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A Mirena IUD sits inserted into the uterus with a floral pattern background.

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

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 it’s 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.

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The Endometriosis.net team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.

  1. Yoost J. Understanding benefits and addressing misperceptions and barriers to intrauterine device access among populations in the United States. Patient Prefer Adherence. 2014;8:947-957. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4090129/. Accessed November 21, 2019.
  2. Gupta J, et al. A randomised controlled trial of the clinical effectiveness and cost-effectiveness of the levonorgestrel-releasing intrauterine system in primary care against standard treatment for menorrhagia: the ECLIPSE trial. Health Technol Assess. 2015;88(i-xxv):1-118. https://www.ncbi.nlm.nih.gov/pubmed/26507206. Accessed November 21, 2019.
  3. Kai J, et al. Usual medical treatments or levonorgestrel-IUS for women with heavy menstrual bleeding: long-term randomised pragmatic trial in primary care. Br J Gen Pract. 2016;66(653):e861-e870. https://www.ncbi.nlm.nih.gov/pubmed/27884916. Accessed November 21, 2019.
  4. Patel B, et al. Progesterone resistance in endometriosis: origins, consequences and interventions. AOGS. 2017;96(6):623-632. https://obgyn.onlinelibrary.wiley.com/doi/full/10.1111/aogs.13156. Accessed November 21, 2019.
  5. Li L, et al. Treatment of symptomatic adenomyosis with the levonorgestrel-releasing intrauterine system. Int J Gynaecol Obstet. 2019;146(3):357-363. https://www.ncbi.nlm.nih.gov/pubmed/31194884. Accessed November 21, 2019.
  6. Bayer. Mirena. Mirena. https://www.mirena-us.com. Accessed November 21, 2019.
  7. Abou-Setta AM, et al. Levonorgestrel-releasing intrauterine device (LNG-IUD) for symptomatic endometriosis following surgery. Cochrane Database Syst Rev. 31AD;1. https://www.ncbi.nlm.nih.gov/pubmed/23440798. Accessed November 21, 2019.
  8. Yeung P, et al. Laparoscopic Management of Endometriosis: Comprehensive Review of Best Evidence. The Journal of Minimally Invasive Gynecology. 2009;16(3):269-281. https://www.jmig.org/article/S1553-4650(09)00111-3/fulltext. Accessed November 21, 2019.
  9. Bhattacharya S, et al. Hysterectomy, endometrial ablation and Mirena® for heavy menstrual bleeding: a systematic review of clinical effectiveness and cost-effectiveness analysis. Health Technol Assess. 2011;19(iii-xvi):1-252. https://www.ncbi.nlm.nih.gov/pubmed/21535970. Accessed November 21, 2019.

Comments

  • Heidijoy
    2 months ago

    I had the Mirena put in and it worked great for me for about 2 years. The process of getting it inserted was not a great experience. Even taking the amount of pain meds beforehand that the dr recommenced, did not feel it helped with any of the pain. I overheated because it was the summer and the air was not working great in the room I had the procedure done, which made things worse and I got light headed and dizzy, so it took awhile for me to get up and move after it was inserted. I also felt uncomfortable with the feeling of having something in there for the first few days. However, life was the most normal it had been for me in years. Then my symptoms returned with a lot of pain and breakthrough bleeding around the 2 year mark. The dr said it should still be working, because it lasts 5 years, but my body seemed to say otherwise. I am glad it worked for me for as long as it did.

  • JoBodner moderator
    2 months ago

    Hi @Heidijoy! Thanks for sharing this! You are describing my nearly same experience w/the Mirena…minus the no A/C (that’s brutal), but otherwise same feelings. I’d say I got close to more 3 years, but right around that mark it seems all started going south. I was/am still not experiencing as much endo pain prior to the Mirena & debilitating periods, but emotionally feeling out of control, fatigued, constant break through bleeding/spotting, horrible bloating…just bleh all around. It’s frustrating. I actually am scheduled to get mine out next week and not sure what I should do! My doc has already encouraged me to jump into getting another one or getting the Kyleena. Not sure what I will do! 🙁 Again, thanks for taking the time to share your experience. Have a good night.

  • lullaby219
    2 months ago

    Sorry for spelling mistakes and I meant I hope it works for you hun. Ty for taking time to write. I don’t want to hurt your feelings. I just had to be honest just in case it could help another down the line. Again it was such a dark phase.. it came to lead me back to a much better life.Honestly my Endo sisters online or my most helpful supporters. Have a nice holiday season

  • lullaby219
    2 months ago

    I know we are all different with endometriosis but the mirena IUD came to completely ruin my whole life & newly licensed broker career.. and leave me in one of the most dangerous levels of estrogen dominance. I am very sensitive overall with foods,fragrances and medication. I just figured this out a year ago and 20 years after having Endo show up in my body
    What I would do to go back in time and never get that thing put in me. By the time I found an answer.. 4 years after getting it removed , Losing half of my hair, fibrocystic breast, covered in cystic acne, hyper vigilance, and my endometriosis pain tripled, basically housebound

    When I begged them to remove it I laid in bed bleeding 55 days The heaviest I ever had in all my experiences with horrible periods. It was the most terrifying experience in my life. And as usual no one in my life or doctors believed me ..even losing 40 pounds when I was not really overweight ..and all the scarring and all the hair loss ..still the doctor that put it in said it was nothing to do with the IUD

    I was a shell of the person I once was not to mention when I finally found a diagnosis not by an American doctor I had suffered so long that I was told I was highly highly susceptible to five different cancers.

    I had to do research on my own and found a holistic program By chance that would come to finally diagnosed me with one simple blood test. Also would come to put my endometriosis into full remission. So I guess I can’t be too mad at that IUD because if you didn’t destroy my career and life I would’ve never gotten a hold of my endometriosis pain. I still have Endo I just don’t have pain anymore

    Please I’m just sharing my story in case one other may have a sensitive body that it doesn’t work for. I have tried everything birth control Lupron pain medication.

    I appreciate simply being in Endo sister and you taking the time to write articles. I say this all the time whatever way we choose to dI appreciate simply being in Endo sister and you taking the time to write articles. I say this all the time whatever way we choose to manage our pain is up to us ..but we truly need each other’s support. Again this is just my story I am not saying it to make your article sound wrong. As you can tell it really triggers me personally. I’m glad it works for you and I hope it works for many others but just in case there are some others that may start to get symptoms that sound familiar to mine I thought I would please share. Thank you and I hope you have many more good days to come

  • Keri Wiginton moderator author
    2 months ago

    I’m so sorry that you had this experience. And it’s unacceptable that your doctors wouldn’t take it out. Even if they didn’t think your symptoms were from the IUD, you shouldn’t have anything in your body that you don’t want.

    I personally didn’t try Mirena, so I can’t speak to what it’s like to use it. But everyone is different and I’m really glad to hear that you found something to help you. Did you ultimately find treatment because you were diagnosed with estrogen dominance? Is that the blood test you’re referring to? Wishing you well and thank you for being part of the community! – Keri (endometriosis.net team member)

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