The Mirena Menace: Are IUDs Intra-Uterine Disasters?

June 13th, 2009 | Posted by Fred Bloem, MD in Cancer | Fred Bloem MD | Hormone replacement therapy

From time to time patients come into my office who are using the Mirena birth control method.

Mirena is a T-shaped, plastic IUD (intrauterine contraceptive device) that is inserted by a physician into the vagina, passed through the cervix, and implanted in the uterus. It stays in place for five years while it releases levonorgestrel.

Levonorgestrel is a chemical that is not normally found in the human body. Many health professionals refer to levonorgestrel as a “progestin” or “progestagen”. This misleading term leads many to believe that progestins are somehow related to the hormone progesterone that the human body produces. Nothing could be further from the truth. Because their biochemical structure is different, all progestins have hormone disrupting effects and their effects are opposite to the effects of progesterone. Therefore it is not surprising that many women experience adverse reactions while they are using Mirena.

Levonorgestrel is found in many oral contraceptives and it was also the active ingredient of Norplant which consisted of implants that were injected into women’s upper arms. Some Norplant users experienced significant side effects.

Some women choose Mirena because they tend forget to take oral contraceptives and because they want the security of knowing that for five years they will not have any children unless they remove it. It is believed to be 99.9% effective in preventing pregnancy.

This is how Mirena works:

  • It blocks sperm from reaching or fertilizing the egg.
  • It makes the lining of your uterus thin (this may also result in less menstrual bleeding over time).
  • It stops the release of your egg from the ovaries.

Here is a list of common side effects:

  • Prolonged menstrual bleeding
  • Prolonged uterine cramping
  • Dizziness
  • Weight gain
  • Low back pain
  • Headache
  • Stuffy nose
  • Depression
  • Abnormal Pap smears
  • Ectopic pregnancy (which can be life-threatening and result in infertility)
  • Intrauterine pregnancy (birth defects are a possibility)
  • Sepsis (an infection which can be fatal)
  • Pelvic inflammatory disease (which can result in infertility)
  • Irregular Bleeding and Amenorrhea (no periods)
  • Embedment (in the uterine wall)
  • Perforation (of the uterus or cervix)
  • Ovarian cysts (can cause severe mid-cycle pain)
  • Breast cancer
  • Risk of Mortality (risk of dying is low)
  • Lower abdominal pain
  • Upper respiratory infection
  • Leukorrhea (abnormal vaginal discharge)
  • Nausea
  • Headache
  • Nervousness
  • Vaginitis (irritation or inflammation of the vagina)
  • Dysmenorrhea (cramps or painful periods)
  • Breast pain
  • Skin disorder
  • Acne
  • Decreased libido
  • Hypertension
  • Sinusitis

Many women don’t even come back for follow up with the physician who inserted the IUD. As a result physicians often don’t make the connection between these women’s health complaints and the levonorgestrel that is being released from their Mirena IUD. Some women even forget to mention to their physicians that they are using Mirena because they don’t consider it a medication or a drug that they are using. Something else that may make it difficult to correlate certain symptoms with the Mirena IUD is that many of the side effects are nonspecific and that they may be ascribed to other factors.

Some women consider the lack of menstrual periods to be a blessing. However, having normal, regular menstrual periods is a normal and essential part of being a healthy woman.

Medications and devices that contain levonorgestrel are marketed without regard to the health of women and children. They are marketed to pregnant women for use after pregnancy. A study done in Mexico with breastfeeding Norplant users found that their infants had significantly modified thyroid stimulating hormone (TSH) levels.

According to Bayer, the manufacturer, the Mirena IUD is an effective, long-acting and reversible method of birth control that delivers 20 µg/day of levonorgestrel directly into the uterus and protects against pregnancy for up to 5 full years. Due to the local action of levonorgestrel on the endometrium, there is often frequent irregular bleeding or spotting during the first 3-6 months of use. The number of days with bleeding or spotting decreases gradually, and by the end of the first year approximately 20% of women will experience a total absence of bleeding. A decision to use Mirena® must include consideration of the risks of PID [pelvic inflammatory disease]. Candidates should have no history of ectopic pregnancy or a condition that predisposes to ectopic pregnancy.

In Norway there was a one six-year followup study that followed breastfeeding infants exposed to levonorgestrel (Norplant) and that found that they had higher incidence rates of respiratory infections, skin conditions and eye infections than the control group. They were later were found to have a higher proportion of neurological conditions.

My advice to women who are using Mirena is to have it removed as soon as possible. It’s not worth it. Please don’t gamble with your health. Stay away from any chemical contraceptive method, including oral contraceptives and contraceptive injections such as Depo Provera. I have seen many women whose health was drastically altered because of these poisonous drugs. Instead, I recommend natural family planning or barrier contraceptive methods such as condoms, cervical caps, diaphragms in combination with the use of spermicides.

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