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Thread: Mirena and PCOS

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    Registered User lola2101's Avatar
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    Default Mirena and PCOS

    My OB told me to look into this, then when I got home I googled PCOS and Mirena and read that it really doesn't mesh well. Anyone have this..if so any issues?
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    Registered User lopinpony's Avatar
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    I have had Mirena for maybe 8 weeks now? No issues either, so far I love it.

    My ob says he actually thinks Mirena is a good choice for those with PCOS... but I think everyone's hormones are so different you never know how it will affect you. I had mine put in 8 weeks postpartum, I actually had just started my 1st period after giving birth. Bleeding quit within a few days, and since then I had 1 day with bleeding... no spotting or anything else. I seem to have escaped that common side effect.

    I'm curious to hear from those who've had one for years who they are doing with it.

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    Registered User srugg's Avatar
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    I was told that Paragard would be a better choice for me b/c of PCOS. Sadly, it failed and I ended up with a big surprise, due this November. I actually went into the OB around 9 weeks pg (not knowing) for an annual and complained of my hormones being funny (tired, irregular bleeding, etc.) and the midwife removed it and put me on the pill (still not knowing I was pg; we didn't figure that out until 11 weeks, lol). Her reasoning was this: PCOS makes your hormones wacky, and you need some sort of hormone supplement to even everything out. Also, she explained that their office, which is based on Christian-beliefs, doesn't insert the Paragard anymore because of HOW it works. Basically, if you get pg while on Mirena, it won't "abort" the fetus, but Paragard will. Obviously this didn't happen for me, and I'm happy with that, but if I had known more I would've gone with the Mirena over the Paragard. Now, why the two midwives had such different views on the IUD, I don't know, but the midwife who removed my IUD seemed to make more sense to me, PLUS she HAS PCOS and really seemed to know what she was talking about.

    I doubt I'll go back to the IUD, but hope that info helps you out!
    Stephanie


    Two early miscarriages 11/06 & 8/07
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    May 2010: Surprise BFP with IUD in place
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    Registered User Blessedtobeme's Avatar
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    I bleed for a really long abnormal time and it was a fight to get my doctor to remove it. I never recommend it, pcos or not.

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    Registered User dramaqueen24's Avatar
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    I had the Copper IUD up until 10 days ago and hated it from the second it was in. I had SUPER long and heavy periods, constant discharge and lots of pain. I had it replaced with the mirena and so far so good. I can't tell you much about it as its not been in 2 weeks yet, but if I had my time again I'd go straight for the Mirena. I
    I don't think you can know how you'll react until you try it.
    I was reluctant to try it as I'd heard that it can cause problems for some ladies with PCOS, but it was my last resort. As the hormones are localised to your womb I was ok with it.
    Do you have any other possiblities to use as contraception???

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    Carrie's Mama MOJO33's Avatar
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    I love my Mirena. I had a couple of periods and then some spontaneous spotting for about 7 months. Since then I may spot one day a month. My OB recommended Mirena because of my PCOS. It keep the utering lining thin which is important and when we are ready to TTC again there is no waiting period.

    I have had my Mirena since May '09.
    Mary Jo
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    Colorado SoulCyster taradon's Avatar
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    I had the Mirena put in when I was 8 week PP with my 3rd. I had spotting for a month or two, but nothing too extreme. Then I had very few periods for the next two years. Kind of unpredictable - never knew when to expect it. But when I did have a period it was just a couple of days of light bleeding. I never had any problems with my hormones getting out of whack (you know, any more so than they usually are with PCOS).

    When DH and I decided to try for another child, the doc removed the Mirena, put me on metformin, and 4 months later we were PG.

    I liked Mirena a lot. I'll get it again after this baby is born.
    Tara-35, DH-36
    daughter, Haley Maree, born 12.27.03
    son, Preston Kyler, born 5.20.06
    m/c 5.25.07 @ 11 wks
    son, Brekken Malachi, born 5.07.08

    PCOS & thrombophilia

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    Registered User smeets88's Avatar
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    my mirena fell out at 5 months, i bleed the entire time until i think it fell out. I thought i got lucky and the bleeding finally calmed, but the stupid thing just fell out. Never saw it, didn't know until i did a string check and they were gone.... Then had to wait 2 weeks for a Dr. appt... Good thing PCOS kept me infertile! lol
    (Jess) 27Hidden Content (Chris) 30

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    Registered User karla215's Avatar
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    I had the Mirena for about 4.5 years, and I loved it. Never felt it, never had even 1 period or really any spotting to speak of, and it didn't impact me as much as BCP had been doing (nauseous regularly!!). I got it out because in the meantime I had been on metformin for the past 2 years (never lost weight due to it, but that was my hope - it did regulate my insulin resistance, so I stayed on it), and I wanted to know, had to know, if my female system was finally working, at least once in my life! Before it STOPPED working again, probably due to menopause, but who knows when that will be. Anywho, I figured out 2 years ago that I was wrong about not needing a baby (I have 2 stepsons and DH is 47, so, I can sympathize why he is resistant), but DH is still in the same place we used to BOTH be in...sigh...And now 2+ months after getting UID out and nothing - not a spot! Sigh...

    Anyway, I did love the Mirena - but in the future will probably try BCP again to see if that helps my weight - just been heavier in general, by 5-10lbs, since I got the Mirena...

    Karla
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    Metformin 2000 mg XR (spiro and victoza temp stopped)

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    Travis W. McCoy, MD FACOG DrTravisMcCoy's Avatar
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    The mirena is a wonderful instrument for the right people. It all depends on what you are trying to accomplish in the setting of the IUD. Some info about IUDs and PCOS.

    1) IUDs are wonderful birth control and in most studies are as effective or even more effective than having a tubal ligation.
    2) There are two forms marketed in the US, the Copper-T (Paragard), and the Levonorgestrel containing IUD (Mirena). The Paragard is indicated for up to 10 years use, and has no hormones. The Mirena is indicated for up to 5 years use and has a slow release of a progesterone. Some countries such as France have used the Mirena successfully for up to 7 years for birth control.
    3) One concern with PCOS is that with chronic anovulation, a woman can develop hyperplasia (overgrowth) of the endometrium (uterine cavity lining), which over times could develop in to pre-cancer, then into cancer. I have seen many handfuls of women in their 20s with endometrial cancer due to this. The Mirena IUD would protect nearly 100% from this type of overgrowth, whereas the Paragard would have no effect at all.
    4) Paragards are associated with slightly heavier bleeding, and with those who do not regularly ovulate, this could lead to chronic significant bleeding.
    5) The mirena does not have enough progesterone to lead to any body-wide effects, thus it is not helpful in PCOS except to protect from endometrial hyperplasia
    6) The Mirena is associated with some irregular bleeding, which decreases over time. I tell patients that if they can put up with it for the first 2-3 months, it will usually get much better. Overall, even in women who have regular cycles, by one year's time, over 40% will become fully amenorrheic, and over 95% will have significantly lighter menses, with most being only a few days of light bleeding or spotting. This happens from the endometrium getting chronically thinned out over time, but does take a few months to acheive this steady state. Inserting one right after pregnancy will usually result in reaching this end result much faster.

    The mainstay of treatment for PCOS is an oral birth control pill. I have used both the Mirena and BCPs in the same patient if she needs contraception but is not a good consistent pill taker (such as in a younger girl), so the Mirena would give the contraception, and the BCP would still give improvement for the PCOS.

    Hope this helps to clarify things. Have a great long weekend!

    Travis W. McCoy, MD
    Travis W. McCoy, MD, FACOG
    Reproductive Endocrinology & Infertility
    Florida Institute for Reproductive Medicine (FIRM)
    The Center for PCOS
    Jacksonville, FL
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