Does The Mirena Coil Help With Menopause?

mirena coil menopause perimenopause
Is the Mirena Coil helpful with menopause and perimenopause symptoms? We explain how it can help some women manage in these midlife years.

This article answers some frequently asked questions about menopause and the Mirena coil, including:

During our regular Instagram Live Midlife Health and Menopause Clinics we get many questions about the Mirena coil, menopause and perimenopause. We’ve also added some other popular questions from our community, Women With Ambition, Attitude and Brain Fog 

READ MORE How to book a private menopause specialist.

At Hylda we get a lot of questions about women’s sex drive at perimenopause and menopause. We believe finding the right contraception is critical to creating a safe and relaxed environment for midlife sex. In fact, many of the questions women have are about the use of the Mirena and its effect on the end of the menstrual cycle and on menopause and perimenopause symptoms.

Some women believe that the Mirena controls the onset and the symptoms associated with menopause; this is untrue. Others think that Mirena masks the symptoms of menopause and perimenopause; it does, but only one of them.

Like the rest of our decision-making around health issues at midlife, it is important to understand the information available before deciding on the best option.  Some women do not believe that you need to use contraception in the menopause transition – but this is not the case either. More about this below.

READ MORE What are the 34 menopause symptoms?

What is the Mirena?

The Mirena coil, also known as the hormonal intrauterine system (IUS), is primarily used as a form of contraception before the menopause – and also as a treatment for heavy periods. It releases a small amount of progestogen hormone into the uterus, which can help reduce the thickness of the uterine lining and decrease menstrual bleeding. This can be beneficial for women who experience heavy or prolonged periods during perimenopause.

The IUS contains a progestogen hormone (like progesterone – the hormone made by the ovaries) that prevents pregnancy by thickening the mucus in the cervix, stopping sperm from fertilising an egg. It also works in thinning the uterus lining, affecting menstrual bleeding. In addition, according to the medical team at My Menopause Centre (Hylda’s women’s health partner), it has a license for use as part of your hormone replacement therapy (HRT).

Can you go through menopause with Mirena coil?

The IUS is form of long acting contraception that can be used by women of all ages. GPs also prescribe it for women with other conditions. These include painful periods, endometriosis, heavy bleeding associated with fibroids, and adenomyosis.

A lot of confusion surrounds the use of the Mirena and the role that it plays in the menopause. The Mirena officially lasts for five years as contraception, but can be used for up to six years. If it is fitted at the age of 45 though, it lasts for longer and you can keep it till you are 55 if you are using it for contraception only.

At the age of 55, all contraception can be stopped. If you are using the Mirena as part of HRT (more about this later), you need to change it after five years, regardless of how old you were when it was fitted. This can lead to a little confusion – just remember, it can stay in place for up to five years if you are using it as part of your HRT, regardless of the age it was fitted.

Will the Mirena Coil help with menopause and perimenopause symptoms?

HRT consists of two hormones if you have not had a hysterectomy – oestrogen and a progestogen. The oestrogen helps manage symptoms of the menopause. If oestrogen is taken by itself it can lead to thickening of the womb lining and this can significantly increase the risk of abnormalities and even cancer in the womb lining. It’s really important, therefore, that if you have a womb you take a progestogen hormone. The progestogen is generally only needed to keep the womb lining thin and stable. The Mirena can be used as the progestogen part of HRT.

Therefore, the Mirena coil does not provide systemic hormone replacement therapy (HRT) that addresses menopausal symptoms such as hot flushes, vaginal dryness or mood changes. If you are experiencing a wide range of menopausal symptoms, you may need additional treatment options, such as oestrogen-containing oral or transdermal HRT to manage those symptoms effectively.

Where a Mirena can help is with a common symptom of these midlife years, irregular periods. Some women will experience light, shorter or longer, heavy periods for years before they reach the end of their menstrual cycle. 

When you have a Mirena fitted, there may be initial irregular bleeding or none at all – and by one year, the majority of women will have no bleeding or occasional bleeding only. Some women continue to have a regular bleed – it’s impossible to predict what your bleeding pattern will be.

How do I know I’m in menopause if I have a Mirena?

For some women, the Mirena stops periods altogether. The only way to tell if you are in the perimenopause or menopause is therefore to watch out for symptoms.

Since the Mirena does not contain oestrogen, it does not affect symptoms that arise with decreasing levels of the hormone. These include hot flushes, trouble sleeping and mood changes.

The Mirena releases a tiny amount of progestogen into the body. When it is first fit, this amount is higher and it can result in a few side effects – headaches, irritability, headaches and bloating for example. However they usually settle with time. The vast majority of women feel fine when they have a Mirena – a small percentage do not tolerate it and will ask for it to be removed. 

READ MORE: What is the difference between perimenopause and menopause?

Can the Mirena mask menopause symptoms?

Most menopause symptoms are as a result of loss of oestrogen. The Mirena does not contain oestrogen – so if you have a Mirena fitted you will still experience symptoms of oestrogen deficiency. It can stop periods, so you don’t have periods to tell you when you are in the menopause transition. This is why it’s important to know about other symptoms of the menopause.

Occasionally, some women experience ongoing side effects of the Mirena such as breast tenderness, mood swings, and headaches. These are also menopausal signs, so it can be tricky to know what is causing them. It is more likely that these are side effects if they started when you had the Mirena fit.

If you are using the Mirena for contraception, you should continue to use it until you can confirm with your GP that you can no longer become pregnant. Fertility begins to decline in women who are in their 40s, but it is still possible (although rare) to become pregnant in your 50s.

When it comes to deciding when you can stop using contraception, the rules are a little complicated, but in a nutshell over the age of 50 and before the age of 55 you can stop using contraception when you have not had a period for one year (assuming you are not taking hormones. Under the age of 50, you need to have stopped bleeding. It’s best to discuss your own circumstances with a doctor to avoid unwanted pregnancy/mishaps. 

If the Mirena has caused your periods to stop, your GP may sometimes take blood tests to establish whether the symptoms you have are menopausal and to rule out other causes of your symptoms. Hormone tests are unreliable in diagnosing the menopause and are only recommended for younger women. This is because hormones can fluctuate erratically in the perimenopause.

How long before menopause does perimenopause start?

Perimenopause begins eight to 10 years before the end of your periods. During this phase, menstruation often becomes irregular and may involve more or less bleeding. Most women who are between 45 to 55 years of age have perimenopausal symptoms to a greater or lesser degree. The average age of perimenopause in the UK is 45. The average age of menopause is 51.

The end of your period usually begins when the last follicles in the ovaries have disappeared. Before the onset of the end of your periods, these follicles produce hormones such as oestrogen and progesterone. Periods stop when the ovaries stop producing these hormones.

Can I take HRT with the Mirena?

Yes, the Mirena can be used together with hormone replacement therapy (HRT).. If the Mirena was fitted within the last five years, it can provide the progestogen part of your HRT and you would then take the oestrogen separately as pill, patch, spray or gel. If it is more than five years, you will need to use an alternative progestogen until you can have the Mirena replaced. The Mirena can stay in place while you are taking the alternative progestogen. So, your doctor does need to be aware of the fact that you are using the Mirena Coil when prescribing

Do I need HRT if I have a Mirena coil?

If you have a Mirena coil, it can help manage the unpredictable and often heavy bleeding of the perimenopause. It won’t help manage the symptoms of oestrogen deficiency such as hot flushes, night sweats, psychological or physical symptoms. There are other options available to help manage these symptoms, including oestrogen containing hormone replacement therapy. The Mirena can form part of your HRT – it contains the progestogen which protects the womb lining – and you can take the oestrogen separately to help manage the symptoms of the menopause.

READ MORE Read more about My Menopause Centre and how to book a private menopause specialist appointment here.

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