What’s the lowdown?
It can be difficult to understand what happens when you hit menopause in any circumstances. But what about when menopause starts whilst using contraception, or with the Mirena coil (IUS) in place?
Some people think the Mirena coil encourages menopause, some think it delays it and others think it masks the symptoms altogether. So what’s the truth?
If you’re not sure what to expect during this time then look no further. In this post, The Lowdown’s medical experts answer all your questions on the Mirena coil and the menopause.
What is menopause?
So first things first, let’s explain this one. The natural menopause is when women’s ovaries stop producing the hormones oestrogen and progesterone. Hormone levels can fluctuate for several years before eventually becoming so low that the lining of the womb no longer sheds, meaning periods stop. After the menopause (usually after 12 months with no periods) women are no longer able to become pregnant naturally.
The menopause is a natural part of ageing, experienced by all women, and normally happens between the ages of 45 and 55. There can be exceptions to this and before the age of 45 is considered early menopause. When menopause occurs under the age of 40, this is known as premature menopause. In the UK, the average age for menopause is 51.
Can the Mirena cause menopause?
Many people think that interfering with hormones or being on contraception that stops your period can have an effect on when you hit menopause, but this is not true.
Even if you are using a form of contraception that stops you ovulating, as you get older you steadily lose follicles in the ovaries (which produce eggs) and the ovaries stop producing oestrogen and progesterone. The Mirena (or any other type of contraceptive) does not have an effect on the time it takes to get menopause.
Treating severe menopause symptoms with Mirena: the benefits
Help with heavy bleeding during the perimenopause
The IUS, such as the Mirena coil, is incredibly good for treating one menopause symptom in particular, heavy periods. In some cases, your monthly flow can get so heavy that you soak through a pad or tampon every couple of hours. Studies have shown that having a Mirena coil inserted during the perimenopause (from the beginning of menopausal symptoms to the after menopause) can help treat heavy menstrual bleeding.
What do Mirena reviews say?
56% of Lowdown users said the Mirena coil stopped their period altogether, and 15% said it made them lighter. The Mirena IUS is therefore a recommended treatment for women who bleed heavily during their perimenopause.
Whilst the Mirena coil may be a good treatment for symptoms like heavy bleeding, some women can experience side effects from the IUS such as acne, headaches or breast tenderness, although these tend to settle after a few months.
However… the Mirena coil may mask menopause symptoms
As the Mirena coil may stop your periods altogether, it can be hard to tell whether you are perimenopausal or not. This is the same for all hormonal contraceptives (such as the pill, patch, vaginal ring, injection, implant and other forms of IUS) which can affect your menstrual cycle.
The Mirena coil can also cause a few symptoms that look a lot like menopause, including mood swings and irregular periods.
33% of The Lowdown user reviews said the Mirena coil had a negative or very negative impact on their mood, whilst 45% said it had no impact.
The Mirena coil shouldn’t affect other menopause symptoms. As your oestrogen levels naturally drop, you may still experience hot flushes, night sweats and sleepless nights, amongst other symptoms. Starflower oil is a little-known natural remedy that’s great at helping to ease hormonal symptoms due to the menopause, like hot flushes. Intrigued? We’ve got you – check out our product page for more information on the benefits of starflower oil.
HRT can help during menopause
Although the Mirena coil may lighten your bleeding or make it stop altogether, it doesn’t alleviate other symptoms such as hot flashes. However Hormone Replacement Therapy (HRT) might.
HRT is available in pills, patches, and gels for example and can help women with menopausal symptoms like:
- Night sweats
- Vaginal dryness
- Hot flushes
- Weak bones
HRT comes in two forms:
- oestrogen only therapy for women that have had a hysterectomy
- oestrogen plus progestogen for women who have a uterus
The Mirena coil can be used as the progestogen element of HRT.
HRT is not a method of contraception
Although HRT contains oestrogen and progestogen, it does not act as a form of contraception. You should therefore make sure you are using effective contraception in addition to HRT if needed.
You may need a test to see if you’ve reached menopause and you have a Mirena coil
Typically you don’t normally need a test from the doctor to diagnose menopause.
A clinical diagnosis can be made without laboratory tests in otherwise healthy women aged over 45 years with appropriate symptoms. Diagnosis of the perimenopause is made based on symptoms such as hot flushes and irregular periods. Menopause can be diagnosed in women who have not had a period for at least 12 months and are not using hormonal contraception, or in women who have had a hysterectomy who have symptoms.
Since the IUS can stop your periods, you may not know if you are menopausal. If this is the case and you are looking to stop using contraception, your doctor can do blood tests to check levels of follicle-stimulating hormone (FSH). FSH helps regulate your menstrual cycle and egg production.
During menopause, FSH levels rise, whilst oestrogen levels drop and a blood test can reveal these changes. Your doctor may need to take a couple of tests over a period of time, as your FSH levels can rise and fall throughout your cycle. They’ll also consider other symptoms.
If you’re not sure whether the Mirena coil has made your periods stop, or whether you are menopausal, speak with your doctor or book an appointment with one of The Lowdown’s women’s health GPs for a personalised appointment to discuss your concerns.
Mirena and menopause: when to remove your coil
If you want to remain protected from pregnancy, continue with the Mirena coil until you’re 55 years old.
Naturally your fertility slows down in your 40s, however it is still possible to get pregnant until the menopause. To be safe, if you have a Mirena IUS or are using another progestogen only method and are not having periods you could continue to use this method until you are 55 years old, after which point you do not need to use contraception and can safely have your coil removed.
Mirena coils normally provide protection against pregnancy for up to 5 years. However if you have had your Mirena inserted after the age of 45 it can be used for contraception without being replaced until you are 55.
Alternatively your doctor can test your FSH levels to determine when contraception should be stopped.
You could remove your Mirena coil and opt for a different method of contraception such as condoms or non-hormonal methods.
You will still need to use contraception until you are:
- aged 55 or over
- or aged over 50 and it has been more than 12 months since your last period
- or aged between 45 and 50 and it has been more than 2 years since your last period
Combined hormonal methods containing oestrogen and progestogen are not recommended over the age of 50 due to increased risks in this group.
A Mirena coil doesn’t kickstart menopause or have any impact on at what age you will go through the menopause. However it can have an effect on your periods which may make identifying signs of the menopause more difficult. The Lowdown’s team of women’s health GPs are available to talk about contraception and the menopause, or any other hormonal questions you may have!
Maddie is an English Language and Linguistics graduate who is passionate about writing. She writes fun and informative content on the weird and wonderful sides of contraception!