Does Mirena Help With Heavy Bleeding?

Mirena IUD for the Treatment of Heavy Periods

Mirena for Heavy Bleeding
The Mirena IUD is a form of birth control that may also help with heavy periods. Vesna Andjic/E+/Getty Images

If you are thinking of an IUD for birth control and have heavy periods, is the Mirena IUD a good option? How does this compare with both oral medications and surgical options (such as endometrial ablation and hysterectomy) for controlling heavy bleeding?

What Is the Mirena IUD?

The Mirena IUD is one form of IUD (intrauterine device) used for birth control. This hormonal device can prevent pregnancy for five years—by slowing releasing the progestin, levonorgestrel, over this time.

If you choose Mirena for birth control, you may also be able to benefit from some additional non-contraceptive benefits such as relief from heavy periods.

Mirena for Heavy Bleeding:

The FDA approved Mirena in 2009 to help treat heavy bleeding. It is currently the only type of birth control approved to help manage excessive menstrual bleeding. Mirena is also the only good non-surgical treatment option if you suffer from heavy periods.

How Many Women Suffer From Heavy Bleeding?

It is estimated that between 9 and 14 percent of healthy women are 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.)

Heavy periods can, in turn, lead to anemia and other problems, not to speak of the lifestyle issues of living with heavy periods.

How Can You Know If You Have Heavy Periods?

It may be difficult to tell how much blood you lose during your period, and few women would be able to estimate the number of teaspoons or tablespoons of blood lost. 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: What Does the Research Tell Us?

There have been many research studies done to see if Mirena is an effective treatment of heavy periods, both alone, in comparison with oral medications, and in comparison to surgical procedures such as endometrial ablation and hysterectomy. 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 percent after 3 months of use. After 6 months, bleeding way reduced by 90 percent.
  • 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.
  • When compared with both the progestin-only birth control pill and Depo-Provera, Mirena has been found to be more effective in controlling 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 fewer side effects and Mirena does not affect your future fertility (vs. endometrial ablation which can make it difficult to become pregnant).
  • 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 percent 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).
  • A 2017 study evaluated the differences between Mirena, hysterectomy, and endometrial ablation for heavy bleeding. Mirena ranked as best with regard to the number of quality of life years, followed by a hysterectomy, followed by endometrial ablation. Adverse effects are somewhat more common with Mirena than endometrial ablation, but Mirena is more cost effective in comparison.

How Does Mirena Reduce Menstrual Bleeding?

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.

After the Mirena IUD is inserted into your uterus the progestin released helps to reduce the thickening of the lining of 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.

How Long Does It Take for Mirena to Reduce 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 roughly an 85 percent decrease in blood flow at 3 months after insertion whether you have regular bleeding or heavy bleeding. After a year of use, over 95 percent of people have a reduction in bleeding.

After 6 months of use, around 20 percent of women who use Mirena will not get a period at all. This number rises to about 50 percent after using Mirena for 5 years.

Spotting May Increase Initially With Mirena

Some women fear that Mirena won't help early on, as they notice that they have more spotting rather than less. It's important to point out that this initial spotting (more days of spotting or irregular bleeding) is normal after Mirena has been inserted, but usually decreases after a few months of use.

Bottom Line on Using a Mirena IUD for Heavy Menstrual Bleeding

The Mirena IUD can significantly reduce menstrual bleeding for the majority of people who have the IUD inserted. This may help not only with lifestyle issues and the potential for anemia but is less invasive than some of the surgical procedures used to reduce bleeding. It also has the advantage of better preserving your fertility if you are considering having a child or another child in the future.

Any method of reducing menstrual bleeding can have side effects, and it's important to have a careful discussion with your doctor about what is right for you.

Sources:

Lethaby, A., Hussain, M., Rishworth, J., and M. Rees. Progesterone or Progesterone-Releasing Intrauterine Systems for Heavy Menstrual Bleeding. Cochrane Database of Systematic Reviews. 2015. 30(4):CD002126.

Marjoribanks, J., Lethaby, A., and C. Farquhar. Surgery Versus Medical Therapy for Heavy Menstrual Bleeding. Cochrane Database of Systematic Reviews. 2016. (1):CD003855.

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