It can be difficult to understand what happens when you hit menopause whilst having the Mirena coil (IUS or intra-uterine system) in place. Some people think it encourages menopause, some think it delays it and others think it masks the symptoms altogether.
If you’re not sure what to expect during this time then look no further, because this post will answer all of the questions you could ever have 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.
Does the Mirena coil have an effect on the start of the 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.
The IUS can be used to treat some severe menopause symptoms
The IUS, such as the Mirena coil, is incredibly good for treating one menopause symptom in particular, heavy bleeding. Studies have shown that having a Mirena coil inserted during the perimenopause (from the beginning of menopausal symptoms to the after menopause) is happening can actually help treat heavy menstrual bleeding. In some cases, your monthly flow can get so heavy that you soak through a pad or tampon every couple of hours.
56% of Lowdown users said the Mirena Coil stopped their period altogether, and 15% said it made them lighter. The Mirena IUS is 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 experience side effects from the coil such as acne, headaches or breast tenderness, although these tend to settle after a few months.
The Mirena coil may mask other symptoms
As the Mirena coil may stop your periods altogether, it can be hard to tell whether you are perimenopausal or not. The Mirena coil can also cause a few symptoms that look a lot like menopause, including mood swings and irregular periods.
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.
HRT can help during menopause
Although the Mirena coil may lighten your bleeding or make it stop altogether, it doesn’t alleviate other symptoms. However Hormone Replacement Therapy (HRT) might.
HRT is available in pills, patches, and injections and can help females 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 progesterone for women who have a uterus
The Mirena coil can be used as the progesterone element of HRT.
HRT is not birth control
Although HRT contains oestrogen and progesterone, it does not act as a form of contraception. If you’re less than 12 months since your last period you will need additional contraception.
You may need a test to see if you’ve reached menopause
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.
However 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.
Mirena coil removal after menopause
Naturally your fertility slows down in your 40s, however it is still possible to get pregnant until after the menopause. To be safe, if you have a Mirena IUS and are not having periods you should continue to use this method until you are 55 years old, after which the FSRH advises you do not need to use contraception. Alternatively your doctor can test your FSH levels to determine when contraception should be stopped. If you’re not sure whether the Mirena coil has made your periods stop, or whether you are menopausal, speak with your doctor.
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.
Published 04/09/2020. Reviewed and edited by Dr Melanie Davis-Hall 04/01/2021.