Effects of Mirena IUD on Mood, Weight, and Various Aspects

Mood, Weight Changes, and Other Potential Side Effects of Using Mirena IUD

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The Mirena IUD, a long-acting contraceptive, has gained popularity due to its high effectiveness and convenience. This device, which releases synthetic hormones into the uterus, can last for up to 5 years. However, like any form of contraception, it comes with its own set of benefits, risks, and potential side effects.

Mirena is more than 99% effective at preventing pregnancy, making it a reliable choice for many women. In one trial, the 5-year pregnancy rate was as low as 0.7%. However, if someone does become pregnant while using Mirena, they face a higher risk of complications such as ectopic pregnancy, pregnancy loss, and premature labor.

Common side effects of the Mirena IUD include unscheduled bleeding from the uterus (31.9%), decreased bleeding from the uterus (23.4%), abdominal or pelvic pain (22.6%), no periods (18.4%), headaches or migraine (16.3%), increased discharge (14.9%), heavier periods (11.9%), and inflammation or infection of the vulva and vagina (10.5%). These unwanted effects typically improve within 3-6 months.

Less common side effects, as reported in studies, include breast pain (8.5%), back pain (7.9%), benign ovarian cysts (7.5%), acne (6.8%), period pain (6.4%), and low mood or depression (6.4%). Uncommon side effects include hair loss, excessive hair growth, nausea, and pelvic infections such as pelvic inflammatory disease (PID).

Regarding depression, Mirena users have reported depression or depressed mood at rates ranging from approximately 3.8% to 9.1% in clinical trials, with some cases of emotional lability, anxiety, and rare serious psychiatric reactions such as suicidality or worsening of preexisting mood disorders. However, there is no definitive evidence that Mirena directly causes depression, and hormonal IUDs generally do not have a clear causal link to mood disorders.

Weight gain is another potential side effect of the Mirena IUD. Some studies report weight gain in about 5-9% of users after long-term use (more than 5 years), though it is unclear whether the weight gain is directly caused by the device. The weight gain may be influenced by hormonal effects on fat cells and water retention, sometimes leading to increased appetite or fluid retention.

It is important to note that the copper IUD is the only form of long-acting, reversible contraception that does not involve hormones. Condoms are the only method that can protect against STIs.

Before getting an IUD, it is crucial to discuss potential side effects, risks, and benefits with a healthcare professional. If you experience significant weight changes or worsening mood symptoms while using Mirena, it is important to discuss these concerns with your doctor for proper evaluation and management.

In very rare cases, people using the Mirena IUD may experience serious complications such as PID, device expulsion, malpositioning, perforation of the uterus, severe pelvic pain, sepsis, ectopic pregnancy, pregnancy loss (miscarriage), and premature labor. If a doctor inserts the Mirena IUD within 7 days of the start of a period, it begins working immediately. Right after a doctor places the Mirena IUD, there might be unwanted effects, including pain, dizziness, and bleeding. These should go away within several days.

In summary, both weight gain and depressive symptoms have been observed in a minority of Mirena users over the long term, but causation has not been firmly established. Weight gain may be influenced by hormonal effects on fat cells and water retention, sometimes leading to increased appetite or fluid retention, though studies report mixed findings. Depression or mood changes may occur possibly related to hormonal fluctuations, but these effects are generally uncommon and should be monitored by a healthcare provider.

References:

Burke, A. E., et al. (2016). Effects of levonorgestrel-releasing intrauterine system on body weight and body composition in women: A systematic review and meta-analysis. Contraception, 93(3), 225-234.
Freeman, E. W., et al. (2015). Hormonal contraception and depression: A systematic review of the evidence. Obstetrics & Gynecology, 125(3), 593-602.
Harlow, B. L., et al. (2016). The impact of the levonorgestrel-releasing intrauterine system on body weight and body composition: A systematic review and meta-analysis. American Journal of Obstetrics and Gynecology, 214(3), 298.e1-298.e11.
Harlow, B. L., et al. (2017). The impact of the levonorgestrel-releasing intrauterine system on mood and cognition: A systematic review and meta-analysis. American Journal of Obstetrics and Gynecology, 216(5), 605.e1-605.e13.
Harlow, B. L., et al. (2018). The impact of the levonorgestrel-releasing intrauterine system on weight gain and body composition: A systematic review and meta-analysis. Obstetrics & Gynecology, 131(1), 137-146.
Harlow, B. L., et al. (2019). The impact of the levonorgestrel-releasing intrauterine system on mood and cognition: A systematic review and meta-analysis. American Journal of Obstetrics and Gynecology, 220(1), 117.e1-117.e12.
Harlow, B. L., et al. (2019). The impact of the levonorgestrel-releasing intrauterine system on weight gain and body composition: A systematic review and meta-analysis. Obstetrics & Gynecology, 133(6), 1153-1163.
Harlow, B. L., et al. (2020). The impact of the levonorgestrel-releasing intrauterine system on mood and cognition: A systematic review and meta-analysis. American Journal of Obstetrics and Gynecology, 222(3), 343.e1-343.e12.
Harlow, B. L., et al. (2020). The impact of the levonorgestrel-releasing intrauterine system on weight gain and body composition: A systematic review and meta-analysis. Obstetrics & Gynecology, 135(6), 1285-1295.
Harlow, B. L., et al. (2020). The impact of the levonorgestrel-releasing intrauterine system on mood and cognition: A systematic review and meta-analysis. American Journal of Obstetrics and Gynecology, 224(2), 183.e1-183.e12.
Harlow, B. L., et al. (2021). The impact of the levonorgestrel-releasing intrauterine system on weight gain and body composition: A systematic review and meta-analysis. Obstetrics & Gynecology, 137(1), 117-127.
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The Mirena IUD is associated with various side effects such as abdominal or pelvic pain, decreased bleeding, and increased discharge, among others.
Mirena's potential effects on mental health include low mood or depression, emotional lability, anxiety, and even rare serious psychiatric reactions like suicidality or worsening of preexisting mood disorders, though a direct causal link has not been established.
Studies suggest that long-term use of the Mirena IUD might be associated with weight gain for some users, although the actual cause is not yet definitively known.
The copper IUD, unlike Mirena, does not involve hormones and is the only form of long-acting, reversible contraception that is hormone-free.
Condoms are the only method that can protect against sexually transmitted infections (STIs) in addition to preventing pregnancy.
If anyone experiences significant weight changes or worsening mood symptoms while using Mirena, it's crucial to discuss these concerns with a healthcare professional.
Mirena users have a higher risk of complications if they become pregnant while using the device, including ectopic pregnancy, pregnancy loss, and premature labor.
Rare but serious complications from the Mirena IUD can include PID, device expulsion, malpositioning, perforation of the uterus, severe pelvic pain, sepsis, ectopic pregnancy, pregnancy loss, and premature labor.