Buyer Be Aware Report on Mirena

This high-tech form of contraception should not be taken lightly.

The Mirena* IUD, which its manufacturer calls an IUC (intra-uterine contraceptive) is being heavily promoted to young women in the U.S. as a wonderful high-tech, no muss, no fuss, put-it-in-and-forget-about-it for five years form of contraception. But it’s really just a levonorgestrel uterine implant, the same old side-effect ridden progestin that was in Norplant, a tiny implant that is injected into women’s upper arms and then causes many of them months if not years of misery.

According to Bayer, the company that makes the Mirena IUD, “MIRENA® is an effective, long-acting and reversible method of birth control… that delivers 20 µg/day of levonorgestrel directly into the uterus and protects against pregnancy for up to 5 full years. Due to the local action of levonorgestrel on the endometrium, there is often frequent irregular bleeding or spotting during the first 3-6 months of use. The number of days with bleeding or spotting decreases gradually, and by the end of the first year approximately 20% of women will experience a total absence of bleeding. …A decision to use MIRENA® must include consideration of the risks of PID [pelvic inflammatory disease]. Candidates should have no history of ectopic pregnancy or a condition that predisposes to ectopic pregnancy.”

Underinformed about Side Effects
Some women will do fine with the Mirena, but I have two big beefs about it. One is that I believe women are grossly under-informed about the side effects of levonorgestrel. Some women will understand that the crampiness and nausea they may feel may be caused by the device and will decide it’s worth it in order to have relatively trouble-free contraception. However, it will just not occur to most women that their lower back pain, headache, stuffy nose, depression, weight gain and abnormal pap smear (to name a few) could be caused by the progestin in their Mirena. The health care professionals who insert them are unlikely to directly warn women about those symptoms or ask about them when they come in for a follow-up visit (if they even have one).

Marketed to Breastfeeding Women
My other big beef is that these devices are being intentionally and consciously marketed to pregnant women for use postpartum. There is even an implication in the literature that it could be inserted during a C-section. There is very little research about the effects of progestins on nursing infants, and most of what there is was done for one year in third world countries such as Egypt, Bombay and Chile, which is always a red flag to me because it’s so easy to get away with shoddy research in those settings. (If you’ve ever been to a hospital in Egypt you know what I’m talking about—primitive would be a polite description of the one I visited.) A study done in Mexico with breastfeeding Norplant users found that their infants had significantly modified thyroid stimulating hormone (TSH) levels.

The one six-year followup study I could find that followed breastfeeding infants exposed to levonorgestrel was done in Norway and found that they had higher incidence rates of respiratory infections, skin conditions and eye infections than the control group, and later were found to have a higher proportion of “neurological conditions.”

To me it’s unthinkable to even consider exposing a nursing infant to any type of progestin. I would call this a form of corporate sociopathy—marketing without a conscience to unwitting, under-informed women who are just trying to responsibly avoid an unwanted pregnancy. Since the FDA is unlikely to take action against this practice it’s up to the rest of us to spread the word.

Warnings for Mirena Include:
Ectopic pregnancy (which can be life-threatening and result in infertility)
Intrauterine pregnancy (birth defects are a possibility)
Sepsis (an infection which can be fatal)
Pelvic inflammatory disease (which can result in infertility)
Irregular Bleeding and Amenorrhea (no periods)
Embedment (in the uterine wall)
Perforation (of the uterus or cervix)
Ovarian cysts (can cause severe mid-cycle pain)
Breast cancer
Risk of Mortality (risk of dying is low)

Possible Side Effects of Mirena Include:
Lower abdominal pain
Upper respiratory infection
Leukorrhea (abnormal vaginal discharge)
Vaginitis (irritation or inflammation of the vagina)
Dysmenorrhea (cramps or painful periods)
Back pain
Weight increase
Breast pain
Skin disorder
Decreased libido
Abnormal Pap smear

Increased Body Awareness

Now I understand that what I'm about to suggest is, in some ways, the opposite polarity of Mirena®, but consider the possibility that simply gaining greater body awareness could be a key to feeling better and choosing the best possible form of contraception.

One way for a woman to increase her body awareness is to keep track of health issues and symptoms, especially those which may be associated with her periods. Here's where you can find a free download of a handy chart to help keep track of symptoms. This was originally published in our book Hormone Balance Made Simple, but I've made it available on this website to help women increase their body awareness.

Other Resources

Here’s where to find the complete Physician information Sheet for Mirena (look in the upper right-hand corner for a link that says Prescribing Information.

Here’s an online forum for Mirena users who have experienced side effects. Notice that many of the women didn’t realized until the Mirena had been taken out and they started to feel dramtically better, how many negative side effects they had been having but hadn’t attributed to the Mirena.

Here's a letter from a friend of mine who had a Mirena inserted and didn't even realize it contained a progestin.

Here's a letter from a woman who used Depo-Provera.

*Mirena is a registered trademark ®

Bassol S, Nava-Hernandez MP et al, “Effects of levonorgestrel implant upon TSH and LH levels in male infants during lactation,” Int J Gynaecol Obstet 2002 Mar;76(3):273-7.

Schiapacasse V, Diaz S, “Health and growth of infants breastfed by Norplant contraceptive implants users: a six-year followup study,” Contraception 2002 Jul;66(1):57-65.

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