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Bcps vs Mirena
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Shanji1 posted:
Hello Nurse Jane, when I am on low dose bcps, I get moody, my behaviour is erratic and agressive and I have no libido. If I switch to the Mirena, will this improve?My Gyne told me that the hormones are a mere fraction of the bcps.I presently take Triregol, used to take Trinovum and Yasmin (that was the worst). My behaviour is the same with all of them, including the loss on libido. Please share your valuable advice. Thanks
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Jane Harrison Hohner, RN, RNP responded:
Dear Shanji: It is true, with the Mirena you will be receiving only a small dose of systemic hormones (the synthetic progesterone and absolutely no estrogen). Libido is a very complex process. Yet with the average birth control pill (BCP) hormonal contributions to sex drive are be blunted via two mechanisms. The first is increased amounts of sex hormone binding globulin (Mirena does not have this since it does not have estrogen). The second is suppression of the LH surge which precedes ovulation at midcycle (Mirena is not designed to suppress ovulations).

In terms of mood swings and irritability/aggression it is more difficult to postulate the exact hormonal mechanisms. One POSSIBLE thing could could consider trying is as follows. There is a synthetic progesterone "mini-pill" called Ovrette which contains 0.075 mg of norgestrel (similar to the levonorgestrel used in Mirena. You could go on Ovrette and see if you have the severe mood symptoms.

Truly the only way to know for sure is to have the Mirena inserted. You should also look at the side effects mentioned by the manufacturer of Mirena to the FDA:

The most common adverse reactions ("2655% users) are uterine/vaginal bleeding alterations (51.9%), amenorrhea (23.9%), intermenstrual bleeding and spotting (23.4%), abdominal/pelvic pain (12.8%), ovarian cysts (12%), headache/migraine (7.7%), acne (7.2%), depressed/altered mood (6.4%), menorrhagia (6.3%), breast tenderness/pain (4.9%), vaginal discharge (4.9%) and IUD expulsion (4.9%).

Other relevant adverse reactions occurring in <5% of subjects include nausea, nervousness, vulvovaginitis, dysmenorrhea, back pain, weight increase, decreased libido, cervicitis/Papanicolaou smear normal/class II, hypertension, dyspareunia, anemia, alopecia, skin disorders including eczema, pruritus, rash and urticaria, abdominal distention, hirsutism and edema.


Shanji, perhaps other readers who have used Mirena will chime in about their experiences with libido and mood.

Yours,
Jane


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