Mirena is a brand name for a type of intrauterine device (IUD) that contains the hormone levonorgestrel. It is a T-shaped plastic device that is inserted into the uterus to provide long-acting, reversible contraception.
Starting around age 40, I experienced perimenopause symptoms (night sweats, restless legs syndrome, PMS migraines, shorter but more intense menstrual cycles) that I managed with a grin-and-bear-it attitude and big pads. Then in 2016, I had a few heavy periods that lasted more than a week and I decided to see a gynecologist for medical care.
After telling her my medical history and symptoms she performed an endometrial biopsy and sent me for blood tests and transvaginal ultrasound. The biopsy came back negative. However, the ultrasound found that I had endometrial hyperplasia (thickening of the lining of the uterus) and a fibroid, and the blood tests showed I was anemic. My doctor prescribed me medroxyprogesterone for 1 month to handle the heavy bleeding (or as she put it to close the tap) as well as iron supplements for the anemia.
It was most likely that my ovaries were making less progesterone and causing my perimenopause symptoms such as heavy bleeding. With that in mind, we decided that a Mirena IUD would be the best treatment to keep the endometrial hyperplasia at bay. It would provide my body with a small amount of progestin hormone consistently.
The Mirena IUD would be hormone replacement therapy (HRT) and protect me from developing endometrial cancer. Now I did get endometrial cancer in 2021 but that story is for a future post.
Note: There is no test of your hormone levels that tells you if you are perimenopausal as progesterone and estrogen naturally fluctuate each day of the menstrual cycle, but certain symptoms can inform us.