches and Migraines
Headaches are a common side effect of most hormonal birth control options. If you develop new onset of headaches or migraines it is important to discuss this with your doctor.
9. Bloated Belly and Other Gut Trouble
I’ve seen many patients who complain of bloating after having their IUD placed. We are just at the cusp of understanding how our gut, microbiota and hormones interact, but we do know they are all intimately linked.
In my practice, I’ve reviewed women’s timelines and found that all their digestive symptoms began following the IUD placement. Some of these patients have gone on to be diagnosed with SIBO, yeast overgrowth and bacterial dysbiosis.
While we can not say definitely that the IUD causes digestive issues, it is definitely a symptom I tell my patients to be on the lookout for.
10. Acne, Hair Loss, and Funky Skin Symptoms
Rashes, acne, eczema, growth of hair on your chin and hair loss have all been reported by women who use progestin based contraceptives. If you develop any of these then that is a sure sign that the IUD is not your friend.
Struggling to Kick Those Synthetic Hormones for Good?
If you're a woman struggling with your hormonal IUD or feeling fearful of Post-Birth Control Syndrome, I want you to know your symptoms are not in your head. Many women experience this condition, in fact, clinically I see that the majority of women struggle to balance their hormones post-IUD. And most women experience some form of Post-Birth Control Syndrome. The good news is that it can be reversed and you can restore health, hormone balance and maintain your fertility if motherhood is in the plans.
If you're in need of more support then I invite you to check out my Birth Control Hormone Reset.
This is the first and only physician designed program to teach you how to transition off of hormonal birth control, reverse symptoms of PBCS and create amazing hormones!
Within the Birth Control Hormone Reset program you'll be introduced to the Brighten Protocol™. This method was developed within my medical practice and have helped thousands of women who are struggling with PBCS.
Discover how to get off birth control, kick your unwanted hormone symptoms, and make friends with your period all in 5 weeks!
This program is designed to help women ON hormonal birth control and OFF! If you're not ready to ditch your current contraception then no worries. You can learn what you need to do to take incredible care of your body.
You can learn more about the Post Birth Control Hormone Reset Here!
- Association of short-term bleeding and cramping patterns with long-acting reversible contraceptive method satisfaction.
- Heinberg EM, McCoy TW, Pasic R. The Perforated Intrauterine Device: Endoscopic Retrieval. JSLS : Journal of the Society of Laparoendoscopic Surgeons. 2008;12(1):97-100.
- Pitfalls of research linking the intrauterine device to pelvic inflammatory disease.
- Risk of uterine perforation among users of intrauterine devices.
- Risk of uterine perforation with levonorgestrel-releasing and copper intrauterine devices in the European Active Surveillance Study on Intrauterine Devices.
- Sivin I, Stern J. Health during prolonged use of levonorgestrel 20 micrograms/d and the copper TCu 380Ag intrauterine contraceptive devices: a multicenter study. International Committee for Contraception Research (ICCR). Fertil Steril. 1994 Jan;61(1):70-7.
- The efficacy of intrauterine devices for emergency contraception: A systematic review of 35 years of experience.
- Paragard package insert.
- Mirena package insert.
- Liletta package insert.
- Kyleena package insert.
- Skyla package insert.