Birth control is driving me up the wall.
June 3, 2015 9:54 AM

Can the Mirena IUD cause joint/back/neck pain, sore tendons, or clicking joints? A great deal of elaboration within.

As an introduction: I'm 25. Last year, I was on the Lo Loestrin FE birth control pill. It was giving me headaches every day and my tendons were constantly sore and all my joints were cracking. After I went off the pill, all of that cleared up quickly.

Last January, it was clear various pills were making me feel awful (except Levora, which no one seems to be able to prescribe anymore), so I decided to get a Mirena IUD. Insertion was painful and took about 6 weeks to calm down; until recently, I had no libido, anxiety, insomnia, and constant bloating. Now the bloating is down and my libido has slowly crept back up to moderate-low. My anxiety is under control with Zoloft (I should have treated it pre-IUD, tbh), and after a bit of treatment with melatonin, my sleep is pretty normal. It was not fun before, but now that things are improving, I was thinking about keeping it awhile longer to see if they keep getting better.

However, I have the joint pain of ages! And not just joint pain, but back and neck pain. I completely believe that it's possible that I pulled a muscle in my neck (last week, my doctor thought I had meningitis, so there was lots of head turning and touching my chest and so forth). But that doesn't quite explain the back and joint pain, which has been more persistent. I can feel pain in obvious areas where my posture is bad (left shoulder, lower left back/pelvis area), so that makes sense. I've been sitting up straighter. But I don't know why suddenly my wrists and knees and ankles are popping like gangbusters. My spine aches deep in the spine(?) and I get random leg cramping and little twinges of achy pain in one hand/finger at a time. I had some sciatic pain (? a doctor called it this) in my leg the other day while lying down to sleep. I definitely have sore area where my legs meet my pelvis-- feels like sore tendons, mostly on the left side, but definitely on both. Last time I had this kind of leg/joint pain and popping was when I was on Loestrin.

I just had a complete blood panel done but haven't received the results yet. I also recently had some kind of flu-like symptoms (fatigue, mostly) without any sneezing or coughing. I have terrible allergies at the moment (eyes leaking, ears popping). I take Zoloft, Zyrtec, Nasacort, and omeprazole for various ailments. My allergies are mostly under control, but tree pollen is really bad right now.

Naturally, I googled this (horrible idea), and there is a lot of anti-Mirena conspiracy stuff on the web-- like Mirena gives you rheumatic arthritis, for instance. I am frankly terrified of this, as a couple weeks with fatigue/sore joints has been really compromising my ability to work and focus (and I am starting school in a couple weeks). My urgent care doctor prescribed taking ibuprofen for about a week to see if the inflammation would go down. It helps, but when I stop taking it (in between doses) I get tension headaches and feel like I'm getting the flu again. The stiffness is very apparent when I first wake up, and the pain gets worse throughout the day.

Of course, I'm going to see my doctor, but getting an appointment through my insurance is an ordeal (I'll be on a waiting list). I am ready to yank my own Mirena out due to paranoia (ok not really, but close to scheduling a removal appointment), but it feels dumb to do it if there's no chance it will help.

I know I have health anxiety, and it's been flaring up over this! But on the other hand, I undeniably feel bad right now, and it's impairing my life. So point taken about taking a chill pill, but I also am having a hard time figuring out if this is even a possible side effect-- I can't seem to find full side effect information for Mirena on the web. I have some of the usual side effects.

I wanted to ask here, because the internet at large is full of people who want to sue Mirena for giving them ebola, and IUD divas is overwhelmingly positive about IUDs, so no help there. The only reason I really even suspect it could be related was that I had similar difficulties with Loestrin. Anyone else have these problems with Mirena, and did they go away upon removal?
posted by easter queen to Health & Fitness (14 answers total) 2 users marked this as a favorite
Keep in mind that if you had these symptoms while you were on the pill, you may be having them in relation to something that is NOT birth control related. You changed BC options; many other things stayed the same, for example:

1) Diet
2) Home Environment
3) Work Environment
4) Daily exercise habits (or lack thereof, this is just an example)

Which is a long way of saying, don't start with a conclusion. You'll get results from your blood panel; in the meantime, the best idea (IMHO) is to journal daily for food, exercise, allergy badness, and how you are feeling. This will help you establish patterns and will give you a starting point to talk with your doctor when your blood panel comes back (with or without results). Also, not for nothing, there is something extremely nasty and flu-like going around where I live, so don't discount that you could just have some lingering, disgusting spring/summer virus. It's mowing people down like crazy here.
posted by Medieval Maven at 10:04 AM on June 3, 2015


This is totally anecdotal and I have no hard science to back it up, but my wife has noticed a lot of these kinds of complaints and a lot of them have cleared up since she had her Mirena removed.
posted by sleeping bear at 10:23 AM on June 3, 2015


Mirena tanked my libido, increased my anxiety, caused back pain, and resulted in a huge ruptured ovarian cyst that sent me to the ER.

The above advice about not jumping to conclusions is good, but I found when I told two different gynos I suspected all my symptoms were caused by the Mirena, both told me the Mirena did not cause those types of side effects. After leaving an appointment in frustrated tears I resolved to just get the thing out already, doctors be damned. I did, and the side effects disappeared.

The Internet is full of stories much worse than mine. I say get it out and try a Paragard after your body settles.
posted by sevensnowflakes at 10:34 AM on June 3, 2015


A quick search of the hypermobility forums found women having issues with different HBC causing different effects on their hypermobility. Read through some of those and see if it sounds like your symptoms.

Hormones definitely play a role in ligament laxity. The only way you will know if the hormones cause this is to remove the IUD.
posted by littlewater at 10:39 AM on June 3, 2015


(Anecdotes, and all that...I'm on my second round of Mirena and have had no joint pain, or really anything after the spotting settled down after several months. I'm sure you can get anecdotes relating proximity of Mirena to anything you like.)
posted by leahwrenn at 10:41 AM on June 3, 2015


[I]t was clear various pills were making me feel awful (except Levora, which no one seems to be able to prescribe anymore)

For what it's worth, Levora is a name for one version of a fairly generic monophasic pill; the same pill type also goes by "Portia" (and "Nordette" and a bunch of other names I forget). It's .15mg levonorgestrel and .03 mg ethinyl estradiol per pill. It is super common and I've never encountered a pharmacy or doctor who can't find it under some generic name or other. If you do not end up sticking with the Mirena, perhaps you could go in and request it by the ingredients/amounts, and the doctor can put in an appropriate prescription, and you can find out what name it is listed under in your area/your pharmacy.

I should note - and I am not a doctor, mind, just someone who always reads up on the active components of medications - that the Mirena IUD releases levonorgestrel (one of the two chemicals present in Levora pills), and the Loestrin pills that disagreed with you contained ethinyl estradiol and norethindrone (neither of which are in the Mirena, and one of which is in Levora), and while the Mirena is progestin-only, both the good and bad oral contraceptives were estrogen and progestin. Oh, and Levora has a higher estrogen level than Loestrin, and Mirena should have a lower dose of progestin than the pills. I'm not sure I see a particularly consistent pattern here, in terms of a component of hormonal birth control explicitly and consistently causing your symptoms, and "joint and muscle pain" is certainly a less common negative HBC side effect than lost libido, fatigue, exacerbated anxiety or depression, etc. This isn't to say that the Mirena/HBC is definitely not at fault - you might be having an uncommon reaction, or be part of some subpopulation that is susceptible to a certain sort of weird side effect, and you might find that official side effects list be damned, getting rid of it makes a difference for you - but in your place, I would absolutely actively pursue other possibilities as well (including keeping a detailed health journal.) Your symptoms sound really miserable, and as Medieval Maven suggests, you don't want to risk missing the actual cause because you were overly focused on the HBC thing.
posted by ubersturm at 10:56 AM on June 3, 2015


I developed severe join pain in all my joints about 2 months after I had the Mirena inserted, my doctor told me it was coincidental and absolutely not connected to the Mirena. Like you, I read all the horror stories on the internet but I kept it in because I have fibroids and it did help that pain so I figured the trade off was worth it.

I had the Mirena in for 5 years and the joint pain never went away, it was cyclical though and sometimes it was better than other times but often so bad I couldn't get out of bed. Sitting for any extended period became unbearable. I went to a host of doctors all who could find nothing wrong, they tested everything from Rheumatoid arthritis to Lyme disease.

I had it removed 3 months ago and I have had no relief from the joint pain, not sure if I left it in too long or if, like the doctors have been telling me all along, it's not connected but if I had any other options for my fibroids I would have taken it out right away.
posted by doublenelson at 10:56 AM on June 3, 2015


Mirena was great for 2-3 years and then something interacted and it got worse and I had a bunch of the side effects at the fine print on the brochure. My sister had the same effects, and had her Mirena removed, they cleared up within a month, and then I had mine removed and the symptoms eased up hugely. It was definitely to do with the hormones, and the depo-provera shots I tried earlier were also bloody awful. I'd still recommend Mirena to most people to try, because the side effects are rare and it was so great the first few years but yes - yank that sucker AFTER your doctor has ruled out other obvious causes of neck/back pain.
posted by dorothyisunderwood at 11:28 AM on June 3, 2015


no libido, anxiety, insomnia
I had all of these symptoms plus hypermobility/joint pain while on Depo Provera (another progestin-based contraceptive). I sprained/strained my knees, rolled my ankles, injured my hip joints, etc. too many times to count during the 10 years I was on it (thanks 99.9% of the doctors I saw for, you know, not mentioning any of these things could be related to the Depo). Going off Depo cured all of these symptoms for me. I'm still achy at times, but I've finally been able to use a physical therapy and yoga regime to re-strengthen the muscles needed to hold everything in its place (my back/hips were all kinds of messed up from 10 years of a suboptimal posture/gait).

From what I understand, high levels of progesterone are associated with ligament laxity - this is one reason, in addition to swelling and weight gain, that pregnant women's shoe size may increase during and after pregnancy. Anecdotally, my feet shrank by half a size after going off Depo.
posted by melissasaurus at 11:52 AM on June 3, 2015


Where do you live? Is the barometer changing a lot? I get a little achy in springtime as thunderstorms become more common.
posted by WeekendJen at 11:57 AM on June 3, 2015


Another thing to consider is that mid 20s is the beginning of the likely onset range for a lot of autoimmune diseases. It really could be a coincidence.
posted by hydropsyche at 12:01 PM on June 3, 2015


These sound similar to some pregnancy symptoms so maybe the Mirena did indeed knock your hormones out of whack. Or it could just be a coincidence that this started after you got your IUD.

If you want the convenience of an IUD without the hormones, switch out for a hormone-free copper IUD. Just make sure you monitor your iron levels because the copper IUDs can make your periods heavier and you may need to take a supplement to avoid developing anemia.
posted by Jacqueline at 1:20 PM on June 3, 2015


nthing sticking to bc you've found has worked for you. Searching for one that's compatible with your body is such a pain in the butt!

For anecdotal data - after struggling with a couple brands, I took Levora for a few months and it worked beautifully with no side effects. I got switched over to Portia and many months later I am still side effect-free.
posted by blueberrypuffin at 1:21 PM on June 3, 2015


Joint pain and diffuse muscle aches are not part of the many listed potential side effects for Mirena (link to official Mirena website). Therefore it is unlikely your symptoms are caused by Mirena (although not impossible). I do notice that you've been taking Zyrtec for your allergies - fatigue and drowsiness are common side effects of antihistamines.

You don't make it clear what the time course is, but if you got Mirena in January, and your symptoms of muscle aches and fatigue and joint pain etc just started last week, all other issues aside, that makes it seem a lot less likely the two are related. I would also point out that if someone gets symptoms (of anything) while using Mirena, and they persist after removal, then it is quite unlikely that those symptoms are due to some permanent change to their body induced by exposure to Mirena. The same goes for OCPs like Loestrin. Mainly because our bodies naturally manufacture steroid hormones such as estradiol and progesterone - they are present within us at all times.

A PubMed search (PubMed is the database for just about every reputable medical journal in the world) for "mirena+arthritis" - not even limited to rheumatoid, but any kind of arthritis - turns up nothing. So at least in the medical literature, it's unreported. Not even a case study (report on a single patient with an unusual issue). People who say on the internet that they got a diagnosis of arthritis after having a Mirena inserted are probably just coming to spurious conclusions based on when the insertion and the diagnosis happened. Kind of like how autism is typically diagnosed in very young children, and young children get a lot of vaccines, thus many people noticed that the autism diagnosis came shortly after a vaccine and concluded that vaccines cause autism (you've probably heard the news, but they don't). So, this is not to say that we can diagnose what you've got over the internet - of course, no one can. But I do think it is fair to say based on this general information that you can draw conclusions about the likelihood of Mirena being related to your symptoms.

I hope that is helpful!
posted by treehorn+bunny at 5:00 PM on June 3, 2015


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