Get this thing out of me?

April 22, 2011 5:14 PM

I am experiencing serious mood-swings and insecurities. Just got Mirena IUD put in a few weeks ago. Could it be the hormones, and how do I manage without destroying my relationship?

I have not ever been a particularly clingy or needy girl. Started dating boyfriend about 6 months ago (I am 23). He has a "Why should I have to tell you how I feel? Obviously I love you" sort of mentality, which I generally share. We get along great.

About the same time I was getting off HBC pills and onto the IUD, I started feeling some insecurity about our relationship. This could be due to a million other things including:

-work has been very stressful
-both of us have been doing a lot of traveling
-he has talked about moving (many months down the road)

There was a whole week I wavered between "no I totally understand you need to work late this week" and "WHY AM I NOT A PRIORITY FOR YOU?!"... the latter feeling so intense I basically broke into tears at him, more than once. I am analyzing text messages down to the punctuation.

I've already talked to him about the hormonal swings I've been having (and not all related to him) but I can't use this as an excuse for continuing to behave this way. If it's not hormones causing me to feel this way, then I need to pinpoint what is actually going on fast.

Mirena is supposed to have minimal side-effects, but wondering if anyone knows of similar shifts in mood, clinginess, etc. with progesterone hormones. If so, can I expect this craziness to subside once my body adjusts? If it doesn't, I will need to get the thing ripped out, before I have to adjust my dating parameters.

Any anecdata or advice welcome... thanks.

Throwaway [e-mail]

posted by anonymous to human relations (12 answers total)

The Mirena may be causing anxiety, but it's also possible it's withdrawl from the HBC. I had some weiiiird (admittedly, only really physical) side-effects when I transitioned off the NuvaRing, which was already pretty low-dose. If you don't feel comfortably able to give it time, you may be able to ask your doctor to let you remain on HBC for the moment - it's possible to take that AND have Mirena, so you wouldn't need to remove it, and maybe there would be a way of slowly weaning yourself off it if that actually turns out to be the cause.
posted by you're a kitty! at 5:36 PM on April 22, 2011

HBC fucks up emotions in the most extreme ways, and for me, the time between taking Birth Control A (Yaz) and adjusting to Birth Control B (LoestrinFe) was a disaster. I'm only two months into the new pill and I still feel like a wreck one week out of every four and it is gross. The worst part about it is that it is profoundly difficult to distinguish between a real, true emotion (ie: you being insecure about your relationship for quantifiable, valid reasons) and the HBC-addled emotions that pretty much are about as bizarre as they come. I wish I had a fix for you, but I'm in the throes of one of those wrecky moments right now, so clearly all I can offer is anecdata. Best of luck -- feel better!
posted by patronuscharms at 5:41 PM on April 22, 2011

It looks like the hormone levels the Mirena releases are lower than those you'd have been getting with most HBC. So it could be that you're adjusting to the new, lower hormone level. And (as you're a kitty! says) you may have more issues now/for the next month or two as you adjust.

HBC prevents pregnancy by repressing ovulation-- and to do that, it alters changes your hormone levels from their naturally cyclical levels to a fairly steady level. Because HBC stabilizes your hormone level, it can (for some women) also stabilize hormone-related mood swings. It looks like Mirena doesn't generally prevent pregnancy by repressing ovulation the way that HBC does, so it probably doesn't smooth out your hormone cycles the same way HBC did.

The downside is that you may be more moody and emotional for a few days of your cycle-- but you may feel better for the rest of it.

Anecdata: I had more problems with depression on HBC than off it-- the hormone level HBC kept me at meant that I had pretty constant low-grade depression. I didn't realize this until I stopped taking HBC and went to a non-hormonal birth control method. I still have a few days (up to a week) when I am prone to getting the sads in a major way, a few days before my period. How depressed I get during this week-or-so is really dependant on other factors--being tired, stressed at work, etc makes it much worse. However, I find that being happier the rest of the time is a good trade-off for a few really crummy days every few months, and I will not go back to HBC. I have an IUD, by the way-- a Paraguard, which is a non-hormonal IUD.
posted by Kpele at 5:46 PM on April 22, 2011 [1 favorite]

I haven't heard of Mirena causing these crazy emotional swings -- in fact, that's why I got Mirena because HBC made me an absolute basket case and Mirena has such low, localized doses that it's supposed to prevent that type of thing. I'm with you're a kitty! on this one - probably a residual HBC or HBC withdrawal effect. You're probably just adjusting to the lower levels in Mirena, so stick with it if for no other reason than getting those suckers out can be just as painful as getting them put in.
posted by shesdeadimalive at 5:49 PM on April 22, 2011

I can confirm that that definitely sounds like hormones. It took me over a decade to discover that there was a pattern, but holy cow that sounds SO MUCH like what I go through every month before my period. Hormones take any concern I have and amplify them: "LOVER, PAY ATTENTION TO THIS. NOW. HERE IS HOW YOU ARE FEELING. HERE IS HOW YOU ARE FEELING." Tears, etc.? Yes.

I had similar symptoms when I was on the pill for 10 months when I was 18. Never again.

I don't know if the advice carries over, but things recommended to improve PMDD (which basically means I get really bad PMS every month) include avoiding caffeine, sugar, salt, alcohol, and getting lots of exercise and eating lots of greens. Yup, they really do.

They also recommend considering anti-depressants, but for me it's enough to recognize that yes, my concerns are legitimate, and no, I am not allowed to make major life decisions right before my period. Plus being super-healthy. If I had an IUD causing my problems, I'd much rather get that pulled than go on anti-depressants.

As for you, I'd give it a month or so to settle (pending the advice of Ask.Me, your doctor, and your emotions, of course), and then decide whether it needs to stay or go.
posted by lover at 5:53 PM on April 22, 2011

It could be the withdrawal effect.
But: before everyone gets into the "totally localized" effect of the Mirena, I feel I should relay some info from a doctor of mine. While the side effects should be much lower than what you would get on other HBC, there is a progesterone effect. It does get in your blood stream. She told me to not be surprised if I experienced weight gain, acne, anxiety, or another slew of side effects. Her stance was that some people are more sensitive than others, but that a lot of practitioners have been downplaying the effect, much to the confusion of their patients. Her stance was also that I would probably adjust to it and that most of the side effects would abate by the 6-month mark. Which, for most part, they did.

I will note that I've never been on any HBC aside from the Mirena, and my first three months on it definitely affected my mood. Unsurprising, if you look at the side effects stats listed on the packaging. It got better, though.

(also, I know hearsay is not evidence, but hey hey)
posted by vivid postcard at 5:56 PM on April 22, 2011

Research has shown that women on the pill choose the "wrong" partners. Take it with a grain of salt. I ended a very serious relationship (with a fiancé) that was totally wrong for me shortly after going off birth control, and in hindsight, oh my god am I grateful – hey, you asked for anecdotes.

Meanwhile, I love my non-hormonal Paragard IUD and have for the past six years.
posted by halogen at 6:12 PM on April 22, 2011 [2 favorites]

Regardless of whether it is hormonal, I think your emotions and insecurity are worth examining. It sounds like you and your boyfriend are going through a period of high stress right now and are possibly approaching a crossroads at your relationship. This isn't something to be ignored. I don't know if this applies to your situation, but I do find myself somewhat exasperated at how quickly many women tend to chalk up emotional insecurities to our hormones instead of examining the non-biological roots of such feelings.

So I guess what I'm saying is, hormones, if they are a factor, are likely amplifying feelings that were already there in some way or another, instead of creating them out of thin air. If you want the problem completely resolved, you'll have to look directly at these feelings instead of dismissing them entirely.
posted by Fuego at 6:17 PM on April 22, 2011 [3 favorites]

I had a Mirena IUD put in last summer and had it taken out about a week later, as it made me suicidally depressed. My doctor says that she sees very few women who have trouble with it, but that I am not the only one of her patients to "go completely bonkers" on it.

You might talk to your doctor. When I described my symptoms to mine, the response was, "let's get that out right now." But if the symptoms are milder, there may be an adjustment period. Your doctor may have seen previous patients in this early period and may have a better idea of how long it makes sense to wait for things to settle down before taking it out.
posted by not that girl at 6:21 PM on April 22, 2011

After 3 1/2 years on the Mirena a doctor said ---whatt? Did you just say you HATE it? I'll take it out today if you want. Which is what we did. Bodies are different; some of us never adjust.
posted by Ys at 8:07 PM on April 22, 2011

I had a progesterone only implant, which is NOT Mirena and may have different side effects for most people. That said, I had one of the most common side effects common to of all types of progesterone-only birth control: my sex drive tanked. Like, went away entirely, to the point where I was only vaguely aware that at some point in the past I would have some passing sexy thoughts or notice attractive people or get turned on by a movie or something in the course of normal days. All that disappeared and reversed within a month of having it removed. That was the most potentially relationship-destroying side effect I dealt with, and one that crept up on me gradually. I did not have mood swings, however; my moods were almost unnaturally calm, even flat. I am moodier NOT on the implant, if anything.

Big fat YMMV comes with my cautionary tale.
posted by slow graffiti at 9:17 PM on April 22, 2011

As for the "without breaking the relationship" part, I know you talked with him already, but maybe you could set up some kind of 'safeword' he can use with you if your reaction to thinks seems way outside your normal range? The key here is to make it less about "you're acting crazy!" and more about "this may be the hormones talking, rather than how you 'really' feel"
posted by softlord at 10:31 AM on April 29, 2011