Does The Mirena IUD Help Endometriosis?
I've tried about seven different kinds of birth control pills. None were effective for treating any part of my endometriosis. I went on the NuvaRing right after my second laparoscopy. And yet, an ultrasound showed new cysts three months after the surgery.
Since then, I've used pelvic floor therapy, diet changes, and meditation to treat my endo symptoms. And according to my last ultrasound — almost a decade after that surgery — my cysts are gone.
While I'm no longer on hormonal treatment, I'm intrigued by the Mirena IUD. According to Mirena's website, doctors, and my friends, it can greatly minimize or suppress your cycle without using synthetic estrogen. Some women stop having a period after a year. And research shows, over time, it can be an effective way to ease pelvic pain from endometriosis and adenomyosis.1-6
What to do if hormones aren't working
If you're thinking about trying the Mirena IUD, here are some things to think about.
What is the Mirena IUD?
Technically, it's a levonorgestrel intrauterine system (LNG-IUS). This t-shaped device is made of plastic and sits in your uterus. It sends out a constant stream of a synthetic progesterone. In addition to preventing pregnancy, it's the only IUD approved by the FDA to treat heavy menstrual bleeding (HMB)*.6
How does your doctor put Mirena in place?
The IUD is inserted into your uterus through your cervix. Though the procedure is non-surgical and quick, it can hurt. Many OB-GYNs (and my friends) say it can feel like a uterine contraction. Which is to say: it can be very painful. But you usually don't feel the IUD once it's in place. (If you're dizzy, in pain, or bleeding 30 minutes after the procedure, tell your doctor. Something might be wrong.6)
I told my doctor I'd never considered the IUD because the insertion process sounds like a nightmare. While there are medications that can relax the cervix, she told me she takes her patients with endometriosis into the operating room. That means they're sedated and not fully awake for the procedure. You may want to see if this an option from your doctor.
Does it help with endometriosis symptoms?
Anecdotally, I've heard that Mirena really does stop or greatly lessen monthly bleeding and period pain. And that's specifically coming from women with fibroids, endo, and HMB. My OB-GYN says Mirena is what she prescribes most to her patients with endometriosis. Research also shows it can reduce post-operative period pain and the recurrence of other symptoms in women who have surgery for endometriosis.7, If you have HMB, some studies show it may be an effective non-surgical alternative to a hysterectomy.9 But more research needs to be done.
Some research shows that a LNS-IUS can also overcome mild progesterone resistance (PR). That's when endometriosis tissue doesn't respond correctly to the anti-inflammatory effects of progesterone. Experts say PR likely contributes to pelvic pain in women with endo.4
What are the risks and side effects?
Mirena is considered safe.1 It's also one of the most effective ways to prevent pregnancy (99%) and works for five years.6 I have a lot of female friends who love using Mirena. But all of them say it took a little while to get used to. Many say they experienced more bleeding and cramps the first month or two. But eventually their periods were lighter or nonexistent.
However, it should be noted that some women I know said their pelvic pain and bleeding increased too much to continue using their IUD. And research shows that initial pelvic pain is one of the reasons hormonal IUD users discontinue use in the first six months.1
If you're thinking about using Mirena, here are some things you should know:1,6
- You may experience 3-6 months of increased bleeding or irregular periods. But your periods should get lighter or go away completely the longer you use Mirena.
- Less than 1 percent of users get an infection called pelvic inflammatory disease (PID).
- Some women experience more pelvic pain at first. If your endo pain is a lot worse after the procedure or it continues to worsen over time, tell your doctor.
- Though uncommon, the IUD can come out on its own. You should check every month or so to make sure it's in place. (There's a string at the bottom of your cervix that you can feel.)
- Mirena can, rarely, attach or poke through your uterus. Talk to your doctor if you have severe cramps.
- You may get ovarian cysts, but they usually go away.
Note: *There is a lower dose LNG-IUS (Skyla), but it is not approved to treat HMB. The copper IUD (ParaGard) is not a hormonal contraception. So it's not recommended as a treatment for endometriosis, pelvic pain, or HMB.
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