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Answers to Questions from Mandurah Forum 1/6/23

Updated: Jul 16, 2023



The Mirena intrauterine device (IUD) is a form of birth control that releases a small amount of the hormone levonorgestrel into the uterus. While its primary function is contraception, it can also impact menstrual cycles and associated symptoms. However, individual experiences may vary. Levonorgestrel is a progestin, which is a synthetic form of progesterone. Unlike other oral synthetic progestins, it is not believed to have a similar effect on breast tissue. Mirena can be used as part of hormone replacement therapy (HRT) by providing progesterone to protect the lining of the womb. For individuals with a uterus and using estrogen, it is essential to use progesterone to safeguard the uterine lining. If a person has a history of endometriosis and has undergone a hysterectomy, it is important to ensure that all endometrial deposits were removed during the surgery. Otherwise, if estrogen-only therapy is used without progesterone (such as prometrium) and any endometriosis deposits were not removed, the estrogen can stimulate the growth of these deposits and pose a small risk of endometrial cancer.

Perimenopause is the transitional period before menopause when a woman's body begins to produce fewer reproductive hormones. During perimenopause, women may experience irregular periods, changes in menstrual flow, and various symptoms such as hot flashes, mood swings, and vaginal dryness. These symptoms are primarily caused by the drop in estrogen levels. It's important to note that even women with an IUD may still experience perimenopause symptoms. These symptoms can include hot flashes, headaches, dizziness, IBS-like symptoms, facial hair growth, a sensation of crawling or itching on the skin (formication), dry skin, back pain, joint pains, muscle pains, poor sleep, anxiety, depression, irritability, mood swings, dry vagina, increased frequency of urination, discomfort during intercourse, and feelings of lightheadedness.

The Mirena IUD may affect perimenopause symptoms in the following ways:

#1 Menstrual changes:

The Mirena IUD often leads to lighter periods or, in some cases, no periods at all. This can be beneficial for women experiencing heavy or prolonged menstrual bleeding during perimenopause.

# 2 Hormonal effects:

The levonorgestrel hormone released by the Mirena IUD can help stabilize the lining of the uterus, potentially reducing hormonal fluctuations that contribute to perimenopause symptoms. However, it's important to note that the hormone released by the IUD mainly acts locally within the uterus and does not have widespread systemic effects on the body's hormone levels.

# 3 Symptom management:

While the Mirena IUD is not specifically designed to alleviate perimenopause symptoms, some women may find that the reduction in menstrual bleeding and associated discomfort can indirectly alleviate certain symptoms like mood swings or fatigue.

If you want to manage your peri menopaus or menopause symptoms effectively body identical HRT is your best option. Speak to your health care provider about licensed body identical HRT

Dr Purity Carr is a GP and Menopause Doctor in Harvey, Western Australia



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