Does Mirena Help for Heavy Bleeding?

IUD for the Treatment of Heavy Periods

Mirena for Heavy Bleeding
Using Mirena for Heavy Periods. Vesna Andjic/E+/Getty Images

What is Mirena?

Mirena is an IUD birth control option. This hormonal device can prevent pregnancy for 5 years -- by slowing releasing the progestin, levonorgestrel, over this time. If you choose Mirena for birth control, you may be able to benefit from some additional non-contraceptive benefits... such as, relief from heavy periods.

Mirena for Heavy Bleeding:

On October 1, 2009, the FDA announced its approval for Mirena to be used to help treat heavy bleeding.

It is the only contraceptive approved to help manage excessive menstrual bleeding. Mirena is also the only non-surgical treatment option if you suffer from heavy periods.

How Many Women Suffer from Heavy Bleeding?

It is estimated that between 9-14% of healthy women may be affected by heavy periods. Women who have heavy periods will typically lose about five/six tablespoons of blood (totaling 80 mL or more) in a single menstrual cycle. Women with average periods only lose about 4 to 12 teaspoons of blood (20-60 mL) during their period.

How Do I Know if I Have Heavy Periods?

It may be difficult to tell how much blood you lose during your period. Because of this, doctors suggest that you may be suffering from a heavy bleeding if you:

  • Soak through a pad or tampon every 2 to 3 hours.
  • Have ever stained your clothes or bedding as a result of a heavy bleeding.
  • Have to get up in the middle of the night to change your tampon or pad.
  • Wear both a tampon and a pad (for double protection).

Using Mirena for Heavy Bleeding:

There have been many research studies done to see if Mirena is an effective treatment of heavy periods. Here is a summary of some of this research:

  • In one study of women who suffered from heavy bleeding -- Mirena reduced the amount of menstrual bleeding by 80% after 3 months of use. After 6 months, bleeding way reduced by 90%.
  • Another study looked at 50 women who were planning on having surgery to treat their heavy periods -- but agreed to have Mirena inserted instead. Thirty-seven of the women reported that they noticed much lower amounts of blood loss after 3 months of Mirena use. This number increased to 41 after 9 months of use. Forty-one of these women decided to continue using Mirena instead of having surgery to treat their heavy bleeding.
  • A review of six different research studies showed that, when compared to endometrial ablation (a surgical procedure that removes the lining of the uterus), Mirena was found to be just as effective in reducing monthly blood loss. Mirena was also found to be a good alternative to endometrial ablation because there are less side effects -- plus, Mirena does not affect your future fertility (vs. endometrial ablation which can make it difficult to become pregnant).
  • When compared to other progestin-only birth control options, research shows that Mirena seems to be a better treatment method for heavy bleeding than progestin-only birth control pills. One study that looked at women who have heavy periods showed that the women who used Mirena were more satisfied and willing to continue to use Mirena than women who used progestin-only pills. Also, when compared to medroxyprogesterone acetate (the progestin found in Depo Provera), Mirena lowered menstrual blood loss much more than Depo Provera did -- 85% of the women using Mirena were successfully treated (their blood loss was reduced by over 50%) vs. 22% of Depo Prover users.
  • One study looked at Mirena as a treatment for heavy bleeding for one year. Mirena was found to be an effective treatment for three out of four women with heavy bleeding -- 79.5% of the women also planned to continue using Mirena. This study showed that hemoglobin (the main component in red blood cells) levels increased at 3 and 12 months for women who used Mirena. This is important because heavy bleeding can lead to lower hemoglobin levels -- and this can put you at risk for becoming anemic (when your body doesn’t have enough healthy red blood cells).

Overall, it seems that Mirena can help treat heavy bleeding in two ways:

  1. Mirena may lower the amount of bleeding you have each month.
  2. Your total blood loss per each cycle may steadily decrease with continued Mirena use.

It is important to point out that... you may initially have more days of spotting (irregular bleeding) after Mirena has been inserted. But, this bleeding usually decreases after a few months of use.

How Does Mirena Lessen Heavy Bleeding?

The Mirena IUD is inserted into the uterus -- the progestin released by Mirena helps to reduce the thickening of the lining in your uterus (that happens each month). This makes the lining thinner, so there is less of it to shed off during a period... this equals less monthly bleeding.

Mirena can reduce monthly bleeding in both women with average or heavy periods. Most women who use Mirena will experience a reduction in blood loss after 3 to 6 months of use. There seems to be a 86% decrease in blood flow at 3 months after insertion -- this is the case if you have heavy bleeding or even if you have regular bleeding. This reduction in bleeding increases to 97% after one year of use. Plus, after 6 months of use, around 20% of women who use Mirena will not get a period at all. This number rises to about 50% after using Mirena for 5 years.

Sources:

Barrington JW, Bowen-Simpkins P. "The levonorgestrel intrauterine system in the management of menorrhagia." Br J Obstet Gynaecol 1997;104:614–6. Accessed via private subscription.

FDA. "NDA 21-225 Mirena Clinical Review." September 16, 2009. Accessed 3/16/16.

Monteiroa I, Bahamondes L, Diaza J, Perrottia M, Pettaa C. “Therapeutic use of levonorgestrel-releasing intrauterine system in women with menorrhagia: a pilot study.” Contraception 2002;65(5):325-28. Accessed via private subscription.

Kaunitz AM, Meredith S, Inki P, Kubba A, Sanchez-Ramos L. "Levonorgestrel-releasing intrauterine system and endometrial ablation in heavy menstrual bleeding: A systematic review and meta-analysis." Obstet Gynecol 2009;113:1104–16. Accessed via private subscription.

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