Will the Mirena IUD make my brain explode?

June 3, 2015 4:39 PM

I'm on track to getting the Mirena IUD within the next month or so, because I have insanely heavy periods. I know lots of people who have it and love it, but I have one worry -- I get migraines with aura, and am concerned that the Mirena might makes them worse. A bit more detail inside...

I've had migraines with aura for pretty much my entire life, but recently, over the last month or so, I've had a spell of REALLY nasty ones. (I am going to talk to my doctor about them, of course -- I have an appointment with her this Friday.)

I've been Googling, and have read horror stories about women having their migraines get much worse with the Mirena, and that worries me, even though my gynecologist knows about my migraines and doesn't seem concerned. So, I query the hive mind -- migraine sufferers with the Mirena, how has it worked out for you?

posted by sarcasticah to Health & Fitness (21 answers total)

Best answer: I can't speak to auras. But my migraines (with nausea and photosensitivity) have stayed about the same in intensity, and lessened dramatically in frequency, with the Mirena. I'm not sure there's any way to know in advance how you'll respond but FWIW, I would do the Mirena again in a heartbeat.
posted by Stacey at 4:53 PM on June 3, 2015 [2 favorites]

I've had migraines with aura since I was roughly 6. In the 8-9 years since I got a Mirena (1 replacement in that timeframe) their frequency and severity has dropped markedly, to the point where being unable take triptans because of a drug interaction was a thing I could shrug off instead of a life-altering mess. It is miles and miles better than any other hormonal BC I've ever been on, migraine-wise.
posted by dorque at 4:54 PM on June 3, 2015

My migraines decreased after I started Mirena. (I take a preventive medication + 2 doctor-prescribed supplements and have zero headaches most months. It's glorious.)
posted by wintersweet at 4:55 PM on June 3, 2015

I have migraines occasionally and they haven't been affected one way or another by my Mirena.
posted by MsMolly at 4:58 PM on June 3, 2015

I have very bad chronic stress-induced headaches that might be migraines (never really been sure?) that often seem to get worse the first few days before my period. The Mirena hasn't noticeably affected them at all-- actually, now that I think about it, they may be incrementally less frequent.
posted by WidgetAlley at 5:07 PM on June 3, 2015

I know someone with a Mirena who has always had occasional migraines with aura - some seemed to be hormonally triggered, some triggered by other things. She gets a fewer migraines now than she used to. There are a lot of confounding variables so I can't confidently say that it was the Mirena that decreased them, but it certainly didn't increase them.
posted by insectosaurus at 5:09 PM on June 3, 2015

Best answer: This is just one example, but guidance on when to prescribe Mirena in numerous studies suggests that women who have migraine with aura should preferentially use Mirena or other progestin only contraception, because migraine with aura is a risk factor for thrombosis (clotting, i.e. stroke), and contraceptives with estrogen increase risk of thrombosis.
posted by treehorn+bunny at 5:15 PM on June 3, 2015 [5 favorites]

Response by poster: Yeah, I can't do the pill because of the migraines. This is all good to know, thank you!!
posted by sarcasticah at 5:22 PM on June 3, 2015

migraines (with nausea and photosensitivity) have stayed about the same in intensity, and lessened dramatically in frequency, with the Mirena

ditto!
posted by arnicae at 5:28 PM on June 3, 2015

I have a history of migraines with aura that, until recently, I have experienced exclusively* with pregnancy. I had 1 such migraine with my first pregnancy and 2-3 with my second. I have been on Mirena for about 8 months and I have had 2 migraines. As you know, BC options for those of us with auras are limited, so I am going to stay on Mirena for a few more months and monitor the frequency before deciding whether to stop.

*except maybe 2 about 15 years ago
posted by deadcrow at 5:53 PM on June 3, 2015

migraines (with nausea and photosensitivity) have stayed about the same in intensity, and lessened dramatically in frequency, with the Mirena

Dittoing the aforementioned ditto
posted by Ink-stained wretch at 6:10 PM on June 3, 2015

Have you communicated this to your doctor with actionable steps? When you do, ask her to help put a plan in place---eg if headache is intolerable, have Mirena removed, etc.
posted by discopolo at 6:12 PM on June 3, 2015

Also, can you tell us your race/ethnic background because this makes a difference with hormonal birth control (and other medications).
posted by discopolo at 6:15 PM on June 3, 2015

I used to get migraines with aura semi-frequently -- three or four a year. Since I had my Mirena, I haven't had a one.
posted by KathrynT at 6:27 PM on June 3, 2015

For what it's worth, I'm adding to the chorus. My doctor prescribed Mirena as a birth control and endometriosis control method that was appropriate for someone with a history of migraines-with-auras. My migraines (pain, auras, nausea, photosensitivity) have been completely unaffected by the Mirena; they're the same frequency and the same severity.
posted by CtrlAltDelete at 6:42 PM on June 3, 2015

Response by poster: discopolo, I plan to talk it over with my doctor -- well, both doctors, primary care and gyno. Also, I'm Caucasian, and 42 years old.
posted by sarcasticah at 6:45 PM on June 3, 2015

Sorry to be the negative voice here, but my migraines got insane when I had a Mirena. Usually I get aura and they build up over a little time with some warning at predictable times, but these were hitting full force out of nowhere, were coming way more often than my normal ones, and often had no aura. I had to have the Mirena removed after four months, and wanted it out sooner.
posted by dilettante at 7:16 PM on June 3, 2015

I am just switching from an estrogen based BC pill I was taking to stop my period because of heavy bleeding and severe premenstrual depression and migraines. It seems to have made my blood pressure shoot up, which with my "advanced age" (45) and migraines puts me at too high a risk for stroke and heart attack. My GP has suggested Mirena, but because we aren't sure that it's going to do the things I want it to do, she prescribed a progesterone only mini-pill first. I've been taking it for 24 days or so and have an appointment with her next week to follow up.

Is trying a progesterone pill, which is easier to reverse than an IUD, an option for you?

(FWIW, I haven't been happy with the progesterone--I got my period when I stopped taking the estrogen pills and I started the progesterone on day 5 of that period and have basically had my period for a month at this point. And my mood has been terrible, I'm really oversensitive and pretty depressed and have had terrible insomnia, even for a chronic insomniac. No headaches, though! I might be willing to give it another month, to see if things improve, but I'm really glad I don't have to have an IUD removed.)
posted by looli at 7:58 PM on June 3, 2015 [1 favorite]

My occasional migraine with aura stayed occasional on Mirena, but I was told by one ob./gun that they should decrease if your migraines tend to follow some menstrual pattern (or birth control pill) related cycle.

I was previously on HBC and mostly got migraines during no pill weeks a couple times a year, so switching to a no estrogen option didn't do a damn thing there. Frequency & severity about the same, mood issues increased noticeably (in a PMS sense) and more subtly and perniciously (in a depression sense) over time for this migraneur.
posted by deludingmyself at 9:30 PM on June 3, 2015

Best answer: My understanding is that for any contraceptive that helps a specific condition (e.g. migraines, acne, etc) there is a small subset of people who find it makes that condition much worse instead of alleviating it. The best way forward is to have a plan in place with your doctor that covers the warning signs and/or conditions that mean it's not working for you, and how you'll get it removed/stopped ASAP if it turns out you're in that minority.

I have an implant (Implanon) that is supposed to work well with other medication I take. My doctor said if I experienced symptoms X,Y,Z not to worry because they'd wear off, but if I had symptoms A,B or C to start making my way into the clinic immediately and call him on my way in because he'd find the time to take it out ASAP. I didn't need to have it removed, but having a plan for the worst-case scenario made me feel more confident about the risk.
posted by harriet vane at 7:55 AM on June 4, 2015

Response by poster: Thank you all! I talked to my doctor on Friday, and she agreed with your consensus. I'm feeling much less worried now.
posted by sarcasticah at 3:59 PM on June 9, 2015