IUD Symptoms Changed:Could Be Due to Hormone Level Changes

IUD side effects are important to understand and what is more important to understand is that they can be addressed. It is true that some women will request removal, but over 8% of women still have their IUD at the end of the first year of use. Most women have some irregular spotting or bleeding when they first get an IUD. After the first 2-3 months symptoms settle in and don't change significantly over time, but gradually it's not uncommon to notice some change. The change may be in terms of menstrual periods when you had none, or slightly heavier menstrual periods. The medicated IUD Mirena or it's identical formulation the newer Liletta have blood levels that decrease over the years of their use. The hormone level contributes to the effectiveness, which is different from the non-medicated Paragard IUD that works by occupying the cavity of the uterus, and thus prevent pregnancy through physical prevention of sperm and egg meeting. Mirena IUDs prevent heavy bleeding menstrual periods by their hormone, and also prevent pregnancy this way. Interestingly there is less than 5-10% of the hormone level verses birth control pills that contain the same hormone. Blood levels of levonorgesterel containing contraceptive pills are 150-200 pg/ml and the Mirena 20 and Skyla 14. Blood hormones over time will decrease by almost a third in most women and by as much as a half in some women by the 7th year of use.  If the Mirena is dislodged, the hormone can still prevent pregnancy, even if residing in the abdomen and not in the uterus! So the hormonal change doesn't translate into lower pregnancy rates. January 14th issue of Contraception they have a case report of a woman who was unable to conceive after the intrabdominal Mirena was removed. Intraabdominal IUDs can produce problems beyond contraception, and will have to be removed. Tracking menstrual cycles is important, and the best way you have to really determine if there has been a change in your IUD symptoms so that you can accurately report the symptoms to your gyno.


  1. A reader writes a question: Hi! I was wondering if you could me help me? I started my period yesterday and it was a moderate flow. Then when I went to the bathroom last night I had a blood clot that was a decent size and looked different and bigger then my usual small clots. About an hour after that I went back to the bathroom and noticed a long kinda skinny light color (kinda looked like raw chicken) thing on my pad. I took it off to look at it and it was like a tough piece of meat hard to break like. I changed my pad and for a while after that I had just about nothing. I'd go to the bathroom and there wasnt much on my pad, nothing in the toilet, and just little to nothing when I wiped. I went to bed and when I woke up it was a bloody stringy slimmy big mess. I cleaned up and now all day today I'm having a light flow but back to normal clots. I do have my tubes tied and usually pretty regular periods. I have made an appt with my gyno but its not till the 18th and I'm so irrated and alarmed by this, can you help maybe give me an idea on what it is or what's going on?
    Remember this this is not a replacement for medical care. If a woman has alarming symptoms she should go to her nearest urgent care or emergency department of a hospital. Typically normal menstrual blood loss per cycle is about 80 ml. For patients who think they have bleed significantly more than this, or whom have signs of acute blood loss, one example is to be lightheaded, they do need to seek emergency care. In some instances speaking with your provider's staff can give you an indication of their emergency policies. At Women's Health Practice we do take walk in calls for our patients if they want to be seen that day.

  2. A reader wrote: " I have had the skyla for almost 2 years almost a moth ago was the first time of me having sex while on the skyla I am usually right on time with my period but I am a week late and I'm kinda worried I have been very sexually active but I thought I would be okay since I'm on the skyla can you give me any advise." Skyla is protective against pregnancy, whether you have been sexually active the whole time or newly sexually active just now although you have a skyla. Be sure to watch the dates the IUD is due to be changed.


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