The Mirena intrauterine device (IUD) is a popular method of long-term birth control that releases levonorgestrel, a synthetic form of progesterone, into the uterus. It can remain in place for up to 5 to 8 years, depending on the reason for its use, such as long-term birth control or treatment for heavy menstrual bleeding. While the Mirena IUD is effective and convenient, some people experience side effects and may choose to have it removed. Understanding the potential effects of Mirena removal, particularly concerning weight changes, is essential for those considering this option.
What is the Mirena IUD?
Mirena is a T-shaped device inserted into the uterus to prevent pregnancy. It is classified as a hormonal IUD, releasing small amounts of levonorgestrel directly into the uterine lining. This process thins the endometrium and thickens cervical mucus, preventing sperm from reaching or fertilizing an egg.
Reasons for Mirena IUD Removal
A person might ask their doctor to remove the Mirena for various reasons, including:
- End of its Effective Lifespan: The Mirena IUD begins to release less levonorgestrel over time. At this point, a doctor can remove or replace it after 5 years for heavy menstrual bleeding or 8 years for preventing pregnancy.
- Unwanted Side Effects: Sometimes, IUDs cause side effects. If these side effects become too disruptive, a person may ask their doctor to remove their IUD, so that they can try a different method of birth control.
- Fertility: People who want to try to conceive will need a doctor to remove their IUD, as IUDs such as Mirena are more than 99% effective at preventing pregnancy.
- IUD Expulsion: Sometimes the Mirena IUD spontaneously moves from its position in the uterus. This is called expulsion. Partial or complete IUD expulsion may cause bleeding or pain, but some people do not experience any symptoms. According to clinical trials, the rate of expulsion is 4.5% over 5 years.
- Pregnancy: There is a very low risk of becoming pregnant while using the Mirena IUD. However, if a person does become pregnant while using it, a doctor must remove the device immediately because someone who becomes pregnant while using Mirena is at a higher risk for ectopic pregnancy, miscarriage, septic abortion, premature labor, and delivery.
- Perforation: According to the prescribing information, an IUD can puncture the uterus or cervix, although this is rare. If a person or doctor notices a perforation, the doctor must locate the IUD and remove it. In some cases, removing an IUD that has caused a perforation requires surgery.
- Pelvic Inflammatory Disease: Doctors will remove the Mirena IUD if a woman has recurrent PID, endometritis, or a pelvic infection that does not respond to treatment. People using an IUD must report the following symptoms to their doctor: lower abdominal pain, pelvic pain, odorous discharge, unexplained bleeding, a fever, or genital lesions or sores.
- Pelvic Actinomycosis: Pelvic actinomycosis is an infection that occurs due to the bacteria Actinomyces and may relate to IUDs. People with pelvic actinomycosis may have symptoms such as weight loss, nonspecific abdominal pain or pelvic pain, bleeding in between periods, heavy menstrual flow, or a fever.
- Other Reasons: Doctors may also suggest removing an IUD if someone has any of the following conditions, according to the prescribing information: a blood clotting disorder, migraine with aura, severe headaches, a significant increase in blood pressure, severe cardiovascular diseases (such as stroke or heart attack), gynecological cancer, or jaundice.
The Mirena Removal Procedure
Removing a Mirena IUD is typically a quick procedure performed at a doctor’s office. After a doctor removes the Mirena IUD, a person may experience some mild pain or bleeding, which may continue for a few days.
In some instances, doctors may encounter resistance when attempting to remove the IUD, especially if the Mirena has become embedded in the uterus. In such cases, the doctor may use a device called a hysteroscope to visualize the inside of the uterus, locate the IUD, and facilitate its removal. If a hysteroscope is necessary, pain medication or anesthetic will be provided to enhance comfort during the procedure. Following hysteroscopic removal, some cramping and bloody discharge may occur for a few days.
Read also: The Mirena IUD and Your Weight
Individuals with epilepsy may experience a seizure during removal. It is crucial to seek immediate medical attention if a fever, chills, or heavy bleeding develops after IUD removal.
The "Mirena Crash"
Some people report experiencing a ‘Mirena crash’ after the device is removed. Doctors have not defined the Mirena crash in medical literature, so its description comes from personal accounts. One theory about why the Mirena crash happens is that removing the IUD causes a drop in progesterone or a hormonal imbalance, and it may take time for the body to create more.
Unlike the short-term symptoms of Mirena removal, a Mirena crash involves longer-lasting psychological, neurological, and physical symptoms, that might include:
- Depression
- Anxiety
- Mood swings
- Insomnia
- Headaches
- Fatigue
- Hair loss
- Nausea
- Weight gain
- Acne
- Decreased sex drive
People report that these symptoms can last weeks or sometimes months after a doctor has removed the Mirena. However, researchers have not yet studied the Mirena crash, its potential symptoms, its causes, or how to treat it.
Mirena Removal and Weight Changes: What Does the Evidence Say?
Among the common side effects reported by Mirena users, weight gain is frequently discussed. The relationship between hormonal contraception like Mirena and weight is nuanced. Research varies, with some studies suggesting minimal impact on weight, while others cite weight gain as a significant concern for users. A comprehensive review by the Cochrane Database of Systematic Reviews found that most women do not experience significant weight gain attributable solely to hormonal IUDs.
Read also: Weight Loss with Mirena and PCOS
The lack of research on IUD-related weight changes makes it difficult to determine how your weight might change following IUD removal. More studies are needed to support the possibility of weight loss or gain.
Weight Loss After Mirena Removal: Is it Possible?
Yes, it is possible to lose weight after the removal of Mirena, though individual experiences can vary significantly. Mirena may make it challenging for some individuals to lose weight because it releases the hormone levonorgestrel, which can influence the body’s hormonal balance; some users report experiencing weight gain. After the removal of Mirena, the body undergoes hormonal adjustments as it returns to its natural hormonal cycle. This transition can cause a variety of symptoms, such as hormonal fluctuations that may affect mood, menstrual cycle regularity, and possibly weight.
Upon removal of Mirena, any weight changes that occurred due to its use might reverse as the body returns to its natural hormonal balance. However, significant weight loss directly attributable to Mirena removal is not consistently documented in scientific research.
Understanding the Hormonal Connection
The Mirena IUD releases a hormone called levonorgestrel, which helps prevent pregnancy. The Mirena crash is primarily attributed to hormonal imbalance. While the IUD is in place, it releases hormones that alter your body’s natural hormonal balance. When it’s removed, your body must recalibrate its hormone production, which can result in a temporary imbalance. After removal, the body has to adjust to the sudden drop in progestin. In theory, this hormone imbalance could lead to weight fluctuations and other symptoms people report as being part of the Mirena crash.
The cessation of levonorgestrel supply might lead to a temporary imbalance as the body readjusts, potentially affecting weight. When Mirena is removed, the body begins to readjust to its natural hormonal state, which can influence metabolic rate and body composition.
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Managing Symptoms After Mirena Removal
Most people who get symptoms after Mirena removal find that they are mild and improve on their own. Over-the-counter (OTC) pain medications such as ibuprofen and acetaminophen may help with any pain. A person may find it helpful to carry extra personal hygiene products with them to manage bleeding. It is also advisable to avoid inserting anything into the vagina for the next 24 hours. People who experience cramping may also benefit from trying some complementary treatments, such as yoga, gentle physical activity, heat pads, or a warm bath.
Experiencing unwanted weight gain and other side effects after taking birth control can be distressing and overwhelming, especially when symptoms leave you feeling a lack of control over your own body. Rather than drastically cutting calories or ramping up your exercise routine to the point where you feel exhausted, aim for changes that promote overall wellness and leave you feeling nourished and empowered. These strategies can help improve both mood and physical health:
- Choose high fiber, mood-boosting foods.
- Stay hydrated.
- Spend more time outdoors, especially in sunlight.
- Make physical activity a regular habit if you’re able to exercise.
- Try to sleep between 7 and 9 hours every night.
- Consider wellness practices like yoga and meditation.
- Reach out to friends and loved ones for emotional support.
Seeking Professional Advice
If any unwanted side effects linger for more than several weeks after IUD removal, it may be helpful to talk with a doctor or other healthcare professional. Healthy weight loss can take time, but if you’re making an effort to lose weight and see no results over time, a healthcare professional can offer more support. If these symptoms involve depression, anxiety, and other mood changes, a mental health professional can help you explore possible causes and offer guidance on treatment approaches.
It’s always a good idea to reach out sooner rather than later if your side effects or symptoms begin to affect your everyday life or cause significant distress.
The Importance of Individual Experiences and Further Research
Research into the effects of Mirena removal on weight presents a varied landscape. Several studies highlight that weight changes post-removal are often individual-specific and not solely attributable to the device itself. To date, the research on IUD removal doesn’t support the existence of any long-term side effects, including weight changes. Of course, one possible explanation for this is limited studies exploring IUD removal. Future research examining the possible long-term effects of IUD removal may help understand potential symptoms and their causes.
For now, just remember: You know what’s typical for your body. If you notice any unusual changes in physical or mental health, it’s always a good idea to connect with a healthcare professional.
Personal Anecdotes and the "Mirena Experience"
Many individuals share their personal experiences with Mirena IUDs and their removal, providing valuable insights into the potential effects. One person shared how, in 2.5 years of having the Mirena inside her body, she experienced a total body and mind transformation. She experienced constant, consistent, and uncontrollable weight gain and lost her positive nature, with negativity and depression becoming everyday normality. She started to sleep for hours during the day, and her libido completely evaporated from her system. Despite expressing multiple concerns to her doctor, she was assured it could NOT be the Mirena.
After removal, within just two weeks, she felt her mood begin to improve drastically, and her libido came back with a vengeance. More unexpectedly, she started to lose weight dramatically without dieting. For the first few months, it seemed like she was losing 15+ lbs a month. In under 12 months, she lost a total of 63lbs, putting her back at her starting weight before the Mirena. On the Mirena, she couldn’t lose weight no matter how hard she tried to diet or how little she tried to eat and couldn’t stop gaining. Another unexpected side effect of the removal of the IUD was hair loss.
These anecdotes highlight the importance of listening to your body and advocating for yourself when experiencing adverse effects from medical devices.