Using An Iud In Perimenopause
Have you been dealing with heavy and/or frequent periods? Are you tired of worrying where the bathroom is the entire time you have your period? Even worse, are you tired of never being able to predict when your bleeding will startor stop? You are not alone! This is a common concern for women over 35. Often times the only solutions that these women are given are hormonal birth control or the hormonal IUD .
The problem with the pill is that long-term use increases risk of stroke, heart attack, and blood clots. Even worse, that that these risks increase after age 35. Due to these risks many women are given the option of the Mirena which is tempting because it often stops bleeding completely, giving women with heavy periods a much needed break. This usually seems like a great solution to women, but as they reach their mid-40s and enter into Peri-menopause the hormonal IUD can actually create an even greater hormone imbalance then the one that naturally occurring in their bodies.
So, what makes the Mirena so bad for women in Perimenopause? It prevents ovulation suppressing most, if not all, natural Progesterone production. Though progesterone production stops, it does not stop production of Estrogen This leads to an imbalance between estrogen and progesterone that some practitioners like to call, Estrogen Dominance. The result is:
- Mood swings
- LOW LIBIDO
What Is Likely To Happen As I Approach And Pass Through The Menopause
Migraine tends to worsen in the years leading up to the menopause, with attacks occurring more frequently and sometimes also lasting longer. Many women notice more of a link with their periods. In the early stages of menopause, when periods become erratic and more frequent, this also means more migraines. Towards the end of menopause, as periods lessen, so does migraine. For women who have noticed a strong link between migraine and hormonal triggers, post-menopause can be a blessing as migraine is very likely to improve. This may take two or three years after the last period, as it can take this long for the hormones to settle. Non-hormonal triggers can still persist after menopause so if these are important causes for migraine, attacks will still continue.
Can Surgery Treat Adenomyosis
Adenomyosis is not really suitable for surgery because of complications. However, surgery may be an option if small lesions, which can be removed in isolation, are identified.
A hysterectomy is a way to resolve Adenomyosis, especially if you are in severe pain. However, this is obviously only an option for women who are no longer planning to have children.
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How Do I Know I’m The Menopause
The definition of it is that youve not had a period for a year, so you dont know youve had the menopause until that happens, says Dr Goodwin.
Symptoms tend to start in the lead-up time called the perimenopause. That usually starts any time from the mid 40s, and a woman is typically in menopause around 52.
Women can experience symptoms earlier though. They dont tend to think of it being the menopause and nor do their doctors. You might meet a woman whos not had a period for three years in her early 40s.
If you stop having periods and youre younger, dont think its just one of those things. Get it checked out.
Other Mirena Iud Complications
The Mirena IUD can cause other serious complications besides the hormone imbalance referenced above. In fact, Mirena has caused birth injuries to babies whom women conceived and carried with a Mirena IUD in still in place, posing a serious risk to the developing fetus. This is especially true if the IUD is not removed early on in the pregnancy. Becoming pregnant while your IUD device is still in place can also cause ectopic pregnancy, miscarriage, premature birth, and even birth defects and fetal abnormalities.
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How Does The Mirena Coil Affect Menopause
To understand how the Mirena coil could impact menopause, it is important to understand how menopause affects our hormones.
During perimenopause, there is a complex shift in hormone levels and one of the hormones affected is progesterone. Very often, levels of this hormone, along with oestrogen, start to drop, although their levels may be high initially.
Guidance recommends that treatment with hormone replacement therapy can help improve symptoms of menopause, including hot flushes, mood swings, and vaginal dryness.2 There are different types of HRT that may be suitable for different women, but the two main hormones used are oestrogen and progestogen . HRT is available as combined or oestrogen-only. As many menopausal symptoms are due to low oestrogen, HRT is the main treatment offered.
If you are taking HRT for your menopausal symptoms whilst using the Mirena coil for contraception, the Mirena can be used as the progesterone part of your treatment. This means that oestrogen-only HRT could be given in combination with the Mirena
Oestrogen however works in synergy with progesterone and it is therefore usually advisable to take both hormones together. There are certain situations where oestrogen-only HRT is recommended, including for women who have had a hysterectomy.
Treatment For Hyperplasia Without Atypical Cells
A progesterone-like substance is used to suppress the formation and growth of the lining for women with hyperplasia without atypical cells. This can be in the form of tablets, implants, creams or the Mirena coil.
The Mirena Coil is without doubt the best treatment. It has the benefit of working just where the problem is and providing years of treatment without the need for remembering daily medication.
The condition generally regresses in six months however leaving the Mirena in is recommended to reduce the risk of the problem coming back.
Monitoring of treatment involves taking a small sample of the lining 6 monthly and sometimes ultrasound. Other factors such as HRT use and obesity also need to be thought about as extra oestrogen is made in fat cells in women who are significantly overweight and endometrial hyperplasia can be affected by the oestrogen in HRT.
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How Long Can It Be Left In And Is It Safe Long
Dr. Rebecca: It works for 5-7 years, and is safe to leave in that long. It doesnt hurt you to leave it longer, but it no longer works as birth control or to suppress menstruation, and will no longer protect the lining if you are taking estrogen.
Are there side effects? If using Mirena for menopause, when should it be removed?
Dr. Rebecca: There is discomfort with placement and removal.
People are often concerned about infections, as they remember reports from decades ago about different IUDs. With the Mirena, there is a small risk of infection when it is inserted and removed , but once in, it actually thickens the protective cervical mucus and reduces the likelihood of infections travelling up to the pelvis.
Many women see irregular bleeding or spotting over the first 3-6 months after the device is implanted, which resolves.
While there are reports on the Internet of weight gain, in fact, studies show weight gain is not a side effect of the IUD because, remember, it results in very low hormones being circulated systemically.
Mirena Coil & Menopause
Is it possible to prolong your reproductive years?
Women who want to have children later in life may be asking this question. Similarly, those who just dont want to enter their age of menopause would love to have this option!
But while this may seem to be impossible, some reproductive health solutions are believed to affect the onset of menopause, like Mirena Coil.
Though mainly marketed as a contraceptive, the Mirena Coil may also have some hidden effects on menopause.
Read on to find out.
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Why Do Ob/gyns Prefer The Hormonal Iud
For women generally, the hormonal IUD is a good option for family planning and managing periods.
With a 99 percent effectiveness rate, theyre highly effective at preventing pregnancy . Considering perimenopausal women have the second-highest rate of unintended pregnancy , that can be a real benefit.
They dont require perfect use from the woman. Unlike the Pill, you dont have to remember to take them, and unlike condoms, you really cant be caught without.
They can make periods lighter, reduce cramps, have few or no side effects, and last for years. For these reasons, hormonal IUDs for perimenopause symptoms are often the most common.
Vaginal Oestrogen Made Migraine Worse What Next
Vaginal oestrogen is useful to help control local symptoms of pain and dryness in women who have no problems with hot flushes or sweats, or who still get vaginal symptoms despite using HRT. When a woman first starts to use vaginal oestrogens, a rise in oestrogen has been measured in the blood stream. Higher levels persist for a couple of weeks and then drop back down. This rise and fall can be sufficient to trigger migraine in susceptible women. With continued use of vaginal oestrogens, usually only necessary just once or twice a week, oestrogen levels settle and are less likely to trigger migraine. On this basis, dont be put off trying vaginal oestrogens but do be prepared for an initial increase in migraine. If migraine does not settle then an alternative treatment needs to be considered. This will depend on what the initial symptoms were. If vaginal dryness was the main problem, then a lubricating gel is a non-hormonal alternative.
Which Birth Control Pill Is Best For Menopause
It is often the best option to use oral hormonal contraceptives, such as the pill, to control perimenopause symptoms. In addition to helping you regulate your periods, reduce bleeding and pain, and treat acne, they also keep your hormones in check. Therefore, during perimenopause, there may be fewer flashes of hot flashes.
Its Easy To Know When Youre Menopausal
just wait 12 months, and if in those 12 months you havent had a period, its sorted! Sounds easy, right? Well, not quite. Irregular periods, or no periods all together, can be common. This is especially true for those who use a contraceptive like the Mirena Coil, a plastic intrauterine system , which releases small doses of progestogen, making the lining of your uterus thinner and less likely to accept a fertilized egg. While the Mirena Coil is a great option for contraception, especially for those who experience heavy bleeding during their periods, it can often stop periods all together. If your periods have stopped because of the Mirena Coil, how can you know youre menopausal? Heres a few important facts to know about the Mirena Coil and the menopause:
Just because you have a Mirena Coil in, does not mean your menopause will start later than it would have without the coil. As mentioned, you might not know youre menopausal if your period has stopped because of the coil but it does not affect when your menopause will start.
Looking for natural alternatives to tackle other menopausal symptoms?
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What Causes Period Changes
Having a regular monthly bleed relies on several hormones working together.
Your brain and ovaries communicate to keep your hormones in a monthly cycle. Hormones from the ovary cause changes to the lining of the womb , so that every month it thickens . Then, if youre not pregnant, it sheds this is the bleeding you see with a period.
In the perimenopause, your hormones can become out of sync and communication between your brain and ovaries breaks down. That regular thickening and shedding of your womb lining doesnt happen.
Bleeding can become erratic, or you may not get any at all. In the menopause, when oestrogen levels are low, the lining of the womb stops thickening and bleeding stops.
There are other reasons for abnormal bleeding, such as fibroids, polyps in the lining of the womb , and more rarely precancerous and cancerous changes. Bleeding can also come from the cervix thats why its essential to keep up to date with your cervical smears as well as from the vagina and vulva.
Illustration to show the menstrual cycle
Memory And Concentration Problems
During perimenopause, women often complain of short-term memory problems and difficulty with concentration. Study results looking at the relationship between falling hormone levels and cognitive function have been inconsistent. Some women do believe that low dose estrogen after menopause helps them think. But the research has not supported this. Stress likely plays a more important role in memory and thinking compared to hormonal fluctuations.
Treating memory and concentration problems. Just as it isn’t clear what causes memory and concentration problems, there is no obvious remedy. Staying physically active and scheduling at least 150 minutes per week of dedicated exercise may be the best way to maintain brain health. Brain and memory experts also recommend that people work to keep their brain functioning at its peak by taking on new and interesting challenges. Use your mind in many different ways. Do crossword puzzles. Learn a new musical instrument or sport. Play chess. Read more books. Learn a new language or how to use the computer. The idea is to challenge your brain in new ways.
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Who Is A Good Candidate For The Mirena Iud
Dr. Rebecca: Most women are good candidates only women with a history of allergic reaction to levonorgestrel, who have a current pelvic infection, or who have a uterine anomaly are not good candidates.
Unlike estrogen, progesterone is generally considered safe for women who have blood clot risk, and as the Mirena is very low dose, its even safer.
Use of Mirena for women with a history or high risk of breast cancer is generally, but not always, discouraged, so have a good conversation with your doctor about the benefits and risks.
If want an expert’s perspective if Mirena is right for you, a menopause-certified health coach can be helpful. Book 30 minutes for your personal consultation with a health coach.
Can The Mirena Cause Menopause
Many people think that interfering with hormones or being on contraception that stops your period can have an effect on when you hit menopause, but this is not true.
Even if you are using a form of contraception that stops you ovulating, as you get older you steadily lose follicles in the ovaries and the ovaries stop producing oestrogen and progesterone. The Mirena does not have an effect on the time it takes to get menopause.
Migraine Menopause And Hrt
In medical terms, menopause is defined by a womans last natural period. However, we generally also use menopause to describe the time in life when periods become irregular and hot flushes occur. These symptoms result from changes in the ageing ovaries and can start around ten years before a womans last menstrual period. Headaches are common during this time, affecting over 90% of women.
I Notice It Has Strings Can Your Partner Feel It Or Dislodge It During Penetrative Sex
Dr. Rebecca: No, the strings are soft and typically tuck behind the cervix. If a partner does feel something, your gynecologist can trim the strings short. Intercourse will not dislodge it. The only times Ive seen them dislodged are when folks use menstrual cups and accidentally grab the strings when reaching up to remove the cup.
If you’re in perimenopause and experiencing heavy bleeding, and/or you need an effective birth control method, a hormonal IUD such as the Mirena may be a good, safe option for you. As ever, check with your doctor to discuss any risk factors you may have.
Have you used an IUD to prevent pregnancy or handle perimenopause symptoms? We’d love to hear about it. You can talk with us in the comments below, in our community forums, on our , or in Midlife & Menopause Solutions, our closed Facebook group.
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Help With Heavy Bleeding During The Perimenopause
The IUS, such as the Mirena coil, is incredibly good for treating one menopause symptom in particular, heavy periods. Studies have shown that having a Mirena coil inserted during the perimenopause is happening can actually help treat heavy menstrual bleeding. In some cases, your monthly flow can get so heavy that you soak through a pad or tampon every couple of hours.
What do Mirena reviews say?
56% of Lowdown users said the Mirena coil stopped their period altogether, and 15% said it made them lighter. The Mirena IUS is therefore a recommended treatment for women who bleed heavily during their perimenopause.
Whilst the Mirena coil may be a good treatment for symptoms like heavy bleeding, some women can experience side effects from the IUS such as acne, headaches or breast tenderness, although these tend to settle after a few months.
How Is It Fitted
Having a Mirena fitted takes around 5-10 minutes, though your appointment will usually be longer than that.
You can sometimes experience intense, short-lasting period-like pains during fitting, and you may get some period-like cramps over the next few days.
A doctor or nurse will first examine you internally and then use a speculum to see the cervix .
The Mirena comes folded in a slim introducer, which is passed through the neck of the womb and released into the cavity. Two thin threads are left hanging into the vagina. A medical professional uses the threads to remove the coil. You may be able to check the threads are present particularly initially, but with time the threads curl over the neck of the womb and so you may not be able to feel them. Your partner should not be able to feel the threads during sex. If they are felt during sex, please see a doctor or nurse to check the fitting and trim the threads if needed.
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