Experiences with the Mirena IUD?
November 16, 2009 2:00 PM   Subscribe

Firsthand experience with the Mirena IUD, especially after being on the pill?

I've been on Yaz for about a year and a half. I'm a pretty sensitive person, but I think that Yaz has made me really emotional. I also have a slightly decreased libido and don't usually produce lubrication (even if I am up for sex). I used to be ready and raring to go all. the. time.

Because of these issues (and the price), I switched to Ortho-Triciclen Lo for three months this past winter. I felt much calmer, but my libido was completely demolished. I switched back to Yaz, figuring that was as good as I could do.

I like being on the pill because it is easy and I am in a committed relationship. It's also the only thing that cured my acne. However, I've been looking into the Mirena IUD.

I know that YANMD, but are the localized hormones in the Mirena noticeably less pervasive than Yaz, which is considered a low-dosage pill? I am willing to trade in acne for more emotional stability and my old libido, but I don't really want acne AND emotional instability AND no sex drive.

Please share your experiences with the Mirena IUD!

(I've also looked into the paraguard, but I really don't want to deal with the heavy periods. I'm ok with the small amount of hormones in the Mirena.)
posted by anonymous to Health & Fitness (29 answers total) 6 users marked this as a favorite
I was on the pill for several years and went to the Mirena after having kids. I had to have it removed after a year because everytime I had sex there was some discomfort and slight to medium bleeding. I have no idea how common this is but it was remedied after removal. I'm back on the pill which like your experience, is great for the skin but sucks for the sex drive. (I was not at all emotional on the Mirena and sex drive fine.)
posted by greensalsa at 2:12 PM on November 16, 2009

IANA(female) but the ladyfriend has the Mirena - her experiences have been overwhelmingly positive. Fewer of the pill-related side-effects while retaining much of her sex drive etc. As is fairly typical for many Mirena users, her periods are now exceedingly light - if present at all.

Installation (implantation?) is uncomfortable, I understand.

On the plus side, they look kind of like robot embryos, so you always have a fallback joke about growing robot babies.
posted by neksys at 2:16 PM on November 16, 2009

I love the Mirena. I was on Ortho-Triciclen Lo for years, then switched the NuvaRing because I was working a very irregular schedule and couldn't take the pill at the same time consistently.

I really liked the NuvaRing, which is also lower-dose of hormones because it's localized. However, a) it wasn't covered by my insurance, which meant that it was $50 a month, and b) I after a month or two, I consistently had minor spotting/bleeding, as well as a light period. So I decided to switch to the Mirena, as I am also in a monogamous relationship and wanted hormonal, rather than barrier birth control.

I had it put in in April, and its been great so far. It hurt a bit putting it in, in the sharp gasp kind of way when you stub your toe hard, but more annoying as it's in your middle and so I found it harder to say 'this is me, and over there is my toe that hurts'. But it only hurt for a moment, and some cramping that morning. I played in my intermural soccer league game that afternoon and had no problems.

I haven't really noticed any hormone-induced changes in libido or emotions, so I can't speak as much to that aspect of your questions. I've always been a bit of a crier when I'm upset or frustrated, and that's been the same on all the hormonal birth control I've tried. I occasionally have a sore lower back, in that mildly period-esque cramping way, but that's it. No periods at all since I got it put in. For me, that and the amazing efficacy of it as a birth control method are the two biggest wins. Neither I nor my boyfriend notice it during penetrative sex, and I haven't had any discomfort or bleeding.

Hope this is useful!
posted by foodmapper at 2:23 PM on November 16, 2009

I like my Mirena. I didn't think the insertion was that uncomfortable, but I've had two vaginal births, one of those unmedicated, so YCervixMV.

I did seem to spot more, and for much longer, than the average user. Specifically, near constant spotting (though fairly light) for at least four months. Erratic, but still fairly light spotting for another six. Then completely random spotting for another couple of months. Now after about a year and a half there's just an occasional reminder that I'm A Woman Now. So, that was frustrating at first and annoying for a long while. Telling the nurse the first day of my last period was, and still is, kind of a circular conversation at doctor's appointments.

But other than that, no side effects to speak of. My skin's better than on most pills I've tried, my libido is definitely less affected than by most pills and the device itself doesn't get in anybody's way. No weight gain (no weight loss, either, alas--I was hoping some of the weight gain I was blaming on one of the pills I'd tried would magically disappear if I changed methods). My moods are as stable as my moods get. Though one thing I'll mention is that because I don't have a regular and visible "cycle" and the signs that normally point to hormonal strife don't come on schedule, I will get occasional bouts of unexpected PMS that kind of throw everything into chaos before it occurs to me what's going on.
posted by padraigin at 2:30 PM on November 16, 2009

I had it installed last December. I'm only in the last month or so having any days without spotting (apparently this is an ok side effect). It's been a huge drag. There's usually some bleeding after sex. I don't have good info about the libido issue, because I'm still nursing, and I think the nursing hormones are libido-killing, but I can say that bleeding all the time and therefore generally feeling grody is a libido-killer. Of course, now I'm supposed to get 4 years of basically period-free-ness. (It hasn't been---quite---enough of a hassle to get it removed, although I've considered it. And not having to worry about taking a pill every day has been nice.)
posted by leahwrenn at 2:32 PM on November 16, 2009

For what it's worth, I ordered mine from NorthWestPharmacy.com (because my insurance wouldn't cover it, and this way it only cost $225). It arrived fine, but it was the Turkish version (i.e., all the packaging and inserts and stuff were in Turkish). Luckily, my midwife was cool with it.
posted by leahwrenn at 2:34 PM on November 16, 2009

the livejournal community iudivas (maybe 2 d's?) is where you wanna go for complete advice.
posted by k8t at 2:37 PM on November 16, 2009

I love the Mirena. No problems, and for me, no periods, no impact on libido, no weight gain, no skin problems. And while light spotting is common with the Mirena, especially after sex, if you feel pain during sex, it might be because the threads (which are left 2-3 cm long so that you can check to make sure it hasn't detached), were left too long. I got mine trimmed on the six week followup. It did hurt upon insertion, but my partner picked me up and bought me ice cream and a pizza. A couple of days later, there was no pain, and since then, no complications, and no hormonal insanity wrought by Yaz.
posted by dhn at 2:41 PM on November 16, 2009

Hi, are you me two and a half weeks ago? Because you should get it.

I was interested in Mirena for exactly the same reasons you are (though I was on Nuvaring, not the pill). Obviously 2.5 weeks isn't really long enough to report on any changes (from what I read 2 or 3 months was when other women began to notice a difference as the hormones from earlier hormonal birth control wear off) but so far so good. I can tell you about my insertion. It was a little painful but nothing horrible - it's always strange when you become aware of organs you don't normally sense. I've never had children which makes insertion a little more painful and difficult. I went to Planned Parenthood and they do offer a medication to soften your uterus but it takes a couple hours to begin working, and I was a walk-in appointment so I didn't get any. They did give me a whopper does of ibuprofen (800 mg). Afterward I had some cramping but nothing incapacitating, just like menstrual cramps. I had taken my bike to PP, not expecting them to be able to do an insertion that day, but I didn't have any problems riding the half mile home. I took a some ibuprofen to keep the cramps down, but I only needed it for the first 24 hours or so. There was some spotting for about 2 weeks but it seems to have gone away now.

When I was deciding if I wanted to get the Mirena I read a number of previous AskMefis on Mirena, IUDs, and birth control in general, which you've probably already done. Definitely check out the livejournal community IUD Divas, lots of info there. I finally decided to do get a Mirena because it seemed like there were a number of women who were in a similarly dissatisfied with the pill/the ring and were happy with the Mirena. Also, my insurance was willing to cover it so I thought it was worth a shot.
posted by radiomayonnaise at 3:16 PM on November 16, 2009

I got my Mirena last August and I do like it. I love having birth control that I don't have to think about, which is why I decided to get it. The insertion was fairly painful for me and I felt kinda crampy and blah for a few hours afterwords. However, I'm in the minority apparently because it has actually made my periods longer and more painful. That's the part I hate, but I live with it because I like not having to think about BC.

Like some of the other commenters, I really like IUD Divas on livejournal. Learned a lot from them. It's a good group to check out if you're considering a Mirena.
posted by whatideserve at 4:44 PM on November 16, 2009

I have had my Mirena for nearly five years - I'll be getting a replacement this spring. I was on BCP for more or less 10 years before it started to get to where I felt weird on BCP. I've never felt "weird" on the Mirena. I say go for it. It's awesome, and while they can't guarantee it, it seems that odds are that you will have shorter periods (if not nothing at all - I've not had a period in five glorious years).
posted by Medieval Maven at 4:56 PM on November 16, 2009

I'm up for a replacement in January or so, and I say LOVEEEEEEEEEE to my mirena. My insertion was painful, but my Planned Parenthood provider said she would now give me some misoprostol to make the insertion easier this time.

I haven't had but mere whispers of spotting in the last several years. I do not own tampons, pads or any other sort of menstrual blood gathering device.

♥ ♥ ♥ ♥ ♥ ♥ ♥ ♥ ♥ ♥ ♥ ♥ ♥ ♥ ♥ ♥ ♥ ♥ ♥ ♥ ♥ ♥ ♥ ♥ ♥ ♥ ♥ ♥ ♥ ♥ ♥ ♥ ♥ ♥ ♥ ♥ ♥ ♥ ♥ ♥ ♥ ♥ ♥ ♥ ♥ ♥ ♥ ♥ ♥
posted by Stewriffic at 5:12 PM on November 16, 2009 [1 favorite]

I'm on my second Mirena, I the replacement done in January, so all up I've had Mirena for almost 6 years. I still get a regular monthly period but it's very light.

The last time I was on the Pill I had to go off it due to the emotional side effects. I would be in the car with the radio on & I would burst into tears during news bulletins or over songs. It was quite disturbing. The only thing I miss about the Pill is being able to skip periods.
Libido, weight, skin, mood are all normal for me on Mirena, no side effects at all. I used to get cramping & tender breasts with my periods, but don't anymore. I do still bloat up a bit, but that's all.
I've never experienced pain during or after sex, and my partner can't tell there's anything extra there, either.
Some women report they lose their periods all together.
You might feel a bit tender in the tummy for a few days after insertion, especially the first time.

I also tried Implanon about 8 years ago but I had constant bleeding so had it removed.

are the localized hormones in the Mirena noticeably less pervasive than Yaz
posted by goshling at 5:13 PM on November 16, 2009

I love, love love my Mirena. I got it because it was the lowest dose of hormonal birth control my obgyn could come up with. (I had to go off my regular-dose pill for other blood-clot-related reasons).

After the first week or so, I went without a period for over a year. Then I had some weight fluctuations and my period came back, but lighter and less frequent than before. It's irregular now, but so light it's not really a problem. If anything, the mirena has helped my libido as compared to the pill and requires zero thought outside a yearly string check when you get your pap. The insertion wasn't great, but given I haven't had kids, it wasn't bad at all. I can put up with a few minutes of discomfort and an afternoon of lying around with a heating pad once every 5 years. Plus, it's cheaper than the pill, at least in Canada. The Mirena costs around $300, which is only about 25 months of $20/month pills. Buy two years, get 3 free! :)
posted by cgg at 5:21 PM on November 16, 2009

You asked for first-hand accounts so here's mine. I encourage you to read up on other womens' experiences at IUD divas along with the many great AskMe questions on the topic - tags for IUD, birth control, etc will get you lots of great resources.

For me: I LOVE MY MIRENA! I was on Ortho-Tricyclen for 2 years in college, then switched down to a lower dose "mini-pill" for 3 years. The whole time I was on hormonal birth control, my libido was numbed - not so much gone as dialed down, sex was just nice at best. I also gained about 20 lbs and had to live with mild depression but the upsides were lighter, regular periods, clearer skin and a reduction in my more extreme emotional PMS outbursts (in addition to the whole no babies thing). I kinda just got used to "me on the Pill" and lived with it for a long while. I finally decided I needed a change for a few reasons: I was completely frustrated in my attempts to lose weight and my Gyno thought the Pill could be the culprit; I wanted to be myself again without the sort of underlying vagueness to my emotions and sex drive I was feeling; and the clincher was my insurance jacked up my monthly co-pay for my Pills. So after talking with my doctors, my husband, doing a lot of reading and finding out my insurance covered IUDs 100% I decided to give it a shot.

After getting my Mirena quite literally ALL the crappy side affects are gone. Since I don't need to worry about interrupting the hormone dose, I've been able to start taking St. Johns Wort again for my Seasonal Affective Disorder. Sex is suddenly fantastic and my husband is impossibly more attracted to me. It could be my own brand of hormones coming back - we did start dating before I got on the Pill in the first place - or it could possibly be that I'm happier generally and dropped the extra pounds with minimal effort in six months (yahoo!). Downsides? I have had some more whiteheads and uneven skin since switching, but I'm working on that with better face washing and creams. I definitely have stronger emotions again - both bad and good but I feel like ME plus my really nutty PMS does not seem to be returning at all. In a very few intimate positions my guy bumps up against the strings, but its infrequent and not a big deal. The insertion itself was somewhat unpleasant, but as cgg says, it's survivable and having an IUD is completely worry free otherwise so it's worth a day of cramping. I had about two weeks of steady light spotting, but hardly anything since - nothing that couldn't be handled by panty liners. For a gal who pre-contraceptives used to have to lie in bed for two days a month crippled with cramps and was a screaming harpy of emotion - this is pretty f-ing fantastic.

Can you tell I'm a complete IUD evangelist? My good friend who also has a Mirena calls it "my little plastic friend" and I couldn't agree more. Best of luck to you - I hope it's a good fit for your body!
posted by malacologist at 5:54 PM on November 16, 2009

I love my Mirena; I will definitely replace it when it's time. I (used to) get wicked PMS (mood and physical effects are both intense) and the Mirena wiped out my symptoms for some time, as well as reducing and then eliminating bleeding altogether. My libido has been good, my partners have been happy with it, I can't forget to take it though I do forget it exists...I hated taking the pill, and I fully recommend the Mirena.
posted by Bergamot at 5:58 PM on November 16, 2009

I liked Mirena a lot but had it removed early because I thought it was making me have acne. I started doing a bunch of other stuff for my skin around the same time, so I don't know for sure what made the difference, but I don't have acne now. Other than that, I thought it was great; didn't particularly hurt to get it put in, little to no bleeding within a couple of months, and no pills to have to pick up from the pharmacy or forget to take.
posted by lakeroon at 7:24 PM on November 16, 2009

I've been on the pill (low dose), the shot (depo provera), the ring, the patch and now finally I have my Mirena IUD. So I've tried everything hormonal except the implant. I can tell you, from loads of experience, that the Mirena IUD is the least annoying, easiest to use, most fool-proof and virtually failure-proof method that I have ever used.

On another note though, because most of the side-effects etc have been covered:
Have you had any children? Some practitioners are loathe to allow women who have not had kids to have an IUD. This is due to two factors: one, the cervix is allegedly more pliable and allows easier/less painful insertion if one has already given birth. This is somewhat true. My insertion was rather painful (but worth it!) because I have not had a baby. I have one friend who had theirs removed because her uterus somehow bent it in half, but that may be due to poor insertion technique. There is a chance that your uterus is too small but that's a rare problem. Mine was "borderline" according to the nurse doing my insertion but we went ahead anyways and I've had no problems.
The second issue some practitioners have with IUDs is the very small chance of lowered fertility. The IUD can cause scarring within the uterus and the cervix, especially if the insertion is done poorly. It has happened in as many post-birth women as non-post-birth women. For this reason, some practitioners will not insert an IUD into a woman who has not had children because they figure the pain of infertility is lower in a woman who has had children (especially if those women have decided to stop having children).

Another general issue practitioners have with IUDs is the possible increased risk of contracting a uterine infection (Pelvic Inflammatory Disease, or PID) after having been infected with an STI like Chlamydia or Gonorrhea. The theory is that the existence of an IUD connecting the uterus to the vaginal canal somehow allows easier access for bacteria to the uterus. This is bunk. If anyone tries to lay this on you, get a new doctor/nurse/whatever. *If* there is any increase, and mind you, the statistics find it to be laughably small, it is within the first thirty days. After that, you're just as likely to get PID as a woman taking the pill and having unprotected sex. However, they should ask for a recent test showing negatives for both chlamydia and gonorrhea.

I got mine at Planned Parenthood and they were fantastic about it, although I did have to order it specially because apparently they did not stock it due to expense. If your regular gyno will not insert one for you, find a new one. This is a good issue to use to weed out "old-school" practitioners who don't keep up with the latest information/practices.

I wrote a term paper about all this, but of course I can't find it at the moment. Feel free to me-mail me with any other questions.
posted by nursegracer at 8:13 PM on November 16, 2009

I've had a Mirena-like IUS for four years, and it's been brilliant.

Now, every body is different; some people do very well with the Depo-Provera shot -- other people lose the ability to have sex at all due to menopause symptoms. So you should always take someone else's experience with any medication with much salt -- it may not be your experience.

But I had a similar reaction to pills that you did, and the IUS (as it's called in the UK) has been wonderful for me. No effect on sex drive or mood -- the hormones are really much lower than in birth control pills. I, too, had stubbed-toe level pain when it was first inserted, and continued to have mild cramping for about a week (not as bad as regular cramps - just odd twinges). However, since then I have not experienced any monthy cramping (as I had been subject to), and I have had very light periods. And really there was no effect on my mood or interest -- it's been great.

There are situations in which a hormone-IUS/IUD is not a good idea -- your doctor should check all this out. But as far as I know, the hormone dose is much lower than even a low-dose pill, and is there mostly to counter-act the way that an IUD can worsen your periods (without hormones, IUDs make them heavier with more cramping).
posted by jb at 8:18 PM on November 16, 2009

I have the Paragard IUD. If you haven't had kids, you may have a hard time finding a doctor who will insert an IUD, as someone else already mentioned. Planned Parenthood will do it though.

Insertion was horrifically painful for me, and I was pretty much incapacitated for a day or two afterwards, but the very worst pain only lasted for about 10 seconds and was totally worth it. (I've not had kids). I love my Paragard.

The LJ community that was already mentioned is here. They're very helpful.
posted by Lobster Garden at 8:34 PM on November 16, 2009

I got the Mirena IUD a few months ago (at Planned Parenthood), after being on the Pill for over ten years. I loved being on the Pill because it helped with acne, it made me less moody, and I had tiny, almost unnoticeable periods. The Mirena was very painful to have inserted, but since then I haven't had a period at all and it's nice to not have to ever think about birth control. I have had more difficulty with acne, though, and my moods have been, well, moodier. I feel like a hormonal, unpredictable woman. I turn into a bitch sometimes, I cry sometimes, my boobs hurt, it's crazy. From what I understand, the hormones in the Mirena basically only affect your uterus, not your whole body. I think I'm just one of those women who does better on hormones.
posted by Dilemma at 9:30 PM on November 16, 2009

(one of those women who do better on hormones.)
posted by Dilemma at 9:43 PM on November 16, 2009

I know that YANMD, but are the localized hormones in the Mirena noticeably less pervasive than Yaz, which is considered a low-dosage pill?

Yes, Mirena is much, much lower dose, equal to about one progestin-only pill per week. It does not contain estrogen at all.
posted by Violet Hour at 11:55 PM on November 16, 2009

I used to be on HBC and my RN advised I switch to the Mirena to limit my hormone exposure. I am so happy to not have to remember to take pills at the exact same time every day, or deal with the emotional craziness it gave me. The strings were too long at first and they kept poking me, but at my follow-up appointment I got them trimmed and I've had no problems since. I'm really happy with it, but it's kind of weird to have the hormonal surges but no bleeding.

A pretty good sign of your OB-GYN being with-it or not is if they balk at inserting IUDs in nulliparous women. It's totally not a problem, but you may have a slightly harder time. Your insertion experience really depends on the skill of your OB-GYN, as well as your own pain tolerance. iud_divas is helpful, but it is also possible to freak yourself out reading other people's stories. Try and get a person that's done them before, preferably a lot.
posted by calistasm at 12:00 AM on November 17, 2009

I really want a Mirena... tried to get one inserted in April at my primary doctor's office but it wouldn't go in. Not even the initial sound would go in all the way. I apparently have a tight cervix and a short uterus. It was somewhat painful but mostly just freaky since there are things pressing on your internal bits. I had a cervix softener the night before and a painkiller predose but no dice.

I'd love to know what to expect if I go to an OB/GYN and try again. Are some bodies unsuited for IUDs?
posted by rhiannon at 12:41 AM on November 17, 2009

Side note on the doctor thing, and I know it's been said here before, but repeating it for the sake of having it said: If your doctor does not want to insert your IUD, it might possibly be because they are bad at it, and inserting an IUD in a woman who has not had children is just plain more difficult. If the doctor is hesitant, then find another doctor who is not. Not having children is really no reason for someone to NOT have an IUD.
posted by Medieval Maven at 4:52 AM on November 17, 2009 [2 favorites]

I was on LoEstrin, Juvel, and the Nuvaring in the past, and switched to the Mirena in July. Positive reviews all around except for the insertion, which hurt. However, I was back up and going by the evening that same day. Make sure you take someone with you when you get it put in or have some reliable transportation home.

I haven't noticed any increase or decrease in emotional stability or libido. However, tangentially, I ended up doing it more after not having to remember to take the pill every morning (I am terrible at routines). I had spotting almost every day after I had it put in, and since then I haven't had a period at all. I recommend it heartily!
posted by amicamentis at 6:17 AM on November 17, 2009

@rhiannon - Yes, some bodies are unsuited for IUDs. I believe the uterus has to measure at least 6 cm or possibly 6.5 cm and it must be a "normal" shape.

If your primary doctor has a hard time with insertion, you might do well to find another doctor with more experience inserting IUDs. Planned Parenthood is generally very experienced with this and they're willing to insert for nulliparous women, no questions asked. The skill of the doctor who does insertion is very important.

Also, to the OP, you say one of your concerns about Paragard is heavier periods. This side effect generally only lasts for the first 3-6 months (compared to the 12 year lifespan of the Paragard) if it happens at all. I'm on month 3 of my Paragard and have had neither heavier nor longer periods.
posted by Lobster Garden at 8:20 PM on November 17, 2009

I've been on the Mirena for about three months now, and most of the transitional side-effects seem to have dissipated.

Lots of details:

I first started with the NuvaRing and I'd been on that for five years, but I really hate having my period and the ring was expensive, so I decided to try the Mirena. I've never had kids, so insertion hurt, but I don't really mind a bit of short-lived pain if it's for a purpose and it was totally worth it. My awesome doctor, who does a lot of these, gave me a cervical relaxer the night before and I also took some tylenol with codine.

The insertion pain is super strange, for me the sounding was worse than the insertion. It felt like regular menstrual cramps, only so much worse, and then I had one huge, overwhelming cramp that I could actually feel move across my abdomen from left to right, and I had a strong sensation that my body was trying to expel something. I can't say, obviously, but I imagine it's what a contraction would feel like.

I had planned to go back to work afterwards, but when I got there I found that I was making excuses to stay seated at my desk, so I went home and watched a few hours of TV and was nice to myself. After that the cramps pretty much dissipated, though, and I went back to work and felt fine. I had cramps (a bit worse than usual) for about a week afterwards, and a really long, heavy period that lasted about twelve days. Then I started just spotting, and got a bunch of weird side-effects: sore breasts (sore nipples, actually), headaches, my skin freaked out, my boobs got bigger and then smaller. I suspect a lot of that was related to going off of the NuvaRing, which I took out for the last time at the insertion appointment. But pretty much everything disappeared after about a month and half, except my skin's a bit touchier than it used to be, so I guess the ring was helping there.

One thing that did bother me was that sex felt crampy and I'd bleed a little after. During my follow-up appointment my doctor trimmed the strings shorter for me, and that solved the issue completely, I think the strings were being tugged on a little and irritating my uterus.

Also, my sex drive returned; I hadn't even realized that the NuvaRing had been suppressing it, but, yay! And, best of all, no periods for the last two months. So much awesome.
posted by you're a kitty! at 9:34 PM on December 14, 2009

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