Mirena coil quandary

[Verdantview]

Hello,

I’ve had a mirena coil for 11 weeks. I’ve had no side effects except for the ones I’m about to discuss, so from that side I’m pleasantly surprised. I had it fitted as my ferritin was low, and the cause was heavy (but not excessively so) periods. Added benefit was contraception, but wouldn’t have considered it if for this reason solely.

The issue:
Since I’ve had it fitted, I’ve had more painful and probably as heavy periods as before, which I can cope with. What I’m at my wits’ end with, though, is constant spotting or bleeding between periods. Currently the spotting constantly is worse than dealing with heavy regular periods before I had it fitted.

I know it can take 3-6 months to settle, but I don’t know if I can do potentially 3 more months of the spotting; with no guarantee that will stop. I guess it’s the sunk cost fallacy…

Those who had similar, and stuck it out, did the spotting improve? Or did it rumble on? Thank you.

I had very very similar and it finally stopped after about ten months and now is absolutely fine. I had a really heavy period for three weeks with the coil in to the point where I had an ultrasound to rule out anything unpleasant but it was all fine.

My periods now are so light I can go without any protection at all.
compared to being unable to go for an hour without having to go to the toilet previously and wear lots of protection, it’s miraculous.

Yes, it stopped after 4-5 months and never started again, I am on my 3rd mirena now and can't imagine having a period every month.

Thank you for sharing your experiences, they are giving me hope it may improve and that it is possibly worth sticking with it.

I know this isn't what you want to hear, but I had the Mirena, and had the same feelings for the first 6 months, the next year was mostly fine, still had monthly bleeding, sometimes spotting around ovulation too which was a first for me. After that though, I was cramping badly from a few days before ovulation until my period started, and my periods got more and more frequent. Sometimes I would be in pain 3 weeks out of every 4. I got it out, had a massive 3 weeks of bleeding, and i've been totally fine since then. Also noting that I didn't have any excessive bleeding or PMS until I had the Mirena. I think i'm in perimenopause now, and whatever hormones shifts were happening were intensified by the Mirena.

They don’t suit everyone but it’s worth giving it 6months to see if you are one of the lucky ones. You will always hear the horror stories since most of us that had good experiences have no need to evangelise about a coil. I had one placed at 40 after last pregnancy. I had it replaced every 4 years until I finally had the last one removed after it was confirmed I was post menopause at 57.
I would start to get light periods into the fourth year but because it was placed for endometriosis it was the mild cramping that bothered me. After having suffered through my 20s and 30s with severe anaemia and chronic pain my GP was happy to replace the coil early.

Another bonus is that as you approach menopause you only need to have oestrogen because the coil protects your uterus from hypertrophy and increased risk of cancer.
Unfortunately have to stop HRT due to hormone sensitive breast cancer.

It sorted out the anaemia and I credit it with changing my life with regard to endometriosis.

I had a great experience with my Mirena coils. Just be wary, as with any hormonal birth control, that it may affect your libido.

Thank you for sharing some more experiences of the mirena, it is really helpful to hear about long term benefits and risks.

I’ve decided to give it a few more months to see if it settles. If so, wonderful, if not, it’s coming out! Will report back in case it is useful.

I had endless bleeding for 8 weeks and got prescribed norithrostone from the doctor. I then had spotting on and off til about 8 months when they stopped altogether....hope that helps!

Thanks- good to know it did eventually stop!

Thought I’d update as I’m almost 5 months in and things haven’t really improved. Long, painful periods (more uncomfortable than before) and having only about 10-13 days a month with no spotting/bleeding. I don’t know whether to perceive for another 5 weeks to the 6 month mark, or if I should cut my losses and have it out… Can’t imagine it would magically get better by 6 months, but also as I’ve given it this long, I feel like I should try. I’m also worried this is having on my iron levels. Just feel fed up!

I would go and see your GP, ask them to do a panel of bloods and check iron, ferritin etc. Then from there you can see if other issues are happening alongside. So look at TSH, and potential other things. After that depending on results go back to your GP and discuss options e.g iron infusion.

I'd also ask for a prescription of tranexamic acid/or northisterone (works to reduce heavy bleeding) so that you can take it alongside your period to help with the heavy bleeding. Make sure to start taking it 1-2 days before as well and during the whole period to definitely help.

You can also ask for naproxen or mefenamic acid (NSAIDs which are anti-inflammatories to help with pain as well as paracetamol if you use that as well). You should again start using this 3-4 days before your period and then during it as welll.

My periods did take about nine months to settle down and I had exactly the same as you. I persisted only because I couldn’t face having it removed if I’m honest! I think it was also peri menopause for me as a year later and I have just stopped having my periods for the last two months.

Such a helpful post, thank you @LivelyViper

@Haggisfish3 did your periods stop after 9 months or get lighter?

It’s just disheartening as I was told this was the gold standard to reducing blood loss and can do this by up to 90%. Not my experience unfortunately; might give it a few more weeks but this situation is worse than the periods I was having before it was fitted.

No worries @Verdantview, I would see your GP and bring up the points I've mentioned and see how that works.

There is the potential of a cyst or fibroid being there. Is the bleeding heavier than what you've experienced before getting the mirena? It may also be worth getting a transvaginal ultrasound (again ask the GP to book this for you) to double check. They may want to wait till after you try tranexamic acid etc which makes sense but still bring it up.

Definitely get the bloods as you may need an iron infusion, your folic acid could be quite low, or issues with your thyroid leading to fatigue so key you get those all checked.

Thank you for taking the time to respond @LivelyViper
The bleeding isn’t heavier, it’s much the same but so long-lasting. Periods lasting 2 weeks, then irregular spotting between, so barely any break from it.

Will go back to my GP now I have more knowledge of the some the things to discuss. I want the coil to work because other than the bleeding, it’s been great for no other side effects.

My periods got so light I didn’t even need a pad. They have now stopped for two months. I am 49 and have had the coil for three years

I had one in for 13 months to combat heavy flooding periods.

Ironically, it caused increasingly heavy bleeding every day for all of the time I had it including times when I wondered whether I should call myself an ambulance because it was so bad. It was during the covid lockdowns so I simply couldn't just get an appointment for removal, although I did eventually have to just insist on it. I was clearly one of those who was unsuited to it.

It suits some people and not others. I guess the only way you will find that out is by giving it a bit longer. However, if you really don't like it then you may need to be very assertive about wanting it removed. Doctors can be surprisingly reluctant about that.

My first mirena coil took about 8 months to settle, but then I had no periods for 3 years, it was great.

When I had it replaced they really struggled to put the new one in, I ended up having it done at the hospital as my GP just couldn't do it. I had awful bleeding for months and was eventually, after a year, referred for a scan.

The coil had been inserted in completely the wrong place, so wasn't actually working at all. Quite worrying as I was using it for contraception, and for the progestogen part of my HRT. This meant I developed ovarian cysts. Thankfully, once I had a new one fitted properly everything settled pretty quickly, and it wouldn't put me off having another if needed.

It might be worth checking it has been inserted properly if things don't settle for you soon.

It took mine quite a while to settle. Maybe 4-5 months and I haven’t had a period since. That was 15 years ago ….. I’ve just had my third mirena fitted.

Ah sorry that was your experience @Topseyt123.
Thank you for sharing your experiences with the coil; going to give it until 6 months and then speak to my GP.

@Verdantview
I had a similar experience to you...17 years ago.

My first mirena was awful, bleeding and spotting like yourself.
I went back to my dr. and she suggested removing it and trying another...sometimes there's duds apparently!!
Anyway, I removed that first one, had another put in and they've worked perfectly ever since.
Dr was fully supportive that I didn't have to try again and that if I did and it still didn't agree with me, out it'd come.

Except my current one the strings have gone awol, but a scan has shown it's where it's meant to be. Just removal might well be more tricky.

@ThereIsATInWater I have never heard of that as an explanation! Interesting that having it replaced resolved your issue.

Thought I’d update as I’ve had it just over 6 months. Unfortunately not much improvement; period is slightly lighter, but still spotting/bleeding for two weeks of the month. Just when I think my period is finished, I’ll start bleeding again. Blood tests all normal, although ferritin was on the lower end of normal which I expected. Advice was to give it three more months to see if it settles. I’m not sure it will improve, but as I don’t have any other symptoms and it’s a reliable form of contraception, I will give it a bit longer. Just really annoying as it’s the first hormonal contraception that I’ve had no other side effects from and if the bleeding does settle, it would be great!