one year later. After the Mirena break up.

I feel like it is time for a follow up post about my Mirena experience. My original post receives between 700-1100+ visits daily and has generated over 200 comments from women from all over the world who have shared their own, sometimes very personal, struggles and experiences with this supposed innocuous form of birth control. I appreciate each and every one of these women for sharing their stories, for listening to their gut and for persevering for answers when they were not getting any from their health care professionals. It is proving difficult to answer every single comment, but there are some common questions within a good majority of them that I feel like I can answer, at least from my perspective and from my experiences at this point, one year post-Mirena. The dreaded "Mirena Crash".

Before I had my IUD removed, I too did a lot of research and reading on the Internet and the number one thing you hear about is the Mirena crash. This plummet in hormones can cause all kinds if symptoms ranging from general malaise and feeling unwell to outright rage, depression and severe mood swings. It seems to last for about a week in its most severe form and then tapers off. Thankfully, I do not believe that I suffered through any major crash after my removal and I honestly started feeling better within days of having it out.

Bleeding.

I did have some removal bleeding initially the first night and into the next day. It was very bright red, and I admit that after 3 years of not seeing that kind of blood with my 'sort of" periods, I was a bit concerned. Turns out that it really was nothing that a couple of sturdy panty liners couldn't handle and it stopped after that second day.

A return to normal menstrual cycles.

Since that initial visit from Aunt Flo 5 weeks after I had the Mirena removed, my periods have been like clockwork. I have a pretty nice 28 day cycle and a 3.5 day period. And all I use during that time is my Diva cup. THAT IS IT! I can't complain about anything on this front. I feel like a normal woman and aside from the fact that I think I may be a bit peri-menopausal now and experiencing an increase in emotional PMS symptoms, I feel good about all of it.

Hair loss.

The hair loss that I was experiencing while I had the Mirena was REE - diculous!! I would run my fingers through my hair in the shower every morning and they would come out completely COVERED in strands of my hair. Normal daily hair loss for women is between 50-100 strands a day, with new ones growing almost immediately to replace the ones lost. I estimate (based on what I removed in the shower and what I swept up off the bathroom floor every other day) that I was losing about triple this amount EVERY DAY. Luckily I have a lot of hair to begin with and wasn't noticing any balding patches, but I do know that some women are not that lucky. In my opinion, I believe I am back down to a normal hair loss pattern and did notice this difference within about 4 months post-removal.

Weight loss.

I'd love to tell you all that I had the Mirena removed and magically dropped 20 pounds. Alas, this did not happen. Unlike some of the brave women who have posted their stories and comments on the original post, I did not have a huge amount of weight gain while on Mirena. What I did have was an inability to LOSE any weight even with a pretty strict fitness routine and a healthy, balanced diet. One year after my Mirena removal and four months since I stopped nursing my daughter and finally, that extra 10-15 pounds of what I liked to call my "Milk Reserves" is slowly starting to come off.

EXTREME fatigue.

This was one of the side effects that disappeared the fastest. I went from not being able to keep my eyes open while DRIVING and absolutely NEEDING to nap every day, to sleeping better at night (no more night sweats either) and having more energy throughout the day. I am serious people, the level of fatigue I was experiencing was dangerous. I would literally fall asleep at red lights and I even think I somehow fell asleep with my eyes open a couple of times and jerked "AWAKE" just in time to avoid crashing the car with all of us in it.

Libido.

It's BAAA-aaack. And it was relatively soon after removal. The fact that I was not feeling like I could literally fall asleep at any given minute of any day had a lot do do with that. I had ENERGY again. To be with him, to care about my sensual and sexual needs again and to want to just get it ON! Now don't get me wrong, we are still a busy family with a lot going on in our lives and some nights I am thoroughly exhausted and it's a quick peck on the cheek and lights out, but now, I at least have my DESIRE back. While on the Mirena, it was as if that part of me was completely removed from my mind. And I am kind of a sexy beast, so this was very troubling for me! ;)

Abdominal Pain, Bloating, Cramping.

I am very happy to say that since my Mirena removal I have not had one bout of the severe abdominal cramping and the excruciating pain that was a monthly occurrence with it in. As it turns out, I do not have ovarian cysts, I do not have appendicitis or endometriosis and I do not have ridiculous levels of noxious gas in my bowels! Whether my doctor agrees with me or not, I truly believe that I had a device in my body that was poisoning me.

...................

The one thing that has bothered me the most about all of the comments and stories that have been shared with this post, is the fact that so many women (including myself) have had to FIGHT with their healthcare providers to be heard, to be believed and to have this device removed from their own bodies . This speaks volumes to me about the state of our society, where a woman's voice and decisions about her body own are constantly questioned, where the simplest answer is not even considered and where women are being bombarded with more and more medications to treat what may actually be the side effects of what is considered a fairly benign medication.

So benign in fact that last September, the American College of Obstetrics and Gynecology made this statement in their Committee Opinion on Adolescent Health Care:

"Increasing adolescent access to long-acting reversible contraceptives is a clinical and public health opportunity for obstetrician-gynecologists. With top-tier effectiveness, high rates of satisfaction, and no need for daily adherence, long-acting reversible contraceptive methods should be first-line recommendations for all women and adolescents."

And while I understand that the issue that the College was addressing was the increasing rate of unwanted teen pregnancies, I wonder at the long-term effects of this kind of contraception (hormonal IUDs) on these teenage girls still developing bodies and hormonal systems. Will these long-acting contraceptive methods affect their future ability to conceive? We don't know the answers to these questions and I for one don't think it is a risk that I would want to take with my teenage daughter.

Of the 218 comments that have been shared on the original post, there are maybe 5 that reflect a positive Mirena experience. Granted, most women who find my post are doing so by using search terms like "Mirena IUD" and "Mirena side effects" (my post is second only to the official Mirena website on a Google search), the statistics of this small sample population make me feel very good about my decision to remove my IUD and return to a normal menstrual cycle. I am glad that my post has been helpful for so many women and I am grateful for all the shared stories. I feel for each and every one of you who have suffered so much because of this teeny tiny not-so-innocent device.

I can not tell anyone what to do in any given situation, even though a lot of you have asked. I can only tell you to trust your gut, trust your body, and TRUST yourself. If this form of birth control is causing you more problems than it is worth, than try to find an alternative. (For anyone wondering, my husband and I are condom users and NO, he still has not booked his vasectomy!) And if your health care provider is not listening to you, find one who will.

I have one last thing to say to those of you who have decided to have your IUD removed. Please don't let your family doctor or OB/GYN tell you that you shouldn't have it removed or make a big deal about the removal or tell you to go to the doctor who inserted it. If the strings are visible and reachable with a simple pelvic exam, then removal is a 10 second procedure that requires nothing more than a speculum and some medical tweezers. It pinches a bit, but if you have had babies already, well,... enough said.

I hope this follow-up post about my experience with Mirena proves as helpful as the first one has been. I am very happy that one year later, I can say without a doubt, that life has been a lot better since I broke up with my Mirena IUD.

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Take care of yourselves ladies,

Natasha~

The case of the tiny little IUD vs The Stay at Home Feminist.

I have had more than a few 'foreign' materials in my body over the years. I have titanium hip joints and polyethylene and ceramic hip sockets.

I have had surgical steel rings pierced in my belly button and various parts of my ears.

And up until 6 weeks ago I had a tiny little T-shaped polyethylene and hormone-filled device in my uterus.

Yes, I am talking about the ever popular intrauterine device known as Mirena.

Three and a half years ago, after Princess L was born and we were pretty darn sure that we did not want anymore babies, this seemed like a really great birth control option. Easy office appointment to have it put in place, minimal side effects (more on this in a bit), safe to use while breastfeeding and no need to even THINK about having an oops baby for at least 5 years. What was not to like about it?

Mirena.jpg

 

So in I went to get it inserted and off I went on my merry way, having glorious birth-controlled sex with my husband for the next three years without a care in the world. (Uhm, do not try to confirm this with him, his version MAY be a bit different than mine... 2 babies under 2 years old people!!)

I thought I had hit the jackpot of birth control. I really didn't feel like I had any major side effects from Mirena. And I stopped having a real menstrual cycle and period for the three years that I have had the Mirena in place.  I have not had to purchase more than a few boxes of panty liners to deal with dear old rarely visiting Aunt Flo and I told all my friends about Mirena and I have recommended it to lots of mamas.

I was the poster-mama for Mirena!

Or was I?

In the past three years, I have had two major bouts of depression. One I chalked up to postpartum depression (PPD) after Princess L  and one I felt was due to life just overwhelming me.

I have been so severely fatigued for the past two years that no amount of sleep could fix it and no reason identifiable on any blood work or medical test has been found that would explain it medically. This too I attributed primarily to having a newborn and a 22 month old, tandem nursing, and kids that needed a lot of night-time parenting. And later to me just doing too much and staying up way too late trying to get it all done.

I have had multiple episodes of such severe bloating and abdominal pain that I have had an ultrasound to rule out a ruptured ovarian cyst, a trip to the emergency department for a suspected appendicitis, and I have spent multiple nights doubled over and writhing in pain in bed with no relief from any and all forms of over-the-counter anti-gas medications.

I have lost whole handfuls of hair and have the perpetually clogged shower drain to prove it. I thought as first that this was the normal, post partum hair loss phenomenon, but it has continued for three years. I have to clean my hair brush at least twice a week and could have probably made a whole new head of hair with all that I have lost so far.

In the past 6 months I have had more migraines than I have had in my entire life. I never really understood when people would say, "I have a migraine, I have to go lay down" until now. I have had such bad headaches that I have had to turn off all the lights, close the blinds and just lay on the couch with my eyes closed while the kids watch a movie. The last few have been so bad that on those days, as soon as my husband would get home from work, I ended up crashing in my room for multiple hours, waking only to pee and drink water.

And while we are talking about my husband, remember a few lines ago when I said I was having wild birth-controlled sex? Well, we would have been had I had any kind of libido to speak of! I am serious, it slowly but surely disappeared on me completely this past year. Poor dude... and poor ME! Because I kind of like sex and all that goes with it!

And finally...

I have been working out with a personal trainer for the past year. I watch what I eat, I don't drink, I don't over-indulge in sweets or snacks, and I am relatively active given my limitations due to RA. And for the last year I have been trying to lose the same 15 pounds and the scale has not budged more than 3-5 pounds.

Why is all of this relevant you ask? And what does it have to do with Mirena?

Well, have a look at the list of COMMON side effects listed in the product prescribing information for Mirena.

*The HIGHLIGHTED ones are MY symptoms.*

What are the more common side effects of Mirena?

Possible common side effects of Mirena include:

Discomfort during placement. Pain, dizziness, bleeding or cramping may occur during placement. This is common. Let your healthcare provider know if the cramping is severe. If these symptoms do not stop 30 minutes after placement, Mirena may not have been placed correctly. Your healthcare provider will examine you to see if Mirena needs to be replaced or removed.

Expulsion. Mirena may come out by itself and no longer prevent pregnancy. Symptoms of partial or complete expulsion may include bleeding, pain and an increase in menstrual flow. If this occurs, Mirena may be replaced within 7 days of a menstrual period after pregnancy has been ruled out. If you notice Mirena has come out, use a back-up form of birth control like condoms and call your healthcare provider.

More than 10% of Mirena users may experience:

  • Missed menstrual periods. About 2 out of 10 women stop having periods after 1 year of Mirena use. Your periods come back when Mirena is removed. If you do not have a period for 6 weeks during Mirena use, contact your healthcare provider to rule out pregnancy.
  • Changes in bleeding. Your period may become irregular and you may have bleeding and spotting between menstrual periods, especially during the first 3 to 6 months. A few women have heavy bleeding during this time. After your body adjusts, periods usually get lighter and the number of bleeding days is likely to decrease, but may remain irregular. Or you may even find that your periods stop altogether—in which case, you should contact your healthcare provider to rule out pregnancy.Call your healthcare provider if the bleeding remains heavier than usual or if the bleeding becomes heavy after it has been light for a while.
  • Pelvic and/or abdominal pain may occur. Talk to your healthcare provider if the pain is persistent.
  • Cyst on the ovary. About 12 out of 100 women using Mirena develop a cyst on the ovary. These cysts usually disappear on their own in a month or two. However, cysts can cause pain and may sometimes require surgery.

Between 5% and 10% of Mirena users may experience:

  • Headache/Migraine
  • Acne
  • Depressed mood
  • Heavy or prolonged menstrual bleeding

Less than 5% of Mirena users may experience:

  • Vaginal discharge
  • Breast pain or tenderness
  • Nausea
  • Nervousness
  • Inflammation of cervix, vulva or vagina
  • Pelvic pain during your period
  • Back pain
  • Weight increase
  • Decreased sex drive
  • High blood pressure
  • Pain during intercourse
  • Anemia
  • Unusual hair growth or loss
  • Skin irritations (such as hives, rash, eczema or itching)
  • Feeling bloated
  • Swelling of hands and/or feet
  • Expulsion

Every individual responds differently to medication, so talk to your healthcare provider about your individual risk factors and to see if Mirena is right for you.

And here is something else I did not know. The hormone used in Mirena is called Levonorgestrel and is often referred to as a 'progestin', which kind of sounds a lot like the naturally occurring  hormone progesterone right? WRONG. Levonorgestrel is a hormone disrupter and has the opposite effects as our own progesterone (which only makes sense really given that progesterone is often called the 'pregnancy hormone'). Levonorgestrel is also the active ingredient in the Norplant birth control implant (which is no longer available in North America) and also at higher doses is the drug that makes up the Plan B or 'morning-after' pill(s). Huh? The things they don't tell you at the doctor's office....

Here is how this all played out for me and how I figured out what {I believe} was going on in my own body.

About 4 months ago a friend of mine got her Mirena IUD inserted. And a couple of months after that she told me that she was not convinced about it and was having some issues. She was tired all the time, was bloated and had gained about 5 pounds on her VERY fit and tiny runner's body. It was around this time that I started to put two and two together and realized that all of the annoying and kind of non-specific symptoms I had been having for the past few years, might also be related to MY Mirena IUD. I started to do more research.

To be completely honest, I have wanted to have my IUD removed for about a year. I went to see my family doctor about it in 2011 and told her I just didn't want any more foreign substances in my body. At that time she convinced me to keep it in so that we did not have to worry about getting pregnant before SOMEONE had a chance to book his snippity-snip appointment (still not booked BTW)!

Six weeks ago I saw my doctor once again. We went over my list of concerns, what I had found out about the side effects of Mirena, and what I wanted to do about it. She insisted on ordering another laundry list of blood tests, which all came back completely and utterly normal, and a week later at another appointment I finally had the offending little piece of plastic removed from my body.

I have to say, I feel better without it. Whether this is a placebo effect or real relief from the side effects, I don't know for sure. I do know that there have been no more excruciating cramping and bloating, I haven't had a migraine in five weeks, and the 'I can't even keep my eyes open while driving' extreme fatigue is gone. Oh, and that little problem with my libido... that seems to be gone too, which is making someone else around here very happy!

This week for the first time in over four years, dear Aunt Flo came for a REAL visit. To honour this occasion, I took another step in the direction of living a more natural life and invested in my first ever Diva Cup.

So what is the moral of the story here?

Mirena may sound like the perfect birth control solution and for some women it may well be... BUT please be aware of ALL of the side effects, and what can happen to you while on this medication. Do some research, ask around, and make sure that this is the birth control method  that really is for you. There are whole blogs and websites dedicated to the stories and cases of women's lives with and then after Mirena and some of them are pretty scary. And while these may be some extreme cases, they made me pause and re-evaluate the role that Mirena has played in my life and convinced me to have it removed.

I really wish I had known more about this sooner and had stuck to my guns a year ago with my GP and had it taken out then.  But here I am now, I know better, and I now have one less foreign object and synthetic chemical substance in my body.

And that is a good thing.

Natasha~

Have you used Mirena? What has your experience been?

UPDATE: One year post Mirena. Here is my follow up post a year after I had the Mirena IUD removed.