Mirena IUD and Libido Symptoms

In the package insert, the Mirena IUD is said to cause decrease libido in slightly over 5% of users in their original trial. And as far as we know these women did not have sexual dysfunction going into the trial. It is not the set of patients who have had specifically normal function, and it's not clear what percent of these patients had any issues with sex on birth control pills in the past. So if you have an issue with wavering libido do you get a Mirena, or hold off? How to do a short "test" run on longer term methods has stumped gynos. It is possible to use short term POPs (progesterone only pills), but most studies say that each method of progesterone delivery is different enough it's not a great trial. They provide some progesterone exposure with maximum reversibility although the levels would be a lot higher than in a Mirena, but it's a thought. If you are already having issues with libido, gab with your gyno regarding the issues before you choose Mirena which is a 5 year commitment (longer approval times may be  in other countries than the US).


  1. This is a very interesting blog and so i like to visit your blog again and again. Keep it up.



  2. Thanks! and GynoGab thanks the readers for the questions!

  3. I'm 47 and had the Mirena put in about 2 yrs ago when I started to experience heavy periods. I've had no noticeable side effects until the last 6 months. I've all but lost my libido and having difficulty with orgasm. This has never been a problem before, despite being on an SSRI for over 7 yrs. Could this be due to the Mirena, or SSRI or a decrease in my hormones due to perimenopause? I'm considering removing the Mirena but really like it otherwise.


  4. When women in perimenopause want to know the etiology of their libido changes we have to know a lot more than their SSRI use and their Mirena use. Relationship issues, body image issues, exercise, stress, and as you say, the actual hormone levels all seem to play a part. If a woman has difficulty maintaining arousal or achieving orgasm then libido quickly suffers. There are medical causes, even diabetes, hypertension and other conditions that are common in the 5th decade of life that can be evaluated by your gyno that may be contributing to orgasm problems. I always advise a complete work up before giving up on effective contraception that a woman has liked otherwise.

  5. Thank you for your response. I plan on having a thorough hormone, thyroid, cortisol etc level checked in the next month or so. I'm pretty healthy,exercise frequently, feel good about myself in general, but have been through a huge amount of stress in the last 2-3 yrs. It may be having a cumulative effect, I'm not sure. It's just a mystery to me, when this has never been an issue before.

  6. Hello, I wanted to post an update on the Mirena "situation". I had it removed a couple of weeks ago and noticed a complete return to prior libido/sexual functioning after 9 days. I have nothing against Mirena, I thought it was great otherwise but in my situation in most definitely caused unacceptable sexual side-effects. Do you know why this could have happened? just curious. On the paraguard now and so far, no issues.

  7. Always glad to hear about successful outcomes, and it is interesting that within a few days of Mirena removal you felt a return of libido. Since the hormone levels would fade from your bloodstream relatively rapidly it's tempting to believe that the libido is directly tied to those levels. On the other hand there has never been a study that directly links hormone levels and a woman's sexual performance, and a response that quickly has to make a physician question a placebo effect. None the less, ParaGard IUD is a great choice for contraception and it is not a hormonal IUD. Thanks.


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