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

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

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

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

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

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

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

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

I was the poster-mama for Mirena!

Or was I?

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

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

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

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

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

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

And finally...

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

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

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

*The HIGHLIGHTED ones are MY symptoms.*

What are the more common side effects of Mirena?

Possible common side effects of Mirena include:

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

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

More than 10% of Mirena users may experience:

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

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

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

Less than 5% of Mirena users may experience:

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

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

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

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

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

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

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

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

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

So what is the moral of the story here?

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

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

And that is a good thing.

Natasha~

Have you used Mirena? What has your experience been?

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