Sunday, January 3, 2010

Mirena IUD and Your Sex Drive

For women on an IUD sex drive changes are often reported. We have already discussed relationships between the levels of testosterone and a woman's sexual function in a prior post.  Women on OCs (oral contraceptives, birth control pills) have a known decreased levels of male hormones due to suppression of their hormones naturally made by their ovaries. We take advantage of that fact, and it is a bonus non-contraceptive effect of the pill, that when using OCs to suppress ovarian male hormones this treatment therefore helps to control acne, PMS, heavy bleeding, menstrual cramps as well as other hormonal symptoms such as breast pains. But a disadvantage of this is that some studies have reported that the suppression of testosterone by OCs also suppress sexual function and desire. We know that even aging changes our male hormone levels, by your mid 40s you probably have about a 30% decrease in your male hormones due to decreased ovulation and decreased adrenal gland function. Add contraceptive or other hormonal treatments to this natural decline, or be one of those individuals who has even naturally lower levels of testosterone, then the effects on sexuality may be more dramatic.

 Switching over to a Mirena IUDs from OCs is often a great solution for periods, and cramps, not to mention the convenience and effectiveness which are both terrific, and it's completely, and rapidly reversible, but what do we know about Mirena and sexuality?

Reports were filtering in to me from patients expressing various responses: some had a fairly rapid resolution of their sexual OC complaints when switching to Mirena, others had no different response, and some who hadn't had prior problems with sexual function reported new complaints of low libido and arousal from the use of Mirena. Digging into the literature, there's not much to go on in the medical research files to give my patients firm answers on this. First some facts on how it works, then lets talk SEX.

Getting more into the physiology I can tell you more about the interaction of your hormones and your sexual function. Sex may require the interaction of several hormones and brain chemicals to function naturally. Most women become desirous of sex then begin to get aroused when stimulated. Others can respond in the opposite order. Hormones that affect the amount of desire as well as the amount of arousal have some impact on our sexuality. Progesterone's exact role in sexuality is not known, but it may have some adverse effects by lowering estrogen or testosterone. The Mirena IUD has a synthetic type of progesterone, that is a male hormone derivative called levonorgesterel. It is a safe and effective contraceptive agent which has been used for decades. Mirena leaks about 15 to 20 ug of levonorgesterel (LNG) daily into the uterus, this varies among women and will be the strongest in the first 6 months of IUD use. The Mirena prevents fertilization of eggs, and the LNG thickens cervical mucus so sperm cannot even penetrate. The pregnancy rate the first year is 0.2%! About 60% of women will eventually dry up their periods and not bleed at all the way the dose is designed. Hormonal side effects are reported by some as about 1% of the hormone gets into your blood stream. And about 1/10 users will stop the Mirena in the first year due to complaints of the various hormonal side effects.

Sex should improve if you have had a low sex drive on the pill and now are using an IUD. With a Mirena, estrogen levels stay normal, and vaginal lubrication should be normal. Polish researchers from the Medical University of Silesia in 2007 reported that Mirena users as a group had better sexual desire and arousal than control groups studied. When you discuss your sexual symptoms with your gyno, here's what you should bring to the discussion: facts about: desire, arousal, lubrication, orgasm, sexual satisfaction and pain with sex (dyspareunia). And the other thing to consider: what is your normal sexuality, there are women that have heightened awareness of sexuality and place more interest in sexuality. We have this issue with sexuality studies. Women who participate in a sexuality study are suddenly more interested in sex! And yes, if you're tangoing with a partner, what issues are there between you two? That affects sexuality too, and that's a whole different discussion.

326 comments:

  1. I have had Mirena for three years now. I breastfed my daughter for 2 years 5 months and had issues with arousal during that time which I attributed to breastfeeding, but after weaning I've still had issues and I feel so sorry for my husband! I just don't care for sex and when we do, it hurts and I never reach... y'know. Anyway, I'm considering discontinuing Mirena for those and a few more reasons.

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  2. Pain with intercourse should be able to be diagnosed by a gyno. And if you get a diagnosis (common reasons could be infections or low levels of local estrogen), then you might be able to get treatment without loosing your contraceptive method!

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  3. Thank you! I'll set up an appointment for this February. What about low sexual desire? Do you think that's because of Mirena? If so, do all birth control methods have that possible side-effect?

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  4. All medicated (steroid) contraceptive methods might affect libido (sex drive), fortunately for most actually there is improvement. But that might also be the psychological effect of freedom from pregnancy rather than a difference in how each individual responds to actual hormonal levels!

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  5. I'm considering Mirena. I've been on 4 different contraceptives over the last 18 months. I've had break through bleeding with all of them. I'm currently on orthotricyclene and HATE it. But I've heard that Mirena can be uncomfortable and that your partner can feel it during sex. I've heard this from several women. What do you think?

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  6. BTB on multiple OCs needs to be evaluated to make sure there is not another cause. Most men do not feel IUDs, and a gyno can evaluate your pelvic exam to see if an IUD is right for your, watch for other posts that will discuss pelvic factors that make IUDs less likely to be successful!

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    Replies
    1. Yes I do and it feels like I being stuck with a needle and she went back and doc made adjustments and still caused issues

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  7. I had a Mirena inserted back in 2007 by Planned Parenthood because barrier methods were getting annoying and the pill wasn't a good option for me. I would honestly rather just get Essure, but no doctor will even listen to me about it. (I'm 29 and have no children. I've been looking to be sterilized since I was 24) I looked up side effects on the Mirena and some did say that a loss of sex drive could happen and I think that's happened to me.

    I find myself wishing that I had health insurance now so that I could search for a doctor that would do Essure on me.

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  8. Funding for expensive procedures can be an issue. In our area over the years Planned Parenthood has had some funds for sterilizaton, it's something you could look into. We also accept Care Credit (as do others) for medical procedures. Many patients are then able to pay their procedures off over time which is extremely helpful. Finally as for women and regret, sterilization regret is slightly higher in women with children than without! But none the less it is as high as 20% which is still fairly high. Some physicians might prefer to offer women tubal ligations rather than Essure if you've had no children as IVF has been better studied in this group (i.e. if you ever change your mind).

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  9. Sadly Care Credit would likely be declined for me. I will look into Planned Parenthood though.

    I've thought about sterilization for a long time and came to a decision with my husband that if we feel the need to be parents we will adopt. I do not wish to have biological children for many reasons...the highest being the fact that my health is less-than-stellar.

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  10. Please DO NOT get the Mirena. I have had mine since February, 2008, and within months my skin was extremely oily and plagued with black and whiteheads. I never even had acne as a teenager, and here I am at 30 years old with severe acne. I also have not wanted to have sex with anyone since its insertion two years ago, and I have gained 15 pounds. I started getting recurring bacterial vaginosis one month after the Mirena was inserted. The doctors keep saying that none of this is due to the Mirena, but that is the only thing that all of the changes could possibly be connected to. The only benefit for me has been the shorter & lighter periods, but the cramps are way worse than anything I ever experienced before the IUD. I am getting this removed ASAP!!! Please do not let anyone talk you into this damaging device.

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    1. MY LIBIDO HAS DECLINED AS WELL AND IT HAS MESSED UP ANY RELATIONSHIP I HAVE TRIED TO HAVE..oops caps..oh well, thinking of removing it altho i like having no cramps or bleeding

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    2. I've had Mirena for three months and have no complaints thus far. Yes, I've noticed slightly more oily skin. Never had an issue before. That being said, you have to look at YOUR own personal benefits-vs-drawbacks. Do I like having oily skin and the occasional pimple at 37? No. But is sure beats the hell out of flooding thru a super absorbency tampon PLUS pad and being embarassed. I've gone from using a box each of tampons and pads each month, to using liners only.
      That in and of itself is enough to convince me to keep it!

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  11. Individual selection of a method of contraception is so important. Fortunately most research has indicated that only a very small minority of patients will experience the side effects of cramping, acne or skin changes or decreased libido. If a woman switches her contraception due to side effects it is important to get an evaluation if those side effects do not resolve.

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  12. i have had the mirena for almost 3 yrs now.I am 24 yrs old..Slowly over the past 3yrs I have had acne,that I never had before, even young, weight gain, 20 lbs over 3 yrs, headaches, and my biggest problem,complete loss of sex drive which is very much not like me. I noticed the loss of sex drive though once my periods stopped (Which they did not fully stop until 8 months ago) I have been checked by the dr. everything is okay, he said it is common for periods to stop after a few yrs. ever sence that happened, sex is the furthest thing from my mind. I also like you said above, have bad cramping . no periods,but alot of low back pain.This has been checked in to too. Yes, it is convenient, and I trust it, BUT these symptoms are really starting to cause problems. I want my period back~~!! i feel like sence it has stopped, I am not myself.

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  13. Weight issues, headaches and libido are unlikely to be resolved by getting the Mirena out, but the little systemic hormone that is released will resolve rapidly with discontinuing the IUD. If the syptoms persist then the were not just due to those hormonal levels, or at least not completely due to those levels. So, although an expensive alternative, IUD removal may be the only solution for women who cannot find treatments for the gynecologic issues they are having.

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    1. it should be resolved if libido was fine prior

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    2. I have had the same problem with my libido and my hubby is not liking that and neither am I

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  14. I have had Mirena for 3 1/2 years and love the fact that I don't have anymore periods. However, my sex drive is null and void and is causing quite a problem in my marriage. I am looking to have it removed in hopes that my libido will return. I was on the pill for 15 years before my first child and ever since have had the IUD.

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  15. In real estate it's location, location, location. And I can't stress enough, no matter how obvious, in gynecology, we do want to think diagnosis, diagnosis, diagnosis. And in medicine, self diagnosis is not always the same as a clinical diagnosis. In other words: make sure that HSDD is really the diagnosis or you loose great birth control for the wrong reasons. Thanks for the post!

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  16. Hello, I am 28 yrs old. I have been on Mirena for just over a year. I had Mirena inserted after my second child was born. I no longer have a menstral cycle, however, I do have some cramping and I went from good libido to NO Libido. I was thinking it was just me, and then I started researching it. I have found that there are many women also having these side effects. I do believe I will make an appointment with my gyno to seek another birth control option. The loss of libido is causing serous strain on my marriage.

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    1. I agree. I have had me Mirena in for 3 years, and have had issues with depression, and my sex drive is non-existant. It has really put a strain on my marriage.

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  17. Between 20 and 30% of women your age will have issues with libido. One thing to consider is making an appointment that leaves enough time to work through libido issues which may persist with or without new contraception. Some counselors can help with this as well.

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    1. Ms. Gab it occurs to me that you are mainly trying to defend your profession. I haven't seen one person on this thread support Mirena. Ladies, take it from a man that wants to leave his wife due to no libido...Stay away from Mirena!

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  18. Considering an IUD??? I have been on tri-norinyl for 16 years, 2 years ago they switched me to generic (Leena) and I have gained about 10+ lbs??... Also hit the BIG four O...could there be a connection w/ the generic pill and weight gain? My life style has not changed work out 4/5x week and am not an excessive eater.
    Concerned about the IUD? I have a great sex life and I would rather be fat and happy... then thin and sexless.

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  19. IUDs are an excellent choice for those who want to have a non-hormone method of contraception. Hormone use has been associated with weight gain, BUT, in all trials of hormonal contraception most women do not gain significant weight and there are always women who actually loose weight. Generic pills may vary in hormone content from their sister branded compounds, by law they need to be within a certain dose range. And the dosage variance may be less hormone! Metabolic changes due to activity levels, body fat %, thyroid changes, aging and menopause might be just a few of the factors affecting your weight. Small amounts of extra food intake after a work out can make it less likely that workouts alone will lead to much weight loss for the average exerciser. Having sex is an important part of health, so talk to your Gyno about what is really going on with your body and yes, IUD may be an excellent choice for many!

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  20. What to DO? Low sex drive and my husband gets pooked 1/2 the time we are having sex? My sex drive its low, not sure the reason. After 3 children I had Mirena inserted just over a year ago. Iam still nursing. Is the low sex drive from nursing, having 3 kids and tired by night, or from Mirena. Use to be on the pill before having children and inbetween, yes sex drive was lower then when i never used any hormone method but not like this. I do like the 5 year plan, no bleeding after the first 3 months and even my husband said he can live with the odd poke but do i remove or are other options to help with sex drive?

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  21. Poking IUDs can be solved by shortening or eliminating strings. Although you won't be able to feel them any longer. Nursing can alter hormonal levels and change sexual function. Definitely you and your gyno can consult on the nursing aspect and some potential strategies. Don't forget to screen for post partum depression that can first present as lack of interest in things that one used to be interested in.

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  22. Im 28 and have no sex drive. I try to have sex with my husband for him not me and its uncomfortable. He thinks im not attracted to him buy thats not the case. Ive had my iud for year now and love it but i really do think that this is the cause for my decrease interest and desire. I have an appt withgyn next month n hopefully get things solved. I wan to keep my iud and my marriage

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  23. There are over the counter herbal stimulants of libido that are safe if taken according to the package insert. You might want to give them a try and let us know if they helped!

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    Replies
    1. What are those over the counter herbal stimulants. I too have been on Mirena for 2 years and my sex drive is GONE! Help

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  24. I am 26 years old and have had a long history with hormone BCs. I never took the pill, but I was on the Depo Shot for 2 years, went off for less than a year due to no insurance and no man, went back on for 2 years (in total, longer than recommended, certainly) and on the advice of my Gyno, switched to the Mirena in August of 2009. As a result, I have not had a cycle of any significance in at least 4 years. With the Depo, I had experienced a lower sex drive, but now with the Mirena I have none at all! It is very frustrating for me and my boyfriend of over 3 years. I can't seem to get in the mood or stay there, always feeling too tired and distracted. I have tightness and dryness and just a general disconnect from wanting to have sex and actually making my body do it. I have an appt with my Gyno for my yearly exam (where I will make sure we discuss this), but I think it might be time to finally get off the hormones and maybe switch to something like Paraguard. I definitely do not want children, but what good is birth control if there's no sex to protect? What are your thoughts on this?

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  25. While it might not pertain to your case, it's important for readers to understand that, is not "longer than recommended" to be on the DMPA shot for more than two years, although there are considerations for some individuals. Tightness and dryness at the time of intercourse can have several causes, not just a progesterone cause. It would seem that getting a diagnosis and treating that aspect first will be the best way to treat your sexual dysfunction to begin with.

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  26. I have had the mirena for just over 2 years and I have an appt to get it out next week. Since having it put in my sex drive is nonexistant, I have severe headaches, cramps, I spot daily. I literally have to wear a tampon or pad everyday.

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  27. When the Mirena is removed blood levels of the progesterone contained in the device will disappear from your blood stream quickly. After removal any symptoms that don't rapidly resolve need to be evaluated for other medical causes as well.

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  28. I'm 36 yrs. old with a 12 yr. old; I have to get off of the pill because of my age and the fact that I smoke. My Dr. recommended Mirena or the 3 month shot. I decided to go with the Mirena. I have an appt set up for July 7,2010 and getting really freaked out about all of the negative comments made by women. I have had no problems on the pill since I was 16 yrs. old and my periods are light with minimal to no cramping at all, and I know the exact date and time that I will start every month. Anyway, it's just a little scary knowing that the next year or so could be pure H**L when all is good & well rt now. And yes, I know that I could stay on the pill if I quit smoking, but that's probably not going to happen (tried everything on market & thru Dr. & nothing worked). I have an awesome Dr., but still petrified of the actual insertion procedure. I have a very, very low tolerance for pain & meds always have to be increased for me (had to be knocked out for C-section b/c I could feel my dr. cutting-CRAZY, I know! And have to have 9-12 shots instead of the normal 2-4 shots when getting dental work done). My question is: Can I ask my dr for lidocaine or some kind of numbing med to help
    me thru this or am I overreacting? Help, my appt is in two days! Also sex life with husband is GRRRRRREAT - what are the chance of losing that by getting Mirena???

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  29. Mirena's are a fabulous solution, and yes, these comments focus on the negative, and it's my newest resolution to get a lot more positive up there as we all know those bloggers love to blare the negative messages! Every physician handles the insertion and possible pain of insertion differently and yes, there are pain management techniques, should they be necessary! You have GRRRRRREAT (did I spell it quite correctly!) questions and you and your individual gyno need to go over these before you leap, but again, most women find the IUD quite forgettable, and that's what they want...seamless!

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    Replies
    1. loss of libido is negative...for sure! it sucks and no matter how awesome it is to not worry about pregnancy...without libido it does no good. i mean mabey thats how they keep us from getting pregnant by keepin us from having sex....OH GREAT!

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  30. I'm trying to get approved for the Arch program right now because my sister has had the Mirena now for just under 4 months and LOVES it.

    I was on Loestrin 1.5/30 since I was 20, but now that I'm nearly 36 and haven't quite kicked the smoking habit (down to 6 a day on good days, but according to Pl. Parenthood, it's still 6 too many), I had to switch last week to (Progestin only)Micronor...and HOLY COW. I am breaking out on my face and back with cysts...after only 7 days. they hurt and they are soooo unsightly. I'm sick about it.

    I've not had a bad break-out on the pill, and in fact, I'd say that it helped me. I guess that my only concern is that if I'm breaking out with Micronor, will I break out as badly with Mirena?

    I know that despite my great BP, my excellent nutrition, and my 4x a week excercise, estrogen bcp's are out of the question...I am worried that this transition to Mirena (and short term on the progestin only bcp) will be U.G.L.Y., literally and figuratively. But, as my husband and I do not want kids...what else can I do?

    Also, while on the pill, my weight has not changed since I went on it almost 16 years ago...What am I in for?

    I live in Florida and now I can't even wear half of my wardrobe with the terrible mess on my back and it's not like I can afford to go out and buy a any new clothes or see a dermatologist and avoid the embarrasment that is my skin(...hence the Arch program...).

    Bottom line: will the Mirena be a better option than Micronor and bcp's of it's kind? What supplements or foods can help provide some natural estrogens that I suspect my body is and will be missing?

    I need some words of wisdom to help put this in perspective. I do not like change and this is going to be a rough deal for me.

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    1. NO!!!!!!!!!!!!!!! DO U LIKE SEX? YOU WONT AFTER GETTING THE MIRENA

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  31. First the easy question: natural estrogens are very weak and not likely to turn the skin issues around. If they weren't weak then they have the estrogen that can theoretically be a problem with clotting factors and smoking. The Mirena IUDs are weaker than the Micronor, so acne may be less on an IUD. You might want to try a stretch on condoms to see how your skin responds, to see if it's just the progesterone or just not being on the pill. Or a second opinion, some physicians may let patients smoking very little stay on low dose pills. Keep working on stopping smoking, it may work!

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  32. Hi, I have had my Mirena in for a week now (I'm the one that asked you about pain during insertion and losing my GRRRRRRREAT sex with my husband). Well, insertion was horrible even though my doc said he could stop and I could come back another day - I just sucked it up, cried a lot, and finished the procedure. I bled extremely heavy for the rest of the day curled up with Tylenol with codeine and a heating pad :-( Saturday, I checked my "strings" and can only feel one - it's barely out of the cervix and during sex it pokes my husband "like a needle". The other one is stuck in the lip of the cervix skin and hurts. Is this okay? Do I need to see my doc? I am really nervous about barely feeling one of them and that it will also disappear and become embedded in the uterus. Am I being paranoid?

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  33. A a general guideline, all women with questions regarding whether they feel their IUD strings or whether there is a change or if their partner is uncomfortable should see their provider to be sure there is no treatment indicated.

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  34. Thanks for the advice; I will be calling my doc tomorrow just to be safe.

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  35. Yesterday I posted about my issue with husband getting poked and the thread just out of the cervix. Well, my doc was able to see me this AM. He decided to cut the thread back into the cervix, which I can't feel at all now and my husband won't either (thank God!). However, he thinks the pain I am experiencing could be a bacterial infection, so he prescribed cipro just in case. He told me to call back next week to let him know how I'm feeling no matter good or bad (I sooooo love my doc- he's wonderful). Anyway, up rt now b/c the dull pain is keeping me up even with Tylenol codeine. I'll let you know how it goes. And thanks again for the advice; I really appreciated it. Have a great Thursday!

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  36. Complete string removal is successful for many couples. Bacterial infections do plague many women with and without IUDs and are important to treat. Good case discussion. It looks like a sunny one out there, need time to get on a bit of extra sun screen before I get out there!

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  37. I'm 30, do not have children and have had a mirena for almost 5 years now. However, I am not sure if I will get another one, or wether I should consider another option.

    Insertion was VERY painfull, and I have been plagued by bad cramps, painfull breasts and continual heavy bleeding for almost 6 months after insertion. After that it became better, and about a year and a half after insertion menstrual bleeding stopped altogether (which is really great!).

    However, over the past 5 years I have had some other issues.
    The cords keep disappearing for months on end (1.5 years for the longest), and after the 20th visit to my doctor (who referred me for an ultrasound to make sure the mirena was still there - which it was the whole time), I gave up and when the strings disappear I now just assume it is still there. The cost associated with these checks is getting too much, and those examinations are uncomfortably invasive as well. I guess as long as I do not get pregnant it is still there and functioning alright.

    Over the past 5 years I also regularly have had stomach cramps, an increase in acne, increased aggressiveness and mood changes (which for me is the primary reason not to take the pill as ANY contraceptive pill has that effect on me, but than worse), sometimes pain during intercourse (never had that before), a significant drop in my sex drive, and increasing headaches/migraines sometimes with vision loss (certainly never had those before).

    My doctor cannot find anything wrong with me, and keeps insisting that the mirena cannot cause all of this - but if it is not the mirena and I am otherwise healthy, than what is?

    It will need to be taken out, since the 5 years are almost up. However I will need contraception as I do not have a wish to have children. I am considering not getting a replacement mirena (to see if the symptoms will go away), but what other options for bithcontrol do I have? The pill is not an option (see above), and I do want the birthcontrol I use to be reversible (might want children in the future).

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  38. Women who want long term, non-medicated, reversible contraception should consider ParaGard IUD, and they have a lot of excellent information on their site. You can have IUD insertions on the day of a removal, ,or you can have a gyn work up in the days/weeks or months between the two devices to see if your symptoms actually persist with removal. Check at http://www.paragard.com/, and Thanks for your comments, hope to hear back from you!

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  39. Thanks for your reply, and the advice. ParaGard might be worth looking into again. However, when I choose to get an IUD 5 years ago, I did consider ParaGard. I choose Mirena because my periods are really heavy. They are very irregular, and when they come, bleeding often goes on for 2 weeks. It makes me really ill, with heavy bleeding in the first couple of days, often making me miss work for the first day or two. After my period I am often anemic. (I do not have cysts or anything in my uterus causing this - that has been checked.)
    I did not really want to add to that, given that a known effect of ParaGard is that it makes menstruation cycles heavier.

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  40. ParaGard used initially can cause heavier cycles, but even in women who have not had their uterine lining thinned hormonally that effect usually abates relatively quickly. And few women actually have to discontinue due to the heaviness. In women who have been on birth control pills, Mirena, or the progesterone only methods of POPs, DMPA or Implanon their lining is likely to be so much thinner to start with that they may not notice any undue effect. For women who choose barrier methods and still have heavy periods they could look into Lysteda, a new non-hormonal way of controlling the bleeding. Nutritional changes can aid anemia from the bleeding in many cases, so it's important to have your diet evaluated as well!

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  41. I'm 33 yrs old, smoker and high risk for strokes. I now have polycystic ovarian syndrome with side effects that include oily skin, acne, hair growth and weight gain. My GP recommended Mirena, as the pill is not an option.
    My concern is that when I had my child 3 yrs ago it was via c-section due to not dialating. Will this cause problems with insertion? Also my reasons for getting mirena are to reduce the symptoms that most people are saying increased for them. Does this make sense?

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  42. First of all, we cannot change our genes (I assume this is what you mean by at risk for stroke), but we can change our behavior. Stopping smoking is important, and extra important if you consider you may have pass the inherited stroke risk on to your children, and one of the greatest predictors of smoking in children is parental smoking. Maybe you can check my other blog posts for hints on how to quit.In terms of Mirena for your PCOS: Mirena IUDs are an excellent way to counteract the effects of excess estrogen and anovulation (not ovulating) on the lining of the uterus, so I would agree with your physician. For women with prior C/S, in and of itself, having been pregnant should make getting an IUD easier than having never been pregnant, in terms of the size and consistency of your cervix. Sometimes we can get a hint as to the size and shape of the cervix before insertion with an ultrasound, but if the insertion is difficult because of the physical nature of the cervix there are cervical ripening or softening treatments that might be tried that you can discuss with your physician. Furthermore the use of numbing agents can help with the discomfort of insertion. Most women are very happy with their Mirena!

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  43. I am 27 with one child, I have had mire for 2 and a half months, and it is amazing. I want to have sex with my husband ALL the time. I never used to be able to orgasm during intercourse but now I do multiple times. its the best thing that ever happened to me. I'm actually worried that this awesome sex drive could go away.

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  44. And your sex drive shouldn't just go away! Comfortable contraception is one of the most potent aphrodisiacs we know! And side effects of the Mirena are uncommon, but possible. Your blood levels should be close to the permanent steady state already, so I would say, you are not likely to experience a negative effect on this very favorable situation from the Mirena. It is important to remember that couples naturally will experience times when sexuality seems to be less important than the other demands on our busy lives, so a natural temporary lull at some point wouldn't be worrisome either.

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    Replies
    1. WHY DO U KEEP DEFENDING THIS? TOOOOOOO MANY WOMEN SAY THEY ARE HAVING A LOSS OF SEX DRIVE....IT SHOULDNT JUST GO AWAY, BUT IT DOES!!!!!!!!!

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  45. I am 41 and just had my first Mirena inserted about a week ago. Had sex for the first time since insertion last night and my partner complained of something rubbing him to the point where we had to stop because now he is in pain! Could this be the string he is feeling? I feel really bad because today he is in a lot of pain and won't go back in there! I know I've only had it a week but I feel GREAT. Insertion was a breeze - just a teeny bit of cramping when the IUD was inserted but it was over in less than 5 minutes and that was it. I was surprised how quick and easy the whole procedure was.

    I had read a lot of negative things about Mirena and side effects etc but I believe as everyone is different they are going to have a different experience to me but so far I am very happy!

    So, could this mean I have to have the strings shortened or cut? Thanks.

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  46. Many men can feel the strings. As I gynecologist I say yes, it is safe to cut them off completely if that is going to be comfortable. Your gynecologist has to advise you as to whether the strings are in position to be cut, whether it is part of the device protruding that is the problem, and her or his best advice about the string length. IUDs can always be checked by ultrasound if a woman has her strings completely cut off. Your good experience with insertion is common and you will be likely be very happy with your choice as many women are!

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  47. Is there anything that can be prescribed to counter the low sex drive symptom associated with Mirena without removing it...and without decreasing its effective 0.2% pregnancy rate. Ladies, I am the husband researching this for my wife who is on the other end of the "marriage strain" due to the now NULL sex drive of my wife. She is 28 with 2 kids and has had Mirena in since June 2009 (15 months now) and my youngest son is 18 months.

    My wife spotted for the first 6 months it was in, but she now has a NORMAL period. All women differ, but that's kinda cool (I'm assuming as a guy) for a girl to not have her period. Anyways, there was about 2-3 months where my wife had 2 periods a month, but not anymore...thank God!

    Any suggestions for prescription meds to increase sex drive without decreasing Mirena's effects and not having Mirena removed would be awesome, all!! (My wife was horrible with the pill...she remembered to take it once every 3-4 days...hence why we have 2 kids at 28, LOL, JK)

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  48. Seeing a gyno and talking about issues of sexuality can definitely help improve libido! There are no approved medical treatments, but there are treatments that have been shown to help in studies, so she has to work with with a physician. She's got a secret advantage some women can't boast: a very interested partner! Remember, date-nites can be a great start as well!

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  49. I am Anonymous from September 18...

    Thanks Gyno Gab I will go and see about having the strings shortened. We tried again last night but this time using a different position and I made him use a condom because he still was 'wounded' from last week! He said this time he didn't feel anything!

    I also wanted to mention for those considering a Mirena that I've had no cramping, no spotting and my libido is through the roof! As this is only early days, I will keep you posted. I didn't let all the negative comments put me off as I simply had to find out for myself if it was suitable or not and I hope others do the same.

    Thanks.

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  50. Great to hear! Having sex is good for our health! We hope you will enjoy the blog and pop back regularly to have a chat!

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  51. Hi, new to this chat but I am a little confused about my abnormal increase in libido on Mirena.

    I have had the Mirena in for about 2 months and over the last 2 weeks I have had a great increase in my libido. This is very abnormal for me as I usually have none. I asked my GP and she said it is not caused by the Mirena, however even my boyfriend has noticed this change in my behaviour since the Mirena.

    If anyone could shed some light on my situation, I would be greatful.

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  52. It is great to hear that a contraceptive method increases sex drive! The question is: are you having your own private "Summer of Love" the boost women got from feeling sexual because they were free of fear of pregnancy or could something physiologic be going on. We think that it takes about 30 mcg of progesterone to circulate to suppress ovulation and have therefore some impact on testosterone production, Mirenas should only leak about 20 mcg. There is a possible explanation that hasn't been proven exactly: it's biologically a bit complex. We make SHBG in our liver that bindss male hormones and prevents them from being active. On the pill one has more SHBG, on IUDs less. If we theorize that ONE component of sexual function is our male hormone level, then IN THEORY, an IUD would tip the scale towards more male hormone and thus increase sexuality. Female sexual function is very complex, and many factors increase our desire and many factors in turn decrease, it's usually a balance of these factors! Looks like a "fertile" field for research! Thanks, keep us posted!

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  53. Thanks for the response. I think I may have figured out why the Mirena has contributed to a higher libido. My menstrual cycle prior to Mirena made my sex drive excel during pre-menstration and during menstration. I know that is a bit odd as the body is made for procreation and I do not feel sexually excited when I ovulate. I suppose everyone is different.

    Anyway, since Mirena inhibits ovulation and thus contributes to a higher endometrial lining, which is the same biological state that is characterisitic to pre-menstration and menstration. Therefore, I assume that since my body is somewhat "locked" in the state of premenstration and such with the thicker lining caused by Mirena, then I should assume that I could be more sexually excited as my regular cycle also demostrated this same trend.

    I am not too sure if this is correct, but I was reading through the clinical trials from Mirena testing and the biological processes and findings during the initial testing phases. With this, it seems as a possible cause.

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    Replies
    1. this was obviously gyno gab that wrote this

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  54. So, I had a Mirena inserted in early August, and everything was fine until my first period at the end of August, which was a bit lighter than normal but on schedule. Since then, I have not stopped bleeding. A liner is generally sufficient, but I bleed at least a little bit everyday, normally dark, dark red. To stop the bleeding, my GYN gave me very lose dose estradiol. Since the bleeding didn't stop, I went off the estradiol last week. I've spotted, but been pretty clear until tonight; not long after orgasm, I started bleeding red blood. Not so much that I'm creeped out, but I don't like it. There are obviously a lot of factors in play here, but the main thing I would like is some advice about is how long I should give this a chance. I really do want to keep it, and I think it would be good for my sex life with my husband, but I don't want to wear a liner forever.

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  55. @ Anonymous on October 5, 2010 6:34 PM: My wife spotted for 6 months after Mirena was inserted. Periods are normal length and flow now (she's has it in for 16 months now) but she still has a period (unlike what others are saying, no period at all)

    @ Gyno Gab: My wife also in the months of April and May had 2 periods a month (one every other week) but that stopped. She went to her gyno and he gave her Ortho-Lo in addition to the Mirena still being in to "thicken the wall lining" but she never took it. She hates the pill hence why she has the IUD!

    Also, all was normal unil this month where she has had her period now for 12 days now and it doesn't look like it's ending soon. We did have sex this past Saturday (9th day of bleeding) and no blood and a very light tinge of pink when I wiped off my penis with a baby wipe. Any suggestions??

    This also goes to my original comment of her having a low sex drive w/ Mirena and not sure if it's due to stress, the 2 todders (3.5 and 1.5 yrs old), etc.

    Thanks!

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  56. Levels of the hormone leaked by the IUD vary from woman to woman. We know with initial insertion they are the highest and can even approach something close to about 200 mcg per day, after years more like 14 mcg/day. Over time the amount leaking out does affect the level, and yet there probably are many other factors. As a gynecologist the term "period" is not really applied to situations than are not the normal cyclic shedding of a woman's lining. We prefer the "unscheduled bleeding." Term, and yes, unscheduled bleeding and spotting and staining (staining doesn't even require 'protection' it's so light) can occur in users of all steroid contraceptive methods. The first issue is is there a medical problem, the next is it bothersome. A woman's own gynecologist will have to sort those issues out. A simple, over the internet answer is typically, that light staining and spotting is usually not an emergency, will usually resolve, usually will not require one to abandon their contraceptive method, but does need to be tracked and discussed relatively soon with her gynecologist. Libido, now that part of the answer, is even more complex, and yes, some stress may be a factor, if a date night can ever be arranged, it's very appreciated!

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  57. Thanks. Thankfully, there are no libido issues. There are actually no problems except for the regular spotting. I think I'm going to give it a while longer. I keep in regular contact with my gynecologist, but I think he doesn't have a lot of patients with these, since he mainly works with couples trying to conceive! I can't do standard birth control, not only for the side-effect, but because of the meds I take. So, it is relatively normal for someone to bleed (a little bit) for this long? Also, does it make sense that I stopped the estradiol?

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  58. So I have had the Mirena for two and a half months. I did not bleed much but have had a long, nasty period every time. No changes there at all. The strings are only a little bit of a problem but I think it is coming out. I can feel the plastic end of the Mirena. My ob said that it was fine by looking, but I think my cervix was higher and covering it. I feel like something is there, sorry to be blunt but like when you don't have a tampon in right. I have pain during sex and cramps almost everyday. Also my legs hurt so bad when it was put in and hurt during that time of the month really bad. Question is can I just push the Mirena back in and is the leg pain (keeping me up at night pain) normal part of this. I would really like for it to work, and I would really like not having to go to the doctor again. Thanks

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  59. Ultrasound is one very accurate way of checking position, so that is an option. Women cannot just reposition their own IUDs, so that is never a good thing to try.

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  60. I'm thinking about switching to Mirena do a low sex drive on oral contraceptives. I've been suffering from a low libido for a few years now and never thought to blame birth control, until I switched to a new pill a few weeks ago. Very soon after switching I went from low sex drive to NO sex drive, which got me started doing Internet research. This is when I realized that the original decline in libido coincided with my switch from the patch to the ring. I would just go off birth control all together, my husband doesn't mind wearing condoms, but I have endometriosis and the hormones help with those symptoms. However, after reading all these complaints about libido I'm not so sure if Mirena will help. I just want to want sex like I did before going off the patch, what should I do?

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  61. There is no absolute answer, and hormones are not the only factor that control libido. Mirena has levonorgestrel which is a progesterone. there are progesterone only birth control pills. One suggestion is to to try a couple of test months. The first test I would suggest would be to try a progesterone only pill, this would be a stronger progesterone than that of the Mirena, but if the libido is not effected, or effected less then it's likely at least that is less likely to be an issue when you get your IUD. Eventually some women realize that urgery combined with post op condom use is one other option for endometriosis sufferers who do not want hormonal alternatives.

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  62. And thanks for writing and let us know if any of this works!

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  63. Any thoughts on what my wife's OB suggested? Not sure if this was previously suggested in an earlier post...but Mirena + 1 month of the Ortho Tri-Cyclen Lo pill (I think the rationale was to thicken the lining)...I just hope she can follow through...which is why we probably have 2 toddlers (whom I love dearly) at 29 and her 28 but I'm just saying...

    Yes my wife is still bleeding after 4 weeks. This week heavier than the previous 2 weeks but similar to the first week. It's been like heavy--light--light--heavy.

    Thanks all!

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  64. Yes, the suggestion of adding in a low dose birth control pill to try to control a new onset of spotting is a good suggestion. The Mirena hormone level is relatively low and the pill hormone is relatively low, so together they are really quite safe, and would work nicely to stabilize the lining, and absolutely, preserving one's contraceptive method is important!

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  65. ...Willing to try anything short of removing the Mirena or anything permanent like tubal-ligation (sp?)

    I hope this works but am skeptical...my wife has had the Mirena in for 16 months already.

    Her OB/GYN finished her sentence when he told her about the low sex drive. Seems like a common issue and he said maybe my wife was probably not a good candidate for the Mirena. I'm actually kinda jealous of others who say they're NOT bleeding AT ALL after a few months on the Mirena.

    Her doctor also suggested some herbal non-Rx supplement only available online to enhance her libido. He wrote it down on a napkin (LOL) which my wife accidentally discarded. She emailed him and is awaiting a response...has anyone heard of anything/tried anything? There a lot of crap supplements floating around online (and I am skeptical if it's non-Rx) but for a doctor to recommend it must be worth something, right?? Right??

    - "Desperate to have his cake and eat it too"

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  66. Avilmil is the herbal stimulant and the study that I've read did have slight improvement without significant side effects, and it can be tried. Another important thing to check with IUDs is that their placement is correct. Over time they can become dislodged and even ultrasounds can sometimes be a bit misleading as they usually are a two dimensional view. But you are right, it doesn't work out for everyone, just most! We do encourage women to try solutions however! Thanks for your comments.

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  67. Hi Gab,
    I was just wanting to ask if you have encountered any women having a decrease of natural lubrication with the Mirena. I have had my Mirena in for 16 months. I've never had this issue before, and I'veve been with the same partner since before having Mirena put in so I know it's not him! There's been absolutely no decrease in libido- we just have to use lube every time, which is getting a bit tedious.

    Thank you.

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  68. Hello,

    I am 25 years old and I have had the Mirena in for 4 years. I am scheduled to get it taken out next year. Around the second year with mirena, i noticed i couldn't feel my strings so i went in for a ultrasound and it was located a little above my cervix. I am frightened at the thought of getting it out. No one has given me a explanation of the procedure!! I also have a loss of SEX Drive and have gained over 50 pounds since I have had it inserted. I am getting married in June and it's kind of hard going into the marriage with no desire to have sex!!! Will I go back to normal once it is removed? I am not sure what to do because I love having the Mirena but I really HATE these side effects!!PLEASE HELP!!

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  69. Thanks for writing about your Mirena, the se drive, your weight gain, the lack of strings, and your fears of getting the IUD removed next year. You definitely have medical issues to deal with your personal physician. There is no medical basis for a 50 pound weight gain to be attributable to a Mirena IUD alone. I do not know your whole case, but the unfortunate facts of life are that in 4 years: 1 pund a month, a mere extra 1/4 a pound a week gain is 50 pounds: it is possible something metabolic is going on, but most likely the weight specifically is the horrible result of the slow gain many of us experience. Sex drive is often surpressed if the body image is poor, so those two facts are likely related. Now for the string issue: most of the time they can be easily teased down with a very tiny instrument and then the IUD popped out quickly and close to painlessly. If the IUD is in the wall or has to be retreived with an instrument in the uterus your physician can show it to you and explain the technique. There are ways to pain numbing gel on the cervix, or wash with numbing gel or give you medication for relaxation if it would be necessary, but really it's almost never necessary to do any of that! I'm just saying, there are always options for tough cases! Thanks

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  70. Hi, just thought I'd give you an update I wrote to you back in July when I was getting my mirena, nervous about insertion, & really scared about losing my GRRRRREAT sex with my husband. I am now 4 months into having the Mirena & had complete thread removal (back in July as well) because husband could feel it (also voiced concerned about removal if string was cut- he assured me he never had a mirena he couldn't get out). Went to doc in august for annual pap, told dr about issues (feeling preg., tender breasts, constant bleeding, low back pain, depression & mood swings, crying for days, Nooooo sex drive & the list goes on...) absolutely love my dr & totally trust him so I asked him his opinion of "to keep or not to keep??" He told me to give it 4-6 more weeks & if not for me, he'd take it out. Well, saw my dr this afternoon, made sure to take pain meds just in case (very low tolerance for pain & insertion was HORRIBLE). He went in to grab the string; however, he couldn't see it nor could he feel it, kept fishing but no luck. During all this my uterus begins contracting like being prodded with a stick even though he was only touching the cervix. After about 10 mins he suggested an ultrasound, did a vaginal with the big "banana" probe; started having pain again but good news it's not embedded in wall nor did it perforate my uterus. It's in the rt place with only about 1cm more into the cervix rt at the opening of the uterus. He tried on mor time to get it out but still couldn't because I was hurting like crazy:-( he now wants me to come back rt when my next period begins so everything is softer & a little mor open. He'll call me in some strong narcotics (basically to put me in la la land) so I don't have to go through the pain of him digging any further. I'm still hurting now from all the digging - it feels like I have a stick being poked into me(not a good feeling:( hopefully I can get this out before the end of the month with ease - keeping my fingers crossed. Will keep you posted. And hopefully I can get my GRRRRRREAT sex life back:-0

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  71. So I looked back at my one of my posts from 10/5/10 where I said my wife has been bleeding for 12 days already. It's 11/5/10 and the bleeding is still going...I am concerned!

    My wife did go see her OB/GYN on 10/14/10 but it was more of a walk-in being that she's a nurse in the same hospital and (from what she's telling me) this was more of an informal discussion in between patients and prior to her 7p-7a shift started. I told her I was disappointed that she did not insist on an ultrasound. She did not even "gown up". She remained in her work scrubs...ughh!!
    So her Doc (like a previously posted) said she is not a good candidate for Mirena- but my rebuttal to that is AFTER 16 MONTHS?!?! He offered to take it out, and also suggested the Avilmil (still have to order it, but thanks for confirming the name Gyno Gab), but...OK, I'm rambling.

    Anyways, she's about halfway into her 1 month supply of Orth Tri-Cyclin Lo and after a few days I was getting excited that the bleeding turned super light. So we go to have sex, and the following day, HEAVY BLEEDING :(
    It lightens up again after a week or so, and we try again with having sex, and HEAVY BLEEDING AGAIN :(
    So I told her to go to the ER so they can "one-stop shop" an ultrasound and do blood work, despite the 3 hour turn around time...but my wife wishes to wait 1 week after she finishes her round of pills (we're both not even sure when her REAL period is anymore) and then plans to visit her OB/GYN.

    1) Do you think the Mirena might be lodged into her uterus' walls? (from the heavy bleeding day after sex)
    2) Is it true no reputable doctor would touch her if she requested a tubal ligation at 28 years old??
    3) Any recommendations from Gyno Gab or anyone else on this blog about maybe the Nuvaring. It says low dose?
    2a) Does anyone know the percentage of hormone given out by the Mirena vs the Nuvaring?

    By looking at pictures online of the Nuvaring, I find it hard to believe it will not fall out during sex nor that the guy will not feel it...I was under the impression it was small like a wedding ring size...and fit all the way by the cervix...not a rubber looking ring the size of my palm.

    Anyways, that's my rant...and those are my questions. I apprecate any suggestions or feedback provided. Thanks!!

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  72. I had my 2nd Mirena inserted 2 years ago. After the 2nd one was inserted, my sexual drive has increased dramatically. I know I shouldn't complain, but I'm wondering if that is an actual side effect of the IUD. Thanks!

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  73. Women happy with their contraception, regardless of the method find a bit of a boost in their sex drive. The studies that look at sex drive do report a large placebo effect of every treatment! Physicians taking care of women are constantly perplexed by the interactions between our mind and our sexuality, so much yet to learn! We are excited to hear about this benefit to your Mirena use, thank you for sharing.

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  74. Lets try this again, doesn't seem to have posted.
    My partner had a surgery related blood clot 5 years ago, so can no longer use O/Cs, so went the Mirena route. Everything was good to start with, she was happy with it no more pills in the morning etc and her cycle was regular. However after about 6 months her libido started dropping, or rather i noticed it was. She probably noticed long before, yes I'm a male, blah blah blah etc. Anyways we talked about it and she decided to get it removed. This was 4 years ago and the libido has not picked back up, in fact i can count on one hand the number of times we have had sex in that time, and that's not using my thumb.
    It's like a self fulfulling proficy, i don't nag her about it, trying to be supportive and not pressure her about it. I miss even the physical contact of naked bodies, she doesn't even want that, doesn't like me touching her. She says she does but admits she hasn't spoken to her doctor about it. So whilst it might be, or might have been, just the Mirena, reading your other responses it may now be a psychological one.
    Feeling trapped here, because when i bring it up it feels to me like i am trying pressure her. I do not know what i can for her, short of giving up on any hope of intimate contact for the rest of my life.
    What can i do to help her?

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  75. Once some one has had a good libido their is hope that that libido can return, whatever was the reason it dropped off. Professional help, either with one's gynecologist or with a therapist is definitely a strategy to address the issues that may be affecting the couple's sex life. Many gynos are not trained in speaking about or diagnosing sexual dysfunction issues, so that may be a reason for the lack of discussion. At Women's Health Practice I have been trained in diagnosing sexual dysfunction and have worked on a variety of experimental therapies, so as a gyno I have more experience than some practices and we welcome those cases for those in our area. Psychologists who are willing to see the couple and get the issue on the table can be helpful. At home simple things: do dishes together (wet hands touch), exercise or garden together)bother are physical, showering or bathing together, have all been shown to increase foreplay and increase sexual contact.

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  76. This is my second time having the mirena. I had one placed after my first child was born in July 2005. It was removed in august 2006 so we could try for another. We put that on hold after 3 months of trying with no luck. We tried again and had our second child in April of 2008. Now I have been on this mirena since may of 2008, close to 3 years. I never want to have sex. My husband gets frustrated but gives me space. We were every other day people until the last year or so. Now, it is maybe 2 times a month. I used to love it when he touched my boobs, but now he cant at all because i dont like how it feels I have been having trouble orgasming lately too. I know you mentioned the hormone level is so low it can't be the hormones, but I think there are too many who complain of low sex drive for it to be coincidence. I love my husband. I want my sex drive back. I truly think it is the bc because I can't see how it could be anything else.

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  77. In medicine we know that there is a real correlation if the group with the treatment has significantly different effects than the group without. So far there are not enough unbiased studies that can really answer this for us. There are many women who have decreased sexual desire and difficulty with orgasms who are on each method of birth control. It is important to first get seen by your physician to see if there can be other reasons for the poor sexual function. After that you need to decide if removing your Mirena is a step you want to take to see if in your case the sex drive returns. Do have plans for contraception, as Mirena IUDs are immediately reversed when removed and pregnancy is possible.

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  78. So my wife just had her Mirena removed after having it in for 20 months. I've voiced my gripes me (as the husband) and wife have been having with this...low sex drive, spotting/bleeding for 4-6 weeks at a time...then it reducing to a "period" every 14 days, not 28 days...etc.

    She inquired to her OB/GYN about the Depo-Provera 3 month shot, but she is concerned about weight gain so she may go with the pill, although I know she won't be compliant daily. And I'm hoping 2 kids at 29 is it for us. Any one know anyone that's been on or is on the Depo-Provera shot?? My apologies if this belongs in another thread...

    Thanks, all!

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  79. Depo-Provera (DMPA) shots have been used for contraception in parts of the world sine the 1960s! That alone is pretty strong endorsement as both safe and effective. In addition there is a lover dose formula that works well for some women. It is progesterone, but unlike both Implanon and Mirena which have sustained releases of hormone it releases into the blood stream with peaks and valleys, so it is possible that it has a different side effect profile although the hormone is quite similar to what a women has in ther blood stream with the Mirena IUD. Weight gain reports with DMPA vary greatly. The most reliable figures are that about 2% of women gain weight, and a few actually loose weight. Most women on DMPA do not significantly change their weight. Of those who gain weight it may be in the range of 10-15 pounds over 5 years, or 20+ pounds over 10 years. Some reports indicate the weight gained is more the mid abdominal fat gain, but that is more typical of women gaining weight in general. What I advise women who worry about possible weight gain is to actually increase their exercise, improve their diet and then it's very rare that weight gain is an issue with a new Depo-Provera user.

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  80. Since the age of 15 I have been on some form of contraceptive pill or implant. This was due to heavy, extremely painful periods. The combined pill didnt work and over 4 years I tried loads. Eventually I got put on the POP which reduced my symptoms. I then had Implanon inserted and found my periods became light and irrgular but infrequent. The problem then though was spots (which have always been an issue) and intense long periods of period pain without much bleeding. I then had a laparoscopy at the age of 21 to illiminate any underlying causes like endo and was told I was healthy "with good child bearing hips"! Anyway, still trying to treat the pain and have since removed the expired implant and am now on cerazette (because its similar to implanon) whilst I decide what to do next and the option is Implanon again or Mirena. The pain is a big factor as are my spots, i'm 23 and lack confidence when my breakouts get bad. The other major factor is how I have NO sex drive and havent had one for years. This is really starting to get in the way of my relationship and upsets me a lot. Do you think the Mirena could help with everything? This isnt something I can ask my GP as he really doesnt seem to care which is the best option and tells me to pick one. I'll not be going back to him. But still I need to decide. I dont have BP problems or take any other medication.

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  81. This reader describes what many women report: successful contraception from their POP, but their successes in contraception have to be balanced by negatives in other areas.Try looking at some of the other posts on pelvic pain and POP as we have discussed some of these issues previously. When women describe "pain" to their gynos the solution is often best obtained by getting to an accurate medical diagnosis. For instance pelvic pain with intercourse is a different condition altogether from dysmenorrhea which are painful menstrual cramps. Women who have had conditions and tratments that have stretched over many courses of action and many years do best if they can see a gynecologist rather than a primary care specialist. Then testing needs to be done to get an accurate medical diagnosis before treatments can be proposed. Thanks.

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  82. Re. Post made on the 27th Feb 5:16pm and GynoGab reply.
    I have seen a gynocologist. This is why I had a laparoscopy with no abnormal results. I was then discharged by my gyno. What further tests are there? Dysmenorrhea is a big problem for me and the only way I have been advised to deal with this is with contraceptives which I recieve from my primary care, to whom I was discharged to. Could the Mirena help me as it is the last option that I havent tried that is suitable to my age.

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  83. Hello, I had libido issues with OCP several years ago. After discontinuing them, my libido returned to normal. Since then I've had a baby, breastfed, etc. After delivery I had a decent libido for a new mom and had Mirena placed 3 months PP. Slowly my libido has diminished. For months we were unable to have intercourse due to poor healing following my vaccum delivery. It was surgically corrected and things have greatly improved. I love many aspects of the Mirena (great skin, no period, etc.) However, my libido has not returned at all. I am not depressed, as my life as a whole is in a wonderful place and physically I feel so much better following my surgery (7 months ago). We are just wondering if this could be similar to my issue with the OCP. If so, then next time I would like the consider a copper IUD. Thank you!

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  84. Libido suppression by oral contraceptive pills has been theorized to be due to reduction of female testosterone levels. This however is odd since other studies have never demonstrated a direct relationship between male hormone levels and libido in pre-menopausal women. To the extent that a Mirena IUD would suppress ovulation, then the effect may be similar. ParaGard IUD not being medicated has no effect on ovulation and would be a good choice in the future. In our practice we recommend a more complete individual work up before changing one's contraception! Thanks for writing in with your story.

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  85. I had my Mirena inserted in January of 2010 after the birth of my fourth child. Within a week, my normally voracious sex drive turned off...like a light. During the remainder of 2010, my acne got worse month my month (all blackheads and whiteheads, never had this kind of acne in my life). I lost all of my baby weight and then some. I did P90X and frankly, looked... hot. But depression was brewing the entire time, also getting worse month by month. It is now March 2011: I still have my Mirena, my vagina is DEAD, I have horrible acne and am floundering in a profound depression. I went to a Family Practice doctor last week and was prescribed Wellbutrin. We will see how that goes, but all along I have had my suspicions that it was the IUD. I find it frustrating that all of the doctors that I have consulted won't even entertain the idea that the Mirena has caused the nonexistent libido, acne, and ultimately a depression. At 31 years old, I am certain that I know my body and mind (ie. it's not a psychological issue I have with my husband that caused me to one day just forget about sex). My body image was the best it ever was as I did P90X. Yet still no desire to get naked. Bottom line is, it is coming out as fast as I can make an appointment. I think the medical profession needs to accept that the the "uncommon" side effects are more common than originally thought. Women shouldn't be discouraged from getting it, but simply told: If you experience these symptoms after insertion, and other medical issues are ruled out, the Mirena is likely causing them and they probably won't go away. I will update shortly after removal and after I see if this is the thing that has ruined my life for the past 14 months.

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  86. Yea, my wife's libido has definitely returned after having the Mirena removed s few weeks ago...just like @TWEETIE said...like a lightbulb was flipped on.

    The only thing that annoys me is wifey's lack of follow-up with her OB/GYN. He Rx'ed her the Depo Provera 150 IM shot...wifey was concerned about weight gain as I stated in a previous post...Wikipedia says there's a Depo Sub Q 104 shot but the receptionist hasn't heard of it and the OB/GYN is busy and hasn't returned her calls.

    .....thus condoms. Lame! Lol

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  87. Most studies of DepoProvera fail to find a significant amount of weight gain in their patients. I have written on the topic a few times: http://gynogab.blogspot.com/2010/08/dmpa-and-weight-gain.html
    and
    http://gynogab.blogspot.com/2011/02/sustained-release-hormone-v-depot.html
    DepoProvera Sub Q 104 is not covered as well as the traditional dosage of 150 mg so many practices have not incorporated it into use although the studies on it were very favorable. It is possible that one's libido will not be affected by other progesterone methods although you (she) were affected by the Mirena.

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  88. I am 54 and have just had my Mirena out today after 5 years. I had it inserted because of heavy bleeding to the point of anaemia. It took about four months to settle down and then I have had no periods at all. A bit of weight gain but then I have always struggled with my weight. Not sure about libido as I have been celibate. I have not had any of the negative symptoms some of your other posters have described. I have had IUDs before, between my children, and I wanted to share that between child no. 2 and no. 3 I had zero libido, but was very happy when everything was hunky dory after the birth of the third. There were only 17 months between these two babies so if tiredness was a factor then the libido should have stayed away!
    I asked the my doctor if I could have another Mirena and she has said to wait and see if my period returns (blood tests show I am not menopausal yet). I have a clotting disorder so cannot take HRT but have felt very well with the small amounts of progesterone released by the Mirena. I had always said that if I could be 2 months pregnant all my life I would be extremely happy. Does anyone have any experience of a second Mirena around age 55?

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  89. In answer to the reader's question regarding Mirena and the "upper age limit" for use. There is no specific upper age limit for use, and in many women they can provide the progesterone for hormone therapy in menopause (although this would be off-label use and probably not covered by insurance). It will be interesting to see if other readers have used Mirena past age 55. Thanks for your comments

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  90. I have had my Mirena for 2 years and I am only ever in the mood every blue moon. For me this is frustrating and I also have acne, and I have more irritable than I ever have. I did experience some weight gain, but I started watching my diet more, and soon attributed the weight gain to the medication I had been prescribed for PPD. Women using the mirena probably gave birth in the months prior to insertion and could be experiencing PPD. And for some women Mirena could be an alternative to less successful form(s) of contraceptives, which could mean they could have hormonal imbalances that are likely to cause mood swings and/or depression and need SSRI's. SSRI medication may help with the Baby Blues BUT it could be causing the weight gain AND disinterest with sex due to constant levels of serotonin in the brain and the connections between the brain,serotonin,and satiety, all of which signals whether we are aroused,full or satisfied, whether by food or sex. Because of this fascinating connection some pretty interesting processes takes place when we connect the dots. First of all, new mothers are already on the Hormonal Coaster ride. Later, the absorption of synthetic hormones into the bloodstream that stops ovulation creates pre-menstrual state, and we ALL know about mood, appetite, cravings and weight gain during this period BEFORE the period. Over time this could stop the period all together. Hopefully, the hormones will taper as Gyno Gab said they should in her thread, and it won't be so bad. Combined with PPD or NonPPD and the use of SSRI's, the extra serotonin in the brain signals satisfaction and contentment, but since we are seekers of satisfaction we will try to scratch the itch- only there is no itch to scratch in the first place. I used to want chocolate, pizza, any comfort food around and when I ate what I had been "craving" I was still not satisfied and I continued to comfort with food, as many women do. So as a result I gained weight-30 + pounds and not only because of the Mirena, but because of the fattening calories that I consumed thoughtlessly without guilt,due to my tongue no longer "taste" the gratifying flavor of cheesecake, or chocolate or any of the deliciousness that I enjoyed before SSRI's had given my brain more good feelings than I could process. I got off the SSRI's to test my hypothesis on my weight gain and other issues with them, and after the discontinuation symptoms ceased, I was able to experience life the way I feel it is meant to be experienced...you know feeling my highs and lows and everything in between- and re-learning how to Cope with life instead of allowing Postpartum Depression to drag on for 4 or more years. I've lost over 50lbs since stopping them, but I still have the Mirena. I still have that full feeling in my lower abdomen, that I believe is due to my infrequent and light periods, the environment inside my uterus, and my low libido -which has increased a bit upon my discontinuation of SSRI's. I plan on having the device removed and don't think I will use any BC except condoms and spermicide. I only have one ovary and two kids who are 10 years apart and I want to enjoy them without going blind, (vision loss) bald, (hair thinning) or crazy (extremely irritable) due to the remaining side effects.

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  91. A reader describes pelvic symptoms. Lower abdomen "feelings" in women with IUD could be due to irregular placement of the IUD, infection or other medical condition, may want to specifically check that out first.

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  92. I've had the Mirena 2 times and love the fact of "no periods" but the sex drive is down. I started taking a Female Sexual Enhancer and it has worked great. Just concerned that it's okay to use an enhancer with the Mirena.

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  93. To the reader that has begun taking the Female Sexual Enhancer, the package insert for Mirena does say: Drugs or herbal products that induce certain enzymes, such as CYP3A4, may decrease the serum concentration of progestins. So you probably need to bring the product to your physician and make sure that this particular product doesn't fall into that category.

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  94. Gyno Gab,
    Thank you for your input;I concur with your comment about the full feeling in my abdomen. In fact, I believe that I may have an infection and some displacement.I have been feeling a bit off, and made plans to see my doctor ASAP. My gy/obn has tried twice to get out my Mirena, and I have received ultrasounds to check the placement in the past because the string was lost after she cut shortened it, so my doctor inevitably will have to surgically remove the device in the hospital.
    I'm definitely going to call, I don't play around with my health.

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  95. Women with IUDs that do not have strings do not normally have to have a surgical removal of the device in the hospital. Tools for blind removal work, but removal under office ultrasound guidance is also possible. What is important is that for women who used to feel their strings and now they don't, especially with a new IUD, the placement does need to be checked.

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  96. I am 40 years old and considering getting a Mirena in the near future. I like the idea of no periods since in the past I have had heavy and too frequent periods. I have been breastfeeding for 2 months. If I am not bleeding now due to breastfeeding, will I begin bleeding if I have the Mirena inserted? Also in the past I read that all female hormones vary day to day in relation to one another. For instance, if estrogen drops a little one day then progesterone or testosterone or other less common female hormones rise and make up for the drop and vice versa. Is this true? How common are the side effects of Mirena in women -over 40? in women who are thin? in overweight women? Could the Mirena help women who have pre-menopausal symptoms? I heard that Mirena causes a drop in FSH and LH so does this mean that estrogen levels would also drop? And if so, libido could also be effected? If a side effect of Mirena is acne is that caused by increased testosterone levels/lower estrogen levels?

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  97. Women who are breastfeeding and not having menstrual periods likely have a very thin lining that would not be likely to be stimulated by getting a Mirena IUD. So breast feeding women are ideal for the Mirena IUD. Women who are not breast feeding, and over the age of 40 considering Mirena have to understand that they in fact might be perimenopausal and exactly where they are in that process would affect their estrogen levels, their testosterone levels, the frequency of ovulation and their progesterone, and thus, to the extent that libido is regulated by hormones, their libido. Once that is established can your own gynecologist, in consultation, answer how likely you are to have this process improved or hindered by having a Mirena IUD. But the short answer is that most perimenopausal women do not have enough progesterone and do very well with Mirena. Grab your list of questions and head out for a consult appointment!

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  98. I have had my Mirena for almost 5 years now (in September). I had endometriosis in the past, and Mirena was the only thing that stopped my period pains. For three years I loved it! About a year ago my breasts started getting really tender and painful, and it was in synch with my monthly cycle, although I don't actually get my period. The doctor said that this can be common as Mirena reaches its end. The problem stopped after a few months. Now a year after this, I have lost my sex drive. Of course this could be due to other things, for example being in a long-term relationship, but it feels kind of sudden, and physical, not psychological, as if the sexual part of my body has shut itself down. Instead of the swollen, painful breasts of a year ago, my breasts feel lifeless and dead. I need to decide if I want to renew Mirena, (and if it is indeed what is causing this lack of libido) or risk the (potential) terrible period pain of endometriosis. I'm 35 without children.

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  99. When it is time to change one's Mirena is a good time to have a brief break, and any necessary work up to see if in fact the symptom that one is experiencing are actually due to the Mirena, or other medical conditions that may have developed. If low libido or what ever symptoms have developed resolve with Mirena removal, then other forms of contraception can be discussed. For those who live in the Central Illinois region if they have recurrent pain from endometriosis they may be eligible for a research study on a new treatment and should call 217-356-3736 to inquire. Thanks,

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  100. I've had mirena for 3 years this month.. I have had a loss of sex drive! I love my husband and am still very attracted, but I just have no desire what so ever to have sex. This is a big issue in our marriage & I feel it's mirena. It's been this way since I got it, and it's now making a big problem. Please help.. I wanna be sexually there for my husband & have a sexual relationship.. But find it hard to be intimate at all. I just don't want to. Any advice on medication or vitamins to take with mirena?! I love mirena & don't wanna take it out.

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  101. When women report an immediate drop in sexual function after beginning a Mirena IUD the gynecologists are not inclined to think that the Mirena is the ultimate etiology of the problem. From all we know about sexuality women tend to have a balance of enhancing and depressing factors that contribute. Medical examination is important to rule out treatable causes of sexual dysfunction when it becomes a significant issue. After that there are a few treatments depending upon the etiology, but none of the over the counter treatments has been shown to have significant effects.

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  102. I had the Mirena inserted when I was 27, 8/08. I THOUGHT it was the best thing ever, since I stopped menstruating, which led to 80% less migraines. The insertion was pain free,other than when the MD asked me to cough, I almost literally passed out and scared the staff. They kept me there for observation and was sent on my way after a half hour. Experienced the horrible back pain and cramping which I was told was normal-no prob. Over the course of almost three years, I gain 20-30 pounds, did experience subtle changes that I never attributed to the IUD. Well, recently-there was no ignoring the hormonal changes. I had heart palpitations, hot flashes, night sweats, eye twitching which lasted over a month, problems breathing, a heart rate/pulse that reflected a workout rate and not a standing/sitting one...which is what I was doing at the time. I requested to have my TSH and T levels tested since I believed I was experiencing Hyperthyroid symptoms. At the Dr's office, they were trying to convince me I was depressed, when I mentioned nothing to make them think that. They assured me I did not seem like someone with a thyroid problem, but humored me anyway with the blood tests. The next day...TSH 0.01! Gee, I was right-hyperthyroidism! I suggested the Mirena and was told there was no chance of the Mirena causing thyroid problems. I was scheduled with the Endocrinologist and by that time, I had done my research and realized there was WAY too many cases of women suffering the same signs/symptoms as I was due to the Mirena. She of course, blew it off. I had it removed, lost 5 ponds in R days, and 2 inches off the Mirena belly. I feel way better, and will re-test my levels in 6 weeks, will then follow up with the Doc. I will file a complaint on the Mirena with the FDA, because it is so dangerous. The dangers outweigh the benefits. Your thyroid is something you do not want to mess with. The fact that so many Dr's are clueless on these life-threatening results is scary. Seeing as these problems gave been out there for years, I should have never been offered this dangerous device. Bayer/Mirena has fooled us all! Something needs to be done to take this off the market a.s.a.p!

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  103. 5 pounds in 4 days, sorry for the typos...it's past my bedtime. I think the correlation between Birth control, even supposed" low level" hormone b.c. and thyroid problems is too common to ignore. There's no coincidence there. By the way- there is NO history of Thyroid problems in my family history.

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  104. Any associated problems with a device can be directly reported to the FDA. The FDA tracks patient events and compares the number of events in women on the device to women not on the device. To date there has not been an association between hyperthyroidism and IUD use. There are statistics of risk available for Mirena (and all) IUDs. A woman has to weigh the risks of pregnancy, the risks of other contraceptives, and the risk of Mirena use, before getting the device. For most women, the benefits far outweigh the risks. Thyroid disease does not have to be familial to be acquired, so the fact that a patient has no family history, doesn't exclude any particular diagnosis in these cases. We wish you luck in sorting out your symptoms and arriving at treatments.

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  105. I thought so far I would post a positive comment for anyone interested. I have had 2 children in the past 8 years and just had a mirena placed yesterday 5 months after my second was born. I had taken 800mg ibuprofen prior to its insertion; but when I went in and had it placed I felt very little pain! Mostly pressure. With that said - I think we need to take into consideration that pain is subjective and will vary from person to person. I mean, my pain thresh-hold could be higher than yours. If you know your not good with pain make sure you medicate yourself with something prior to the procedure juuuuust in case :). I did just in case lol, though I knew it couldn't be any worse pain then having 12 hours of labor contractions. And I also do believe having children probably makes the cervix more pliable for insertion and less painful to some then someone who hasn't had kids. In that case do take something for pain prior too it, especially if you have a very weak pain thresh-hold on top of it. I am on day one after insertion and I feel great......so far. Its only been 1 day. But its gotta be better than being on BC pills. The estrogen made my BP go through the roof, and its comforting that the progesterone in it is so much lower than BC pills. As for weight gain i'm just going to continue working out and eating right like I have been. Keeping my fingers crossed, and keeping a positive mind over here! Good luck to all the other ladies who want the mirena!

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  106. Thank you for your comments, and as the physician for many patients very happy with their Mirena, it is important to remember the positives as well as any potential side effects! I strongly encourage women to contracept effectively, and that means choices and for many an IUD is an excellent choice!

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  107. I am 28 with two children under the age of 5. My husband and I decided to give the mirena a try since the nuva ring turned me into a psychotic mess. It's been awesome. Yes, he can sometimes feel the strings but they don't bother him. The mirena has actually increased my sexual appetite tremendously! I only wanted sex about 5% of the time. Now, it is about 95%! My husband is much happier and so am I!!

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  108. I HAD MY MIRENA FOR a year and a half, or there abouts. It was painless to get put in, although I just had a baby so I think anything smaller than a babies head at the moment was painless lol. Non the less, I rarely had a period, felt like once every 2 months or so, and when I did it was just spotting for a couple days. I was very happy with the Mirena, however my sex drive NEVER came back. I think that was the worst, i rather have a monthly period then no sex drive. I rather go to bed and read, then you know. lol I had to force myself to have sex with my hubby. I got it removed, was just a bit of pressure, but no pain to get removed. And good news only bled for a few days, and even better I HAVE FINALLY HAD A ORGASM after near 2 years!!!!!! Good luck! x

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  109. I got the Mirena almost two months ago and I am less than pleased at this time. I've bled every single day since it was inserted. I'm starting to think it's so good at preventing pregnancy because who wants to have sex if they are bleeding every day?

    The other thing is I feel like I am totally hormonally out of whack. My sex drive is sky high. It doesn't seem normal. I am thinking of sex all day every day. It sounds like a good thing, but it's not. My breasts are tender and sensitive. I do not know what is going on with me but I feel like I am on a roller coaster. I don't like it.

    Will this even out? Will the bleeding stop? Will my hormones regulate and become normal again? If not, I must get this thing removed.

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  110. Hormonal symptooms after Mirena are in this post: http://gynogab.blogspot.com/2010/08/new-hormonal-symptoms-on-mirena-iud.html, and then there are issues for the women who have been on birth control pills and the switch over is a few month adjustment. Spot bleeding without complications resolves over the third or fourth month. Irregular bleeding that is prolonged can mean a variety of conditons that should be evaluated for: pregnancy, tubal pregnancy, uterine polyps, infections, uterine fibroids or device displacement. First you need to see your gynecologist for a diagnosis, and then you can find out if you have a condition to treat or not.

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  111. i had my mirena inserted in january 2010 after my second child. i love it for the fact that i dont get my periods but recently i have hade a decreased sex drive. i only have sex with my husband to please him but i could honestly do without it. i dont like this because it has recently been causeing arguments between us. i want to resolve this issue and im not sure if my decreased sex drive is caused by my mirena or something else. i am generaly happy and not to stressed but i just never wanna have sex, esspecially oral sex. im just not into it at all.

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  112. Every woman who suddenly develops sexual disinterest should be screened by a health care professional for depression, and depression is a more common cause than your Mirena. Although women may feel they can accurately self diagnose depression, they often can’t, and in some settings the number of symptoms of sexual dysfunction can actually be part of the diagnosis of depression. If it’s depression that needs to be treated, then the sexual function component will likely resolve as the depression is treated. For women who develop a disliking for a particular kind of sex, libido is not typically the issue, but you may in fact be suffering from other problems: performance anxiety, nerve function abnormalities, vascular abnormalities, medication side effects (other than the IUD you are asking about) or have developed a sexual aversion disorder.
    We have learned recently that women often do not distinguish between desire and arousal problems. Arousal may be either subjective (thoughts, feelings) or objective (genital vasocongestion or lubrication). Arousal problems can often be solved by counseling, mixing it up a bit, working with your partner, or actual treatments by your gynecologist.

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  113. I am getting an IUD inserted in January and I was wondering if the Mirena is likely to have any similar side affects to the Seasonique pill. I was given a bunch of Seasonique samples from my old doctor but it COMPLETELY ruined my sex drive. If that is, indeed, a risk because of the progesterone in the Mirena I probably will get a different one (and if so is there one you could recommend?)

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  114. Mirena IUDs should have less ovulation supression and more normal levels of estrogen and progessterone, but for some women the addition of estrogen back may improve their sex drive. LoLoestrin is the lowest estrogen pill we now try that first, but it is a 24/4 cycle which might keep ovulation at those very low levels that still decrease testosterone levels. For those who want the most old-fashioned pill a Ortho Novum 1/35 or a generic of this may work. Buproprion has worked for some women and you may want to try this before IUD removal. It's use for sexuality is not FDA approved.

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  115. I would like to comment on the Mirena IUD insertion. I'm 26 yrs old and I have a 1-yr old. My doctor stated that I was a good canidate for the IUD. I took advil before the procedure and waited until I was on my period (as the doctor suggested). I had mine put in on July 27, 2011, and after all of the horror reviews, I was terrified of the insertion process. I want to say the process was NOT BAD AT ALL, and I would recommend to a friend any time. I got myself worked up for nothing. For me, it didn't feel no more than a menstral cramp. I had slight cramping the following night, took advil, and I am feeling great 4 days into. My sex drive has returned, but I'm waiting 7-days post to be on the safe side. I have slight spotting, but nothing that I can't deal with. I had been on OC's since I was 15, after having my first child, they weren't working with me hormonally (loss of sex drive, moodiness, breast tenderness, etc.) Since I have been on the Mirena, I am already feeling 100% better. I feel great, and my sex drive is returning, and I have also lost 2 pounds (which I things is water retention from the OC's). For anyone considering the Mirena, I would recommend at least trying it. Many people will comment on negative rather than commenting on the positive. I hope this comment helps others to make a wonderful decision!

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  116. Thank you for writing about your good experience with Mirena IUD. For our patients interested in Mirena IUD we suggest a consultation visit to discuss all the contraceptive options so that we can help women have effective methods that suit their lifestyle and health!

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  117. I'm on my second mirena coil totalling now 7 years and it has been fantastic. No more periods and less PMT which is a total bonus. As for sex drive, thanks to mirena, it is much higher. I couldn't praise it enough.

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  118. Excellent news about your successful sue of teh Mirena IUD! Birth control should be "forgetable" or "seamless" with one's lifestyle. Thank you for sharing your experiences with us.

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  119. I am 28 years old, married, and have no children. I started taking birth control pills about 7 years ago for my heavy painful periods. This was before I became sexually active. I think this is why I never noticed I have never had a sex drive. Once I started having sex, I attributed my non existent libido to other factors, but now I realize it may be due to the pills. I spoke to my gynecologist about this and one of her suggestions was Mirena. Do you think Mirena would be a good option to help me have a sex drive? What about the supplement Hersolution?

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  120. When women ask about specific herbal formulations, for whatever indication, it's first important to investigate the ingredients and check with your gynecologist as to the safety of that formulation. For instance, the recent writer is asking me about a supplement that contains DHEA as a "natural ingredient". It's a potent adrenal hormone with potential male hormone side effects, that could affect your natural production of that hormone. The newest thought is that both desire and performance are actually linked as one disorder so beyond checking before using non-prescription sexual enhancers, it is a good idea to have a gyno visit to make sure there is not something physiologic wrong. Beyond that, in a woman who may have her own hormones suppressed by oral contraceptives, Mirena may in fact be a good solution for both excellent contraception, and a more normal cycle. If the levels of hormones are causing your sexual issues, then this should help. Keep us posted on how you do! Thanks

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  121. I've noticed a number of posts stating concern with all the negative reports on Mirena. I've only had mine in for a few months but I love it so far. No pain or discomfort. Periods are a little sporadic but barely even noticeable, like the last day when you barely have to wear a lightday because it's so light. There was cramping the first day or two after insertion but none since. My sex drive has skyrocketed, which is my only complaint so far because it was top notch to begin with and now I want it daily or more. No dryness or discomfort during sex, though the first time I has sex after insertion felt a little different. My partner doesn't feel it poking him. I could say I'm more tired than usual but that's the fault of my schedule and my own irresponsible insistence on staying up far too late and getting up early for work then working a minimum of 12 hours and repeating my ridiculous habits. I struggled with depression, anxiety, and irrational thoughts while I was on NuvaRing, suspected cause being the NuvaRing exasperating my already insufficient production of Serotonin. No such struggle on Mirena. I give it a HUGE two thumbs up.
    Remember, people tend to be vocal when there's something to complain about but remain silent when everything's hunky doory.

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  122. Hi, I am 29 years old, with two children. I have had the mirena iud for 11 months now, and have so many of the same complaints listed on this posting regarding libido. I, too - thought it must've just been me, since mirena's website led me to believe there would be no sexual side effects. My question is this: since this birth control is so reliable and effective (and was so expensive), are there ways to boost libido, without removing the iud? Thanks for any help!

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  123. We have always thought that there should be ways to medically boost a woman's libido. And there are various herbals and medications have been tried. Couples therapy and basic wellness strategies (good sleep, low stress, planning date nights) have been as successful as medications. The most important step is to get a diagnosis and at Women's Health Practice we use screening tools. If just HSDD (hypoactive sexual desire disorder) is the complaint The anti-depressant Welbutrin can have a positive effect, if one's testosterone is low then male hormone use can have an effect, and for those with a component of orgasmic disorders viagra or related compounds can be tried.

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  124. I'm 30 and before I got on Mirena, my boyfriend and I enjoyed sex 2-6 times a day! This is what has always been normal for me. After getting on Mirena, I noticed a sudden sense of generalized anxiety. This ebbed after a few months, but I noticed a gradual decrease in my libido. It's been over a year and I now have to push myself to have sex with a man I've had a crush on since kindergarten even once a week!! It also took a year before I stopped bleeding 21 out of every 30 days. Sex is uncomfortable at the least and otherwise comes with sharp pains. I've been examined by the doctor at intervals and there is no problem with the placement or anything else. At the moment, I have no medical insurance or I would have it taken out because I've simply had it!! I'm normally a very sexual/sensual person and this has taken it all out of me! I was on Wellbutrin at one point to quit smoking and I will never do it again. I had such horrible mood swings and they only got worse.

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  125. I should also say that I DID NOT quit smoking on Wellbutrin, so it wasn't the lack of nicotine causing me to be weepy over nothing.

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  126. First I would like to address your comments about attempted smoking cessation; I need to say that as the number one cause of preventable death, and the cause of untold other health consequences, one of the top priorities in any woman's health is to stop smoking immediately. Smoking also has consequences on one's gynecologic health and can interfere with estrogen levels, and for some one having problems with irregular bleeding on a hormonal method of contraception should consider that the smoking may be playing a part. Nicotine is very addicting, and the nicotine withdrawal syndrome can occur even if the amount of smoking is only decreased slightly. Only about 5% of smokers can quit without some aid to quitting. The sustained release type of buproprion (Welbutrin SR is identical)is approved for smoking cessation and at least doubles the rate of quitting, and in studies with additional counseling and guidance almost 50% of people are able to quit making it a very successful strategy for many people. Some women can successfully quit with a lower dosage if they didn't tolerate the full dose, and many have to stay on the therapy for beyond the typical 12 weeks, and take it for a full 6 months. Varenicline has beaten buproprion in at least one head to head trial, so women should consider this alternative as well. One diagnosis I consider in patients with unexplained pain with an IUD is infection. This can be diagnosed by biopsy, but it can also be treated by presuming there may be a low grade infection and having the patient take a course of antibiotics. Women who have normalized the irregular bleeding they had initially with their IUD typically can have their pains resolve as well.

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  127. Ack! I had the Mirena inserted two weeks ago. My breasts are so sore that I have to sleep with a bra on and going over road bumps is excruciating. I also have a huge, painful zit on my chin--the deep, embedded kind that can't be easily relieved. Not something wanted or expected at age 47. This is miserable and all the effects started with the Mirena a couple of weeks ago.

    On top of that, my sexual response is lacking. Touch feels as good as ever and I can be aroused, but climax seems just out of reach. This is why I quit the pill years ago.

    So much for, "the hormones don't enter your bloodstream." Very clearly, they enter in large enough quantities to have misery-inducing effects. Who wants to have sex when in pain and unable to climax anyway?

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  128. I will say that insertion was not too bad and my partner has absolutely no problem with strings. I had high hopes for relief of menstrual pain.

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  129. The average age of menopause has been quoted to be 51, but recent studies show that it is nearer to 49. Even if women will go through menopause soon the IUD can be helpful to women taking menopausal hormones. Women in the transition process will have a number of hormonal issues, and may even have high as well as low hormone levels. For women who have a Mirena inserted close to the natural age of menopause they should consider where they are in the menopausal process when understanding their risks and benefits and any possible side effects. We ask that patients please also review the possible bleeding patterns on Mirena to understand what to expect in the first 1-3 months. Two weeks after Mirena insertion is not enough time to assume that the use of the Mirena will not be successful. It would be important to see your gynecologist if you are having dramatic side effects so that she (he) can help you work through the transition and understand if your symptoms are likely to resolve.

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  130. I am in dire need to regain my libido but am fearful to see a doctor to find that I have no problems and there are no solutions. I have had the mirena ever since after my first child. Also ever since then I've had no sex drive. I attributed it to being a mother but almost 4 years later nothing has changed and it has now decreased into non existent. My husband has been deployed for 4 months now and I am enjoying not having to have sex, I haven't missed it one bit. I am only 24 and had no problems before childbirth/mirena. There really aren't other options for me though as I am very fertile and very forgetful. I've read there is no viagra type treatment which is very discouraging.

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  131. (cont from previous post) is there anything I should request specifically like hormone testing or something else?

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  132. There is no doubt that working on libido without a partner who is around is very difficult and makes solving the problem in the short run even more problematic. For those who have new onset sexuality problems an examination can determine if there is any anatomic or neurologic problem contributing. A few simple blood tests can determine if there is anything physiologic that can easily be corrected: thyroid problems, anemia, diabetes to name a few. Then the sexual issues can be evaluated. So I do think it is worth seeing a physician

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  133. I also have a different stance. I was previously on Depo and the pill and I had no sex drive what-so-ever. Now, I have the Mirena and I have a high sex drive. I get the occasional cramping, but it is well worth not having the worries. My husband does not feel it at all. The Depo had me losing hair. I must say that my appetite did increase on the Mirena as well because I was dieting and had no problems sticking to my strict diet before the coil. However, I have not gained weight, but I did with the Depo (might have been water weight). I convinced my friend who had the IUD for many years to get the Mirena and she said that she hasn't had any problems either besides the occasional cramping, but she just got it 2 weeks ago. She said that her mood has been better than it has been in the previous years. Before the IUS and with the IUD she used to just wake up and hate her husband for no reason. She also said that she thinks her sex drive has increased.I think that different birth control may affect different people in different ways. By the way, I have heard some saying that sex is uncomfortable and painful; this is not the case with me. I do not know that it is even there. After three children, this Mirena is the best thing that I could have done. All birth control have some type of side effects, even the Depo causes a decrease in bone density.

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  134. Interesting that your sex drive improved on Mirena verses the Depo-Provera shot. It is also reported by others, and we are glad to hear about it. You mention that the Depo-causes decreased bone density, but readers should interpret that statement with caution. The World Health Organization doesn't have the warnings about Depo-Provea and bone density that the US FDA has. Pregnancy and breast feeding decrease bone density as well, but there's not evidence that the amount of decrease is significant in terms of fractures of the bone. Health women should not think that their bones are being harmed by Depo-Provera use.

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  135. I AM 21 YEARS OLD, I PLACED MYSELF ON THE MIRENA BEFORE I STARTED COLLEGE 4 YEARS AGO AND I HAVE BEEN HAVING A NUMBER OF ISSUES THE PAST YEAR AND A HALF! AT FIRST I LOVED IT! NO PILLS, NO PERIODS, NOT PREGNANCY SCARES! HOWEVER THAT WAS UNTIL THE MONTHLY YEAST INFECTIONS THEN THE UTI'S INCREASED TIMES 3!! AND I REALIZED MAYBE IT ISNT WORTH IT!....OVER THE PAST WEEK I HAVE BEEN DOING TONS AND TONS OF RESEARCH TO SEE IF ITS ONLY ME WHO HAVE ENCOUNTERED THIS LOW SELF DRIVE, OR MAKING THE MONTHLY DOCTOR VISITS FOR ANTIBIOTICS, JUST GOING THROUGH THE WORST BACK PAINS..I SEE NOW THAT I AM NOT ALONE!! AND JUST MAYBE MY MIRENA IS TO BLAME! I MYSELF WOULDNT RECCOMEND ANYONE TO USE THE MIRENA! I CANT EVEN ENJOY A NICE BATH WITHOUGHT KNOWING SOME TYPE OF INFECTION WILL FOLLOW....I DO APPRECIATE EVERYONES COMMENTS AND ADVICE, GOOD AND NEGATIVE! HAPPY HOLIDAYS!! :)

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  136. I'm 22, never used any forms of birth control or had any sexual partners before. I am getting married soon and I am considering birth control. The IUD's seem like the most convenient methods but I am scared to start using ANY form of birth control since I don't know what to expect/how my body will react to sex and especially to hormonal birth control. I'm worried about losing "sex drive" or possibly damaging my fertility.

    What form of birth control would you reccomend a woman like me use?

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  137. For women who are not sexually active, and have a chance to plan their contraception before becomming sexually active, as you ask when planning your wedding, it's a perfect time to sit down with your health care provider and decide what sort of contraception is the best. Everyone needs their list of priorities. Are you forgetful and would you find taking daily contraception difficult? Do you have heavy periods or acne that you would like to also treat with your contraceptive method? Does your partner have preferences? How soon do you plan children and how would you feel about a failure. These are they types of individual questions that are very helpful when planning which method to choose. For those who are protected by the Gardasil vaccine, and not at risk for STDs, then STD protection is not going to be a factor, but for some young women this will be very important. Neither pills or IUDs protect against STDs! A gynecologic exam doesn't have to be done before birth control pills, but we do require one before getting an IUD, so without having examined a patient I cannot completely accurately say if an IUD is an option, but they are very convenient as you mention and there are IUDs that do not have hormones in them either so they can be an excellent choice!

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  138. Do you have any advice on how I would go about getting a frame-less IUD, such as the gynefix that's been used for years in Europe? Is there any way to get involved in a clinical trial here in the US? Or how about Canada. I'm not too far from the Canadian border so if they're available there, it might be a possibility. Other than flying to Europe, any other ideas?

    I need non-hormonal birth control and although I could get the Paragard again (and I know that it's a good method of birth control), I'd prefer something that causes less cramping and monthly bleeding, if possible. Although I've had one before, I did have one doc turn me away saying my uterus is barely large enough to accommodate it. That sounded a bit odd to me but she seemed really concerned about perforation (I've never had kids btw). But it occurred to me afterwards that maybe that's why it felt so damn crampy when I had it in the past. Does that make sense?

    Regardless, I've heard good things about the Gynefix and really like the idea of something smaller. Any thoughts on how to get one would be much appreciated. Thanks.

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  139. I am 41 years old and have had the Mirena IUD for 4 years. Which is almost the last time my husband and I had sex. I have ZERO sex drive, acne and no periods. My GYN visit is in a couple of weeks and I'm seriously considering having the IUD removed. I am thankful to have found this site to see that perhaps it's the Mirena lowing my sex drive. It has really become a problem between me and my husband. Also could I be premenopausal?

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  140. For women who think they are premenopausal (we use the term perimenopausal more often now) it is possible to see your gynecologist to have a medical evaluation to determine if your sympotms are due to menopause approaching. If menopsaue is approaching it's not as likely that removing the Mirena IUD will help your symptoms of low libido and acne. If you are not premenopausal, and you are in your last year of the Mirena IUD use, it might be reasonable to try another form of birth control to see if your symptoms improve.

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  141. I'm 28 just had Mirena removed and I'm so happy I did. My OB said my periods would likely stop and that there are very few side effects and it's so much better than the pill for a number of reasons. I had Mirena for a year. Before Mirena my husband would get upset because I ALWAYS wanted sex. When I was on Mirena I had absolutely NO LIBIDO. I had to talk myself into having sex with him. I had acne so bad, black heads white heads and deep painful zits. My hair was a grease pit with severe dandruff. I was so moody anything could set me off and I would blow up. I couldn't Lose any weight. I was getting sharp stabbing pains and random bleeds so often I'd rather have a normal period. When I had it removed it didn't take long I started losing weight without changing habits, my scalp, my face my mood & oh yeah baby, that libido is back! I feel like myself again. It was like I had been living someone else's nasty miserable life. I'm pretty sure I have better focus and clear thoughts & concentration not sure why. I'll NEVER get Mirena again. When I had it removed my ob said Mirena couldn't be the cause of lo Libido etc. But I'm positive my libido is back I even wake up frisky.

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  142. Thank you for the story of the return of your libido, your concentration, and it will be interesting to hear if your skin clears up. The scientist in me says that when women say "I just had my Mirena removed and my symptoms have resolved, " I try to caution other women to understand that the effects after days, weeks or months months can be quite different. And most importantly, the reader doesn't tell us what sort of contraception she is now using. For someone to make a decision about changing birth control many factors have to be considered, and if you can accomplish the benefits of another method with the successful prevention of pregnancy with the other, then it is a good choice to switch. For a successful long term outcome, it's important to have an effective contraceptive that you can be happy with. For many, that may mean keeping the Mirena it's five years, then switching methods.

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  143. I am 25 years old. I had the Mirena inserted about 8 weeks after I had my son a little over 2 years ago. The first couple months after insertion I cramped so bad I was perscribed pain medication, slowly the cramping dissipated, so did my period, and so did my sex drive. It's wonderful not to have a period but this libido is just not like me!! I am in a very happy fulfilling relationship and I just don't understand why I have absolutley no desire? This has lead me to believe that Mirena is part of the problem so here I am doing research and I am finding I am not alone. My thought is to switch to Paragaurd as we are not looking to have more children for a long time and I want to be hormone free and see if it gets any better...

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  144. One thing gynecologists are lacking are good treatments for low libido, but there are some that do work. When someone says their libido is down, before just quickly switching contraception, it would be important to see your gynecologist and get evaluated. There are various types of female sexual dysfunction and it helps to resolve the issue if one has an accurate diagnosis.

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  145. I have had the Mirena for a few months now. When I first got it I bled for two month non stop. It was not fun.. My doctor told me it was normal because of my history. I have finally stopped bleeding. The only thing now is that i have had a huge increase in my sex-drive. Before the Mirena I had no sex drive what so ever. Now its in over drive.. Is this normal?

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  146. Sexual dysfunction in women is still incompletely understood. In the 1960s it was thought that the oral contraceptive pill fueled the sexual revolution because couples ithe successful contraception were less inhibited when they didn't have the worry of getting pregnant. Those that lived through the sexual revolution would argue that cultural and psychological factors were as important in the sexual revolution. A couple who has successful contraception now with a Mirena IUD may be experiencing their own sexaul dynamic improvement, and thus experience better sexuality. Oral contraceptive pills would decrease the female ovary's production of testosterone more than the small amount of hormone in the Mirena would, so there are hormonal changes. Although individual women may respond to these hormonal differences gynecologists have never been able to exactly tag sexual dysfunction to specific hormone levels or changes. Libido changes, however, are common wiht a variety of gynecologic conditions. But we do like to tell our patients that Mirena IUD use is a safe and effective method and we do recommend it for many of our patients.

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  147. I am 31 and I have had Mirena for almost 2 years and my sex drive is through the roof. It's really getting frustrating. My husband and I have a great sex life, but even he can't keep up with me and it puts a strain on our relationship. I am so close to having it taken out just to keep my sanity and put an end the sleepless nights. However, I chose Mirena as a possible treatment for my Endometriosis, since other drugs weren't an option for me, and it does seem to be helping with that. So, I feel really trapped into keeping this thing, especially since we didn't want a baby right away. I just don't understand how the drugs in Mirena can completely kill sex drive for so many and ido the exact opposite for others. I don't know what else it could be in my case. I can have completely satisfying sex with multiple orgasms and be woken up by my physical needs early the next morning. I hate it and my husband doesn't understand.

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  148. Any hormone treatment will affect the balance of hormones in one's body. This is why it's not unreasonable that the same treatment will have virtually opposite effects in different women. It's also important to remember that these case studies are glimpses of the patient's and we cannot hope to understand all the various contributing factors of a case from just a brief blog post. This reader is asking about why she should suddenly, after Mirena insertion, become over interested in sex, both physically and emotionally; and furthermore, what to do about this behavior. Any new hyperactive behavior that is destructive to one's social, family or work life is definitely worth talking to your health care provider about. The medical term for overactive sexual desire to this extent is hypersexuality and it's clinically, in the psychiatric sense, associated with bipolar disease. Thus we advocate proper medical evaluation as this is a condition that would actually need treatment, and is highly unlikely to be related to getting a Mirena IUD. For some one who is just a bit extra interested in sex, and it's not gotten to the hypersexuality stage, then it's usually a need for the high endorphin (happy hormones of the brain) levels. Endorphins can be stimulated in other ways than sexuality: for some it's high levels of physical activity, for others it's having your favorite chocolate treat. AT Women's Health Practice we'd begin with a sexual history and basic hormonal evaluations before making recommendations. Thanks for writing.

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  149. I got my first Mirena when I was 18. No complaints, it was great- for about 2 years. Then one day my boyfriend (whom I had been with for a year) started to feel the strings poking him (about 50% of the time) and I started to have heavy bleeding during intercourse (most of the time). After several trips to my doc, I got it removed. So for the next 3 years I went on oral contraceptives with no issues until I lost my insurance. So I decided to give Mirena another try. From the day the Dr put this one in it has felt completely different; I have felt completely different. I had terrible cramps everyday for weeks- and I NEVER get cramps. So we decided to wait to have intercourse for 2 weeks because we were scared to have the same issues we ended up having with the first Mirena. The second or third time we had sex it lasted about 5 seconds until I was doubled over with pain comparable to my labor pains. I was paralyzed to the bed in tears. This one long, everlasting cramp lasted about an hour until I finally fell asleep. When I saw my Dr, he said my uterus was probably inflamed and gave me some antibiotics. I have now had the Mirena for 2.5 months, I still cramp almost daily and my sex drive took is completely nonexistent. It is definately putting a big strain on our relationship. We are so in love but sometimes when he touches me intimately it makes my skin crawl. And Im only 23! I havent felt like myself since the Mirena has been put in. I want to get it taken out, but I dont have the money to go back to OCs. Somethings gotta give.

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  150. I never fully recovered from Mirena. My body lost the ability to produce balanced hormone. I had Mirena when I was 23, took it out one and half a year later due to lost of libido and difficulty in arousal. After removal, I got my period back, but it's much lighter than the time before Mirena, althought I'm already 3 years after removal. Sex drive never come back to normal neither.

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  151. Mirena has strings, as all IUDs do, so that patients can feel for the strings and confirm that the IUD is in place. The strings also make removal much easier. Most men do not feel the strings at intercourse, and for those that do, they don't find them bothersome. For couples who find the strings a problem, they can be cut doen to behind the cervical opening without harm or affecting the IUDs performance. It is not often necessary to remove the IUD if the only complaint is feeling the string. The amount of hormone in a Mirena IUD is virtually gone from one's system within days of removal, and symptoms that persist beyond weeks are most likely due to other gynecologic conditions. Desiring sex, enjoying sex, and preforming sexually are linked in women, but they are three separate functions. Someone who develops sexual aversion disorders, such as not wanting even their skin to be touched, is an unusal side effect of an IUD use and there may very well be other causes of these symptoms.

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  152. Hi, I just had a consultation with my doctor as I have been on oral contraceptive for 9 years and do not have such a sex drive. I never knew it was so common! She is going to get me an IUD but I wanted to read her to see if anyone felt great improvement in terms of sex drive once they did change from oral to IUD.

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  153. My symptoms are similar to Anonymous above from Feb 10th. I was 22 in September '10 when I had Mirena inserted. I was miserable on it after about 6 months: gained 10lbs (on a 100lb frame this was a lot for me), was much more irritable when I'd never had irritability as a PMS symptom before, and worst of all I had ZERO interest in sex, and when I did try to have sex to please my SO, arousal and lubrication were very limited. I had the Mirena removed in late April '11 and my periods still haven't returned to what they used to be, and my desire still hasn't returned like it was pre-Mirena either. Luckily, the weight eventually came off on its own without me attempting to lose it. I'm still searching for solutions to my libido issues.

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  154. Thought I should comment as the balance of comments here is sadly negative. I've just had my 3rd Mirena fitted - and it will probably take me through my menopause. As a youngster - I had very low sex drive on oral contraceptives (and even before them), and assumed it was just an oddity of mine. On Mirena I had a noticeable sex drive. Sadly I let my last Mirena over-run it's change date since sex was not happening in my relationship - and my sex drive became very low. I assumed this was due to the imminent/beginning menopause. Imagine my delight when 5 days after the insertion of my 3rd Mirena (for protective effects during the menopause) my sex drive has come roaring back in - wow. It's well worth the very short lived discomfort of the fitting/changeover that I have, as a woman who's never given birth.

    PS Mirena also stops my periods completely - and I never get cramps with it :-)

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  155. I am 42 years old and have had the Mirena IUD for 4 years. While I love not having a period or the worry of birthcontrol, I am overwhelmed with other symptoms: constant fatigue, brain fog/poor memory, depression, headaches, and NO libido! I had my estradoil level checked and it was 37, FSH 15.5, and LH 6.3. Am I perimenopausal or is it the IUD?

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  156. Most women do have very positive experiences with the Mirena IUD, and do come back to be fitted with another when their duration of use of their first device times out. It is interesting to hear about individuals using their 3rd and 4th IUD sequentially as there is not much published regarding very long term use, although it is considered to be safe. For those women with symptoms of the fatigue, depression, mood changes and libido issues having hormone levels checked can be somewhat helpful, but a consultant would need to know a lot more than just a couple of random hormone tests to give a real opinion. For most women FSH levels under 20 (in some laboratories higher levels are still normal) means that you are not in menopause, but someone with a normal FSH reading could be far enough into perimenopause to be symptomatic. I suggest getting a PMS tracking chart (there is one in the Women's Health Practice site), and track symptoms relative to menstrual bleeding, ovulation and diet to help your own gynecologist make a diagnosis for you. Thanks for all for writing their experiences.

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  157. I am seriously considerung getting the Mirena IUD, but am so scared after reading comments. Is it a good idea? I am also worried that the strings poke my boyfriend during intercourse? Is it dangerous to get the strings cut?

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  158. A patient today said "I love my Mirena and I cannot belive more women don't use IUDs!" Of course we know that millions of women do! In fact one estimate is that 70 million use in China alone! IUDs are an excellent idea for many women. Most men cannot feel the strings, but having your strings cut back if your partner is bothered works well for many women. But if you do have your strings cut you will loose your ability to check for the IUD and removal is just slightly harder as well. Many patients do get the strings removed and it works well for them.

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    1. Thanks very much for your feedback, i think i am going to move forward with it.

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    2. Can you get a Bacterial Infection from the IUD? i just had mine inserted a week ago and only after a few days there is an awful odor. i have had BV before but i am not having sex and havent in a few months.. I called my GYN and they never called back but acted like i was crazy. the nurse was going to ask the Dr. I know its something bc like i said its awful!!! im so embarrassed. I feel like if its something im going to have to deal with i dont really want to keep it. my Dr told me when i got it to be patient and give her 6 months. but i dont want this for 6 months. Please help.

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  159. I am 31 years old and have had my Mirena since October of 2009. I got it due to the fact that when I had my 3rd child I had a c-section and ended up with a blood clot in my leg a week later. My OBGYN stated I was no longer allowed to take the regular oral contraceptives for this reason. Once my cycle returned I suffered from what my OBGYN referred to as PMDD. She then informed me that yes, regular birth control would probably fix a lot of the symptoms I was having: depression, inability to concentrate, HORRIBLE mood swings, rage even at times out of no where, terrible cramps, and heavy enough bleeding that I had low iron levels for a week or so out of every month.

    I opted to do the Mirena IUD and haven't really suffered what many have complained about. The biggest problems that I have noticed is the libido & depression. Since we are in the military I visited my PCM and she just told me I was fat and I need to lose weight and that would fix everything. I do realize that this contributes to the problems, but doesn't explain everything. It is putting a strain on our relationship because I never have the desire to do anything anymore.

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  160. I got my Mirena 1 week ago. it hurt pretty bad having it inserted and for a bit after. so far i haven't had my period only mild cramping. but 3 days after getting it i have the most awful odor. ive Been reading about BV and think that might be it. i havent had sex in 2 1/2 months and got the Mirena because of heavy periods. I had my tubes tied. I have had a Bv infection in the past but not having sex it's not anything due to that. i called the Dr and they acted like i was crazy. I'm so upset because i know i stink something awful!!! I dont know if it should have it removed after only a week but im not looking forward to the small if this will happen every so often!!????

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  161. Bacterial vaginosis is common in women with or without an IUD. The insertion process, because of several factors can disrupt the normal vaginal bacterial flora and cause BV. Health care providers should be seen when you have a discharge and odor suspicious for the infection to try to confirm. For the woman asking about herbal formulations for sex drive the best tested one, is Avlimil. In clinical studies herbal medications, when used for libido, just barely do better than placebo, so the effect is not universal for all patients.

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  162. I Got my Mirena insereted 11 days ago. after insertion i had spotting for about three days, and now I have been bleeding ever since. Should I worry about this? What is a normal amount of time to bleed? Also when do I need to start worrying?

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  163. When a woman reports bleeding, her gynecologist needs to know more about the nature and character of the bleeding. Since the Mirena IUD has hormone in it, the initial insertion may cause bleeding and/or spotting and or trigger irregular menses. Most women who have a Mirena inserted will have irregular vaginal bleeding off and on for up to the third month. If there is pain, if the bleeding persists bright red, if there are signs of infection, or other associated symptoms then the patient with a new IUD should go back to her gynecologist and be re-evaluated.

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  164. Hello and thank you for your very helpful blog. I am 28 and married. I have never been pregnant but want to have kids in 4 or 5 years. I have been on various generic forms of microgestin fe 1.5/30 for about 5 years, depending on my insurance. Most recently I changed insurance on Jan. 1 and was switched from loestrin to gildess. I have had a very low sex drive since being on the pill, and hadn't experienced much change between other generics, but for some reason gildess has completely killed my sex drive, and has also given me more frequent migraines (2 a month, up from a few per year), nausea, horrible anxiety, made me always feel warm, and given me sleeping problems. I know that these symptoms could be related to something else, but I haven't changed any part of my routine and have actually started to exercise a little more and eat healthier, which it seems should make me feel better, not worse. I also notice that my symptoms tend to get better when I'm on the inactive week of my pills, and my internist tested my thyroid and it came out normal. So I'm blaming theg the gildess.
    At any rate, I've been thinking about getting an iud for awhile because of my low sex drive, and the new problems I've been having have only made me more convinced that an iud might be a good choice. I was set on the paragard because I wanted to be done with hormones and feel like myself again, but I went to see my doctor today and he strongly recommended Mirena because I've never had children and will likely have heavy bleeding on the paragard. Right now I'm torn. Do you know if there have been any studies done comparing women's sensitivities to birth control to the hormones in Mirena? If I have migraines and nausea on the pill, am I more likely to have them on Mirena? If I could be sure that Mirena won't kill my libido or give me migraines, I would pick it in a heartbeat because I've heard the cramps and bleeding on paragard can be pretty awful, but I also think that getting off hormones completely is most likely to make me feel normal again. I've also read that using ibuprofen can help minimize the bleeding associated with paragard.
    Apologies for the long rambling post. I would really appreciate any advice you can offer!

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  165. Many physicians are recommending that women switch from 30 mcg of estrogen to 20 mcg of estrogen, or even pills with 10 mcg of estrogen if you are otherwise stable and have been on the pills for several years. Oral contraceptive pills are very safe, yet for women who plan to be on them a long time lower hormone doses have some advantages in terms of potential decreased risks. If a perimenopausal woman reports lower sex drive on a lower formulation of oral contraception, it may be worth a temporary trial of adding low dose estrogen after consultation with your own gynecologist. For young women who find that they have lowered sex drive on oral contraceptives when they’ve previously been stable, it’s more important to seek other causes first.

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  166. This blog has been so interesting and I want to thank every person who has taken the time to share and to help other women with their stories. I was feeling uncertain about my decision to try Mirena, actually, UNTIL I read all this. I was on OCP or Nuvaring continuously for 17 years, no kids, married. At 35, I had become irregular with my period, it had become heavier and worse the lower dose pills I tried (including POP). I decided it was bringing me down libido and emotionally, so I just quit and we went to condoms. Which my husband hated. But my libido returned, I lost weight, my energy level went up, I was happy, I felt smarter, and I seemed to just become more sexual in some undefineable way. I became "magnetic". People said I was "glowing". But apparently, I just have too much estrogen naturally, and my periods, though like clockwork, just got even worse. I didn't know you weren't supposed to go through 30-40 super pads in one week of bleeding! I didn't want to admit there was a problem. But I became severely anemic to the point where I was on the verge of needing a blood transfusion. So I got a real Gynecologist (instead of the Health Department) for the first time. Turned out I had a thickened endometrium and lots of small uterine fibroids (non-cancerous tumors). I went on iron pills and OCP sort of against my will. It hasn't shrunk the fibroids and I have been bleeding 120 of the past 140 days, often severely. I had a D&C, and I was passing giant clots 3 days later, like nothing had ever been removed! Progesterone is the only thing that stopped the bleeding for 10 days. Dr. says I can't take it long-term and wanted me to have a Hysteroscopic Myomectomy to remove the fibroids. But I started doing research and decided I want to try Mirena first because:
    1--my bleeding and low libido can't get any WORSE
    2--though it will be expensive and my high-deductible insurance won't pay for it, it is bound to be cheaper than surgery
    3--it sounds like it will probably reduce my bleeding in the long term which is what I am aiming at, the fibroids only hurt when I am bleeding and cramping, so if that ceases, I guess I can just leave them alone. It also sounds like Mirena will help with the constantly thickening endometrium.
    4--the blinding pain I have been experiencing is bound to be worse than the temporary pain and cramping of IUD insertion, right? I still have some Lortab left from the D&C, I will take one before this thing if she says its OK.

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  167. ITS BEEN ONE WEEK SINCE I REMOVED MY MIRENA AND I HAVE NEVER BEEN SO RELIEVED!!! I AM 22 YEARS OLD..HAD THE IUD FOR 4 YEARS AND THAT WAS THE WORSE MISTAKE OF MY LIFE!! I HAD WHAT SEEMED LIKE HUNDREDS OF BACTERIA VAGINOSIS, U.T.I'S, YEAST INFECTION ETC! I LOVED THE LACK ON CYCLES...BUT I HATED THE FACT I ONLY WANTED SEX MAYBE ONCE A MONTH! AND EVEN THEN I WOULD HAVE THE WORSE PAIN DOWN THERE! THIS IUD CHANGED MY LIFE TREMENDOUSLY! LETS NOT MENTION THE MEDICAL BILLS & COST OF MEDICINE! SMH..I HAD SO MANY HOT FLASHES...CONTINUOS BACK PAIN! THE LIST GOES ON & ON! I THOUGHT IT WAS SAD I HAD TO DO MY OWN RESEARCH AND WITH THE HELP OF PEOPLE LIKE YOU ALL WAS ABLE TO FIND THE RIGHT DECISION TO MAKE, MY DOCTOR SEEMED TO ACT AS IF SHE HAD NO RECOGNITION OF MY COMPLAINTS BUT FROM THE LOOKS OF THINGS...IM SURE IT WAS ONLY FROM A PROFESSIONAL VIEW. I AM NOW ON THE PILL & THINGS ARE BACK TO NORMAL!HOPE U GUYS FIND WHAT WORKS BEST FOR YOU! :)

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  168. I have had the Mirena for a little over 2 years now. At first it was great because I didnt have to worry about taking any kind of medications or forgetting to take it. Also the whole period dropping situation got me happy because I have always been a heavy bleeder but after a little while I started to have cronic yeast infections, lots and lots of discharge which practically never go away and my sex drive has dropped so much my husband and I are having many problems because of it. My sex drive went from 1-2 times everyday to 1 every 2-3 weeks and if it is happening it's because I'm forcing myself to do it. Another thing I noticed is pain every time I get excited and there is little to no lubrication. Also, it's getting harder and harder for me to climax. Sex has become A TORTURE for me and my marriage is coming to an end!!!!! I just made the appt to get the Mirena removed and hope for my marriage to be saved.
    LADIES!!!!! Please, please, please look into it before you get it because what is happening to me can happen to you as well.

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  169. For women who develop chronic (ongoing) vaginal infections, sexuality virtually always suffers. It's important to solve the problem of a chronic yeast infection before attributing sexual problems only to the hormones in the Mirena device. When we see patients at Women's Health Practice for chronic infections, we try to evaluate the cause before tackling treatment, but most all those cases can be successfully treated. For women with sexuality issues who do not have vaginitis, a gynecologist visit can help determine if there are hormonal disfunctions or treatments that can successfully reverse the sexuality issues before taking out your successful contraception.

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    1. I've never had problems with yeast until the Mirena. MY OBGYN even confirmed it, it was due to the Mirena. There is no success in a contraception that has a very bad side effect like this one. Doctors should be more careful with what they recommend to their patients.

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  170. The Mirena package insert information from Bayer HeathCare does caution about the risks of pelvic inflammatory disease, but in the research trials done chronic yeast infection is not listed as a common side effect. There are many reasons that our vaginal environment can get disarranged and predispose us to chronic yeast, and hormone use of any kind can be a factor. For women with chronic vaginal infections, there are alternative contraceptive choices to be considered and could be discussed with your gynecologist. Read other posts about vaginal infections for further information. Thank you for your question.

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    1. i'd like to ask if my husband feel the IUD during our sex? and i'd like to ask also if we do any positions even if i have IUD inserted? what do's and don't during our love making?

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    2. Acidophilus tabs taken orally daily seems to help keep the yeast infections and BV away. Havent had another infection while on merenia if I take supplement faithfully every evening. Even helped with gassiness. Good luck.

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  171. This comment has been removed by the author.

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  172. I am a 37 year old women who in general always had great experience with estrogen based BCP. After time it just seemed Like a good idea to change over to nuvo ring for ease of use. This year, gainst my wishes, my doctor decided that since I still smoke(regardless of general good health and perfect BP)to change my BC for that reason alone. After happily being on nuvo ring with no negative effects or weight gain and awesome sex drive- to say the least I was pissed, but followed her advice as she had been my OBGYN for years and I trusted her. In March 2012 I had a mirena inserted. Insertion was painful at best, and with in 3 days started to experience negative effects as stated by others here, that continue to worsen. Since then I have not stopped bleeding or brown weird spotting, constant fatigue, low back pain and shoulder aches, brain fog, unbeliveable dry mouth, I am tired constantly, and 0 sex drive. Im sure this has everything to do with mirena placement.... too many consistancies with others posts and frankly I know my body is having a violent reasction to something - ONKY THING NEW IS MERINA. I have been with the same lover for 15 years and he even notices theses signifigant changes that are affecting our relationship, my quality of life, and complicating the everdays that come with just trying to hold my job down. Not really sure if I want to give up on this particular form of BC yet due to constistant reliable % without otping for permanent sterilazation. Wondering if I may be suffering estgrogen crash effect? Since I felt so wonderful and NORMAL on estrogen based BCP.... if an added low dose BCP would it help me with bleeding and feeling horrible? Honestly- extremely pissed at OBGYN for trying to fix something that wasnt broken as a "just in case" measure. I was happy, vibrant, engergetic, and bubbly person...... and now feel horrible, tired, miserable, and physically worn.. Want my life to be manageable again and having no sex drive is not an option... Any advice would be appreciated. Thank you.

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    1. Sorry about all the type o's, totally literate professional, but as I stated, constant brain fog makes the everyday mundane a bit difficult. LOL

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  173. I'm the one with the fibroids and thickened endometrium from May 9th. I had my Mirena put in 11 days ago and I just wanted to report that so far I feel great, have had no bleeding whatsoever since my last scheduled period. I attribute this to the herbal regimen I have been on for the past 4 weeks. My Gyno is keeping me on OCP for two cycles, so we will see what things are like when I stop the OCP (but remember, STARTING the OCP as therapy in January is what made my bleeding become non-stop for 4 months).
    Truly my only complaint is that they gave me Sidetec (spelling?) to help dilate my cervix before insertion because I've never given birth and it made me extremely sensitive, apparently. It is funny how they do so much for the pain of biopsies and D&Cs, but they don't do ANYTHING to prepare you for the pain of this procedure. It lasted 20 minutes because she had trouble finding my cervix (even though she found it for those aforementioned procedures quite easily. I was so completely tensed from the pain that I guess I pulled it up into my abdomen. My legs and arms were very sore the next day from clutching the table and tensing my legs. I didn't scream (the nurse said some women do) but I cried and found it sort of humiliating that I had to let a medical student (male, looked about 12) observe the ordeal. Although I am glad he got to see that it is a traumatic procedure for some women and maybe he will prescribe some valium or something before he puts someone through it! They said in retrospect that since I didn't find the biopsy to be painful, maybe they shouldn't have given me the Sidetec. Of course, if they didn't give me that, maybe it would have been even more difficult-IDK. Discuss these things with your Gyno beforehand! I'm sure it is different for different women.

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  174. Oh yeah, the reason I didn't take the Lortab before the insertion like I had planned is because they told me that if I was in a wreck on the way to or from the office, even if it wasn't my fault, I would legally be considered driving under the influence so if I wanted to take pain medicine, I should get a ride to and from. My husband and I can't afford to take any more time off work as neither of us gets paid sick days so of course I drove myself and I didn't want to tempt fate.

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  175. I have had my mirena for 7 months now, and although noticing a decrease in sex drive I have noticed a significant improvement in pain due to my Endometriosis and have had virtually no periods since 2 months post insertion.
    I was just wondering, is it normal to get random spotting for a day or two approximately every 2 - 3 months?
    Also, I don't want to get rid of my Mirena as it is the only thing that has helped me with my Endo (I had 2 laparoscopy's in 10 months), but wondered if there were any solutions to counteract the low libido? This is the only complaint I have about the Mirena!

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  176. In studies, in my years of experience, and in speaking to providers, most Mirena insertions are very well tolerated by patients. viders always feel badly for women who have a difficult IUD insertion, and luckily most of thse women will still have an excellent form of contraception that they will be happy with. There are certain medical conditions that can complicate Mirena insertions and it is possible for patients to dicuss with their provider as to whether they should anticipate complications at the time of insertion. Over time menstrual cycles on the Mirena may be reduced to occassional spotting. Any woman with bleeding should track her bleeding exactly and then discuss this with her provider. As for female sexual dysfunction, whether it is low desire, difficulty with arousal, or difficulty with orgasm, there are not specifically approved treatments. What we do is work on those biologic factors that improve sexuality, and decrease the biologic factors that inhibit sexuality, and that does seem to help our patients. We are currently enrolling a trial looking for women who do not have orgasams. Please call 217-356-3736 if interested.

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    1. Thanks for the response! I have been tracking these and am currently waiting for a follow up appointment with my provider next week.

      Unfortunately I am in New Zealand so doubt I could be involved in this study! Otherwise would be very interested :)
      If you ever decide to extend it over this far, let me know!

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  177. I have had Mirena for about 8 months. For me, its a very convenient birth control method. I hvent noticed a decrease in sex drive. I am and have been more interested in sex than my husband, and havent seen a decrease in interest at all. I am however concerned about high androgen levels and would like to take natural supplements to correct the issue. How much, if at all, would taking diindolylmethane, affect the effectiveness of mirena or would it negatively affect me?

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  178. One reader that wrote that she has a high sex drive and has not noticed a decrease with her Mirena, but states she’s worried about high androgen levels and wants to take diindolmethane to control these levels. Again, we have to start each discussion with a caution, that you cannot manage your medical care through a blog. In general, there have not been any studies to back up a “preventative way to hold onto one’s sexual function.” In general, if you are not having a problem with sexuality, any hormonal or herbal way that might change your function could very well decrease your function. We would not diagnose high androgen levels without doing some testing first. Even with women with physical characteristics of high androgen levels this is something that probably needs blood testing to be sure of a diagnosis. Then if testing reveals a treatable condition, we could look specifically at what levels are abnormal and need treatment. Most women with a Mirena will have a normal, not high, range of male hormone levels or androgen levels, so specifically most Mirena patients would not need anti-androgen treatment of any kind. Diindolmethane, also called DIM, is an herbal palant derivative that is not regulated here in the USA so we cannot know what our patients are really getting. It is a product that is derived from broccoli and has been reported to be anti-androgenic. Most women with significant eluviations in androgens would need more potent treatment. But for an individual patient this may be a good alternative treatment if properly monitored.

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  179. Gyno Gab when I had my Mireno inserted recently, the Dr. told me it released estrogen. Is this correct? If so, could the loss of libido stated here be related to excessive estrogen and can this be validated by a test of those levels? I have not had it in very long but, have read SOO MANY testimonies of symptoms that match symptoms of excessive levels. Their symptoms match the following:


    Water Retention/Weight gain
    Fatigue
    Nausea
    Vomiting
    Irregular periods
    Breast swelling and tenderness
    Fibrocystic breasts
    Increased PMS symptoms
    Loss of sex drive
    Uterine fibroids
    Cravings for sweets
    Weight gain
    Headaches
    Recurring yeast infections
    Leg cramps
    Increased anxiety

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  180. I have had my mirena for 9 months now. Is it common to have unexpected gushing of blood then no bleeding at all. I don't have periods, but do have quick gushing of blood then nothing. I also bleed when my bladder gets too full. I get thick clumps of murky white blobs that come out every now and then. Is this normal with mirena too?

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  181. According to the product literature a woman who gets a Mirena IUD period may be less predictable than usual. Bleeding and spotting may increase in the first few months and continue to be irregular. Periods over time may become shorter, lighter or even stop. It is not as common to report unusual new white vaginal discharge just from the IUD and that is worth having your provider evaluate.

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If you are a female between the ages of 18 and 50 years old and are experiencing abnormal bleeding due to uterine fibroids, you may be able to take part in the VENUS research study, testing an investigational medicine. Qualified participants will receive study-related medical evaluations and care at no cost. If interested, please call 217-356-3736.

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