How Does the Mirena Coil (IUD) Impact Menopause?

What is the Mirena Coil?

Before moving into the main topic, let us see what hormonal IUDs are and how they work.

Intrauterine contraceptive devices (IUDs) are tiny T-shaped devices that a doctor places in your uterus and is one of the most effective forms of birth control. It can be used long-term, and its effects are reversible – you can get pregnant if the IUD is removed from the uterus.

There are different types of IUDs. A type of IUD called hormonal IUD prevents pregnancies by continuously releasing small quantities of the hormone progestin inside your uterus. 

How do they work?

The hormone progestin released by hormonal IUDs makes the cervical mucus thicker, making it difficult for the sperm to swim up to the egg. It also causes thinning of the inner lining of your uterus (endometrium), making it less receptive to a fertilised egg.

Mirena coil is a T-shaped hormonal IUD placed inside the uterus that releases a small, continuous dose of the hormone levonorgestrel (a type of synthetic progestin). 

What are the benefits of a Mirena coil?

• This device is mainly used as a long-term, reversible birth control (effective up to 8 years but can be removed earlier if you desire to get pregnant).
• It can effectively reduce heavy menstrual bleeding.
• It can ease the symptoms you experience during menopause and the years that lead to it.

The Menopause Process

A Mirena coil is effective in managing menopause-related symptoms. Before we look into how it works, let us understand menopause and the hormonal changes your body goes through during this time.

Definition of Menopause

Menopause is a natural transitional phase in every woman’s life that marks the end of her reproductive years and a complete stop of the menstrual cycle. Most women attain menopause around their late 40s or early 50s. You reach menopause when you have gone without periods for 12 consecutive months.

Perimenopause vs Menopause

Perimenopause is the transitional years that lead to menopause.

Around your 40s, you might notice your periods becoming irregular – in some months, the bleeding may be heavy, and in another month, you may not have periods at all. Sometimes, mood changes and occasional hot flashes can also happen. These years leading to menopause, where your hormone levels start fluctuating is called perimenopause.

Hormonal Changes

Menopause is all about hormonal changes and the physical and emotional symptoms they cause. The female sex hormones oestrogen and progesterone drop significantly during menopause, leading to hot flashes, night sweats, disturbed sleep, vaginal dryness, mood swings, and even anxiety and depression.

Mirena IUD’s Role During Perimenopause and Menopause

“The levonorgestrel intrauterine system (LNG-IUS, Mirena(®)) has particular benefits during perimenopause and is safe for use in nearly all women. The LNG-IUS is approved for the treatment of heavy menstrual bleeding, a common concern during the perimenopause.” - Contraception during the perimenopause, Pubmed.

Though it mainly functions as a birth control, Mirena also plays an important role when used during perimenopause and menopause. Here’s how it affects your body:

1. Regulation of Menstrual Cycles

Being a hormonal IUD, Mirena can regulate your menstrual cycles, giving significant relief from the uncomfortable symptoms you face during perimenopause and menopause.

Heavy Bleeding Reduction:

Perimenopause can cause your cycles to become irregular and unpredictable. Using Mirena during menopause can reduce excessive bleeding, a problem faced by many women during these transitional years of life.

Spotting vs Periods:

A study has shown that Mirena reduces menstrual blood loss by 80% after 4 months, by 95% after 1 year and can stop menstrual bleeding completely after 2 years of use.

Women who use Mirena experience only slight bleeding or spotting during menstrual cycles or may stop having periods altogether. This helps manage excessive bleeding during perimenopause and increases your blood haemoglobin levels.

2. Hormonal Impact

Unlike hormone therapies in the form of pills or injections that release hormones directly into your bloodstream, the Mirena IUD releases very low doses of the hormone levonorgestrel into the uterus. 

Since Mirena releases the hormone locally, it reduces the chances of hormonal imbalances and side effects caused by the direct administration of hormones into your bloodstream.

Is Mirena a safe option for those who are sensitive to oestrogen?

Absolutely – Mirena does not contain or release oestrogen. In women who cannot use oestrogen therapy due to specific health concerns (history of breast, uterine or cervical cancer, blood clots, heart disease, fibroids), Mirena can be helpful in managing the symptoms of menopause.

3. Symptom Relief

By releasing the hormone levonorgestrel, a synthetic form of progesterone, Mirena coil can reduce heavy bleeding, abdominal cramps and discomfort associated with perimenopause. 

However, as it does not contain the hormone oestrogen, Mirena doesn’t have much impact on menopausal symptoms like hot flashes or mood swings, which are caused by declining oestrogen levels in the blood.

By regulating bleeding and pain, Mirena can improve the quality of life during perimenopause.

Benefits of Using Mirena During Perimenopause

We have already seen the multi-faceted benefits of Mirena. Let us now have a closer look at how the Mirena coil is beneficial during perimenopause.

1. Reduce or Stop Heavy Bleeding:

Mirena can give you significant relief from irregular and unpredictable heavy bleeding during perimenopause. When used for more than 2 years, it can even stop your periods altogether.

2. Convenient Contraception:

At perimenopause, when there are still chances for pregnancy to occur, Mirena provides a reliable form of birth control, which can remain effective for up to 8 years.

3. Reduced Risk of Endometrial Cancer:

A study has proven that Mirena coil is effective in treating or controlling the progression of endometrial malignancy (cancer of the innermost lining of the uterus). Levonorgestrel-releasing IUD system (Mirena coil) has been identified as a treatment for those unsuitable for surgical management.

4. Ease of Use:

Once the doctor inserts the Mirena coil inside your uterus, it requires no further care or attention. This makes this IUD an easy and effective method to manage perimenopause-related bleeding and pain.

Considerations and Limitations

Though Mirena offers lots of benefits, it has some side effects and limitations as well. 

Here are some:

1. Not a Cure for Menopause Symptoms:

Using Mirena does not give relief from the symptoms of menopause caused by decreased levels of oestrogen, like hot flashes, vaginal dryness, and mood swings.

2. May Cause Spotting:

Some women might experience spotting or bleeding outside of the menstrual cycle in the first few months after insertion of the Mirena coil.

3. Hormonal Side Effects:

Though the Mirena coil releases the hormone locally inside the uterus, it can still cause symptoms like headaches, breast tenderness, acne or mood changes.

4. Symptom Recurrence After Removal:

While the Mirena coil is effective in managing heavy bleeding and pain during perimenopause, it does not provide a complete cure – the symptoms return soon after the Mirena IUD is removed.

5. Tear in the Uterus:

Rarely, improper insertion of the Mirena coil can result in a tear in the uterus. The chances of this happening are greater if it is inserted soon after childbirth when the uterine muscles are still weak and lax.

Who Should Consider the Mirena During Perimenopause?

Wondering if the Mirena coil can be a good option for you? Using a Mirena coil can benefit you if:

• You are looking for long-term birth control.
• You experience heavy and irregular menstrual bleeding.
• Oestrogen therapy is not suitable for you to manage perimenopausal symptoms.
• You have a history of breast, cervical or uterine cancer, blood clots, liver disease or heart disease.

To know if Mirena is suitable for you, consult a healthcare provider regarding your symptoms. A proper medical history can help determine if Mirena is the right choice.

Wrapping Up

The Mirena coil is a small device with big benefits – it can help you manage perimenopausal symptoms like heavy bleeding and cramps. However, Mirena IUD is not effective in treating all menopause-related symptoms like hot flashes and mood changes. 

A Mirena coil is more than just contraception – it can help make your transition towards menopause easier and more comfortable. Talk to a healthcare provider about how Mirena can help you and also the potential side effects it may carry before deciding if it’s the right choice for you.