Many perimenopausal women are turning to HRT to help with heavy periods and to bridge the transition into menopause. One of the most popular options is the Mirena coil which is a form of birth control which prevents pregnancy but can also be used to control heavy bleeding.
But is the Mirena coil menopause friendly as well, can you keep it in when you reach menopause? Can it help with hot flushes and night sweats? What about other menopause symptoms?
In this blog we'll cover FSH levels, what happens when oestrogen levels fall, perimenopausal symptoms and menopausal symptoms and the mirena coil intrauterine system. Let's go!
Follicle Stimulating Hormone and Periods
Hormone levels rise and fall when a woman is in her childbearing years. A woman is born with her ovaries full of follicles which contain a developing egg. Follicle stimulating hormone is made by a woman's pituitary gland, stimulates the growth of eggs in her ovaries and helps fsh helps regulate a woman's menstrual cycle.
FSH levels rise and fall during a woman's cycle and are at their peak just before ovulation. A woman will steadily lose follicles as she ages. Blood tests can be used to determine FSH levels.
Perimenopause can be very challenging for women. The average age for perimenopause is 46 and the most common sign of fluctuating hormone levels is irregular periods. Progesterone levels are often the first to decline and symptoms include more intense mood swings or PMS symptoms brain fog, constipation, painful periods, bloating, hot flashes and a menstrual cycle with very heavy periods or lighter periods and light bleeding.
What is heavy menstrual bleeding
What is a very heavy menstrual flow? If you need to change your tampon or pad after less than two hours that would indicate a heavy period. The NHS defines a heavy bleed as losing 80ml or more in each period, or having periods that lasts longer than 7 days or both. They are sometimes accompanied by dizziness and nausea and can, if left untreated, lead to an increased risk of conditions like anaemia.
Menopause occurs when a woman has had her last period and no longer has monthly bleeding and the average age is 51. Estrogen levels fall and progesterone levels also steadily decline. Some symptoms are the same as in perimenopause eg mood swings and hot flushes. Other menopausal symptoms include anxiety, disrupted sleep, a reduced libido, vaginal dryness and joint pains.
What is the Mirena IUD?
The Mirena – often referred to as a hormonal IUD is designed to provide long-term contraception. It’s a T-shaped plastic device that is inserted into the uterus and releases levonorgestrel which is a synthetic hormone version of the natural hormone progesterone.
The Mirena stays in place for 5 years, after that it has to be replaced. As with any hormone-based treatment, there are benefits and drawbacks to consider. Let’s take a look at them to help you decide whether this could be suitable for you.
Benefits of the Mirena coil during perimenopause
Before you consider choosing to have an IUD fitted, as with any hormone based treatment you should weigh up the pros and cons with your doctor. Here are some of the common pro's.
One of the biggest benefits of the Mirena IUD is that it thins the lining of the womb, which means after a few months, you should notice heavy bleeding becoming a thing of the past. In fact, the Mirena coil may make your periods less frequent and up to 90% lighter. Some women stop having periods altogether after a year or so.
Effective, Low Maintenance Birth Control
Another bonus is that the Mirena coil is a very good contraceptive – it helps to prevent pregnancy and is 99% effective. As well as thinning the lining of the womb It releases progestogen which thickens cervical mucus making it challenging for sperm to move through the cervix helping to prevent pregnancy.
Once the Mirena coil inserted it can stay in place for up to five years, so, you can pretty much forget all about it. There are no birth control pills to remember to take every day, which is a bonus, especially if you’re suffering from brain fog!
Drawbacks of the Mirena coil
Many women experience a bit of pelvic pain during the insertion and removal of the mirena. Taking ibuprofen beforehand should help ease any pain. Thankfully, though, as the device can stay put for several years, this temporary discomfort won’t be a regular occurrence. There’s a small risk of a pelvic infection developing after a Mirena coil insertion, too, but this is uncommon.
Side effects of Mirena coil
The Mirena IUD comes with the risk of a few side effects. It’s common to experience some irregular bleeding and spotting in the first few months. Occasionally you may experience breast tenderness. Progestogen based treatments are associated with headaches, nausea and can cause adult acne.
The Mirena can cause mood changes. If changes in your mood persist or you start feeling down or out of sorts for long periods please see your doctor.
Weight gain with mirena coil is fairly common but is probably down to other factors related to hormone changes which can affect muscle mass and fat storage and getting older.
Less common side effects of the mirena coil can include bloating, vaginal discharge, ovarian cysts, depression, bleeding with the mirena coil and pelvic pain. Some women can suffer from recurring thrush, the mirena can move from it's position or be expelled naturally.
Can the Mirena Coil affect Menopause symptoms?
A woman is in menopause when she no longer has a menstrual cycle, a period which lasts up to twelve months. Many women see the Mirena as a great choice for bridging the end of perimenopause and the start of menopause. Menopause symptoms include hot flashes, mood swings, anxiety, trouble sleeping and night sweats.
The Mirena coil may be used as the hormone progesterone component of hormone replacement therapy (HRT) to help keep menopause symptoms at bay. The other part of hrt is oestrogen ( estrogen). Women who have had a hysterectomy don't need progesterone so the Mirena isn't an option.
Alternatives to the Mirena IUD
The Mirena may not be suitable for women women who have had breast, cervical or womb cancer. If your doctor say's it's not is right for you, don’t fret – there are many other forms of HRT available. One of the most common options is to take the oestrogen and progesterone hormones to manage menopause symptoms in patches, gels or hrt pills. This is obviously a lot less invasive and. However, taking HRT pills can increase the risk of developing blood clots. For this reason, patches and gels are often recommended, instead.
The bottom line
While it won’t be for everyone, the Mirena IUD is an extremely popular treatment for heavy periods in perimenopause, doubles up as a highly effective contraceptive and can be used as the progesterone supplement in an hrt program paired with oestrogen to manage menopause symptoms.
When should Mirena be removed?
You should leave the Mirena coil in for approximately 5 years or until your doctor advises it to be removed. If you’re on HRT, you should be consulting with your doctor every 12 months.
Does the Mirena coil help with menopause?
Many women see the Mirena coil as a great choice for perimenopause and early menopause, as it thins the uterine lining, making periods lighter when heavy periods are a problem. It also acts as a contraceptive, prevents pregnancy and can be left in place for as long as five years.
Does the Mirena coil cause weight gain?
There is no evidence that the Mirena IUD causes weight gain in perimenopause or menopause . In fact, only 5% of IUD users experience symptoms of weight gain, and this is minor. This is because only small amounts of hormone actually get absorbed into your system.