Mirena IUD for the Treatment of Heavy Periods

Woman in pain curled up on her bed

Vesna Andjic / Getty Images

If you suffer from heavy menstrual periods, could the Mirena IUD be a good option? How does it compare with oral contraceptives and surgical options, such as endometrial ablation and hysterectomy, for controlling heavy bleeding?

What Is Mirena IUD?

The Mirena IUD is a form of intrauterine device (IUD) used for birth control. This hormonal device can prevent pregnancy for five years—by slowly releasing levonorgestrel, which is a type of progestin, over time. If you have chosen Mirena for birth control, you may find that you're already enjoying 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 approved type of birth control that helps manage excessive menstrual bleeding. Mirena is also a 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 5 or 6 tablespoons of blood (totaling 80 mL or more) in a single menstrual cycle. By contrast, 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 (when your body doesn’t have enough healthy red blood cells) and other problems, not to speak of the lifestyle issues of living with heavy periods.

Symptoms of a Heavy Period

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 loss. Because of this, doctors suggest that you may be suffering from 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)

Research

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 with 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 was 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 with 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 it does not affect 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 the levels of hemoglobin (the main component in red blood cells) increased at 3 and 12 months for women who used Mirena. This is important because heavy bleeding can lead to lower hemoglobin levels, which could put you at risk of becoming anemic.
  • 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 side effects are somewhat more common with Mirena than with endometrial ablation, but Mirena is more cost effective.

How It Helps

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 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 your uterine lining (a monthly occurrence). This makes the lining thinner, so there is less of it to shed off during your period and results in less bleeding.

How Long Does It Take to Work?

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

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.

A Word From Verywell

Mirena can significantly reduce menstrual bleeding for the majority of women who have had 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.

Was this page helpful?

Article Sources