My Mirena IUD Removal & Hormone Balancing Journey

Hi friends! It’s been a long while since I’ve done a personal health journey update. I last left off with the fact that my gut had improved significantly from SIBO and leaky gut, however anxiety, parasites and lingering hormonal imbalances continued to persist no matter what I did.

Here are my previous personal health update stories (most of which were before my time as an FNTP). Listed in reverse chronological order:

• Healing Journey Part 3: Invasion of the Parasites, Plus Tips for Easing Parasite Die-Off Symptoms
• Hormone Balance: Healing Journey Phase 2 Update
• Healing Journey Phase 2: Hormone Balance
• Second Update on SIBO & IBS Journey
• Update on SIBO Die-Off & Recovery Progress
• My Diagnosis of IBS & SIBO, Plus Potential Autoimmune Disease and Mood Disorder

I am so grateful to be armed with the knowledge to heal myself as a holistic practitioner, however that doesn’t mean that I have some magical “cure.” I am not in the business of “curing,” I am in the business of preventing, healing and educating. And even us NTPs have to manage our own health issues at times because we are only human after all. And for me (as well as many others), stress continues to be the biggest barrier to my healing journey. And I think we can all agree that 2020 has been significantly more stressful than we all would have liked.

But, the goal here, and what I often convey to my clients, is not to eliminate stress in life. We will NEVER be able to do that, but instead, learn the tools and techniques available to us in order to better manage and respond to stress. If we can take back some control over our lives and our emotions, we can more steadily navigate life’s stressors.

But this is a story of my Mirena IUD removal. If you are triggered or freaked out by talk about blood, medical images of the uterus, the female reproductive system or bodily fluids and processes, then this post may not be for you.

Here’s a breakdown of what’s covered in case you want to skip around:

• What is the Mirena IUD
• How the Mirena works
• My Mirena IUD experience
• IUD Removal Nightmare
• Risks of Hormonal & Non-Hormonal IUD

WHAT IS THE MIRENA IUD?

First, let’s set some background. I had the Mirena IUD put in about five years ago when I was living in Baltimore. I had gone a few years without any form of birth control (and wasn’t very sexually active during that time), but I started seeing someone and asked my gynecologist for birth control options other than the pill. The pill I had taken in college, and had tried many different brands, all of which made me feel crazy and led to a slew of other symptoms like weight gain, horrible periods/PMS, moodiness/anxiety and acne. TMI, it also made my boobs grow like wildflowers. And I wasn’t a fan. 

Been there, done that, not doing it again. My doctor recommended an IUD (intrauterine device), either the copper IUD, which is a non-hormonal form or the Mirena, which contains a synthetic form of our natural hormone progesterone. It’s called Levonorgestrel and is a progestin that slowly releases in your body over time. Bear in mind that this is a SYNTHETIC form, meaning not natural, and it does not behave the same way in our bodies as natural progesterone. 

The Mirena is a small t-shaped piece of plastic inserted into the uterus to prevent pregnancy. It is over 99 percent effective and lasts for about 6 years. It also releases the most amount of progestin per day compared to similar brands on the market, containing 52 mg of progestin with an anticipated release of 20 mcg per day. The Liletta, Kyleena and Skyla are other popular hormonal IUD brands.

I don’t particularly remember how the conversation with my doctor went other than I knew absolutely nothing about my cycle or this form of birth control so I asked her for her recommendation and she said to go with the Mirena, so go with the Mirena I did. 

HOW DOES THE MIRENA WORK?

The Mirena primarily works by stopping your body from fertilizing an egg. It does this by the release of progestin, which thins the lining of your uterus, the endometrium, so a fertilized egg would be unable to implant. Normally, we would rely on progesterone in our bodies to prepare the uterus lining for egg implantation. The Mirena stops this process, which is also typically why women tend to have lighter or absent periods — the thickening of our lining is what induces bleeding. 

The Mirena also stops ovulation by suppressing the production of two important hormones that are found in the brain: Follicle Stimulating Hormone (FSH) and Luteinizing Hormone (LH). FSH and LH work together to mature an egg and trigger ovulation. They are also responsible for signaling the rise and fall of your hormones and play an important role in sexual development and functioning.

Lastly, the Mirena also thickens cervical secretions, making it difficult for sperm to make it to the egg in the event ovulation does occur.

MY MIRENA IUD EXPERIENCE

Before we get into data and statistics and the nitty gritty talk of birth control risks, let’s fast forward to present day, early/mid June 2020. 

For the last five years, I had struggled with a lot of health issues: SIBO, IBS, leaky gut, anxiety/depression and more recently, parasites, hormonal imbalances and adrenal dysfunction. I originally had connected my SIBO to all of the antibiotics, steroids and opioid painkillers I had to take post-spinal fusion surgery in 2012. And I still believe that to be very true. You can read more on how antibiotics wreck havoc on your gut flora in a previous article I wrote. 

In terms of hormonal issues, I was incredibly moody all of the time. Now some of this was due to parasites, which quite literally take over control of your body/brain and make you feel as if someone else is in the driver’s seat. It’s like having an out of body experience. You see the world, but it’s as if you are watching your life from outside of your body. It’s the most unstable I’d ever felt. 

But beyond that, for two weeks out of the month (during my luteal phase when progesterone is supposed to be higher while estrogen drops), I struggled with:

• Debilitating insomnia
• Severe mood swings
• Constipation
• Breast tenderness and swelling, like a lot.
• Bloating
• Weight gain
• Headaches
• Constant anxiety 
• Chronic fatigue

These are all signs of estrogen dominance, which occurs when either you have an excess of estrogen OR not enough progesterone, which means estrogen takes the wheel. Progesterone is a calming hormone, unlike estrogen, which is excitatory, so it makes sense that without progesterone, you would experience increased levels of anxiety, irritability and moodiness. 

Two weeks out of the month I felt like I was losing my mind. I had never been so happy for my period to arrive because I was able to finally grab at some sense of normalcy again. My periods were long and light, sometimes they lasted 10 days and there was barely any bleeding. I could wear 1 pantyliner ALL DAY and be totally fine. 

I was convinced at this point that something else was wrong and it might be the foreign object cohabitating in my body.

Also, the more I researched the Mirena/hormonal birth control and GI disturbances, the more of a connection I was finding. For instance, there’s a connection between birth control and increased risk for developing Crohn’s Disease, an inflammatory bowel condition that is autoimmune in nature. One study conducted by Harvard researchers showed women who were on hormonal birth control were three times as likely to develop Crohn’s and Ulcerative Colitis. The same researcher went on to also show that there is a connection between birth control and altered gut microbiota, which leads to increased pathogenic activity in the host (us), especially a type of fungal infection, candida albicans, and a bacteria known as prevotella. 

Most of these studies were done with oral contraceptives (the pill), but still, logic follows that any form of hormonal birth control that directly impacts your natural hormones can affect your gut because hormones are such a crucial part of gut function. I believe that IUDs are still too new of a “technology” and people aren’t looking at them as the source of health issues…yet. Many doctors in the functional world are starting to notice patterns and are asking the right questions, but conventional medicine is lightyears behind. 

And the fact that despite all of my knowledge about balancing hormones, how to heal the gut and open detoxification pathways, mindfulness/stress management techniques and vagus nerve toning, nothing was working. I did acupuncture, IR sauna, epsom salt baths, took herbs and supplements to help with my recurring health issues. I kept slamming into a brick wall headfirst. 

It was frustrating. And confounding. I knew about a year ago that I wanted to get my IUD removed, and my husband was supportive. If I am being honest, I kept putting it off because I was scared. I didn’t know how my body would react post-birth control (especially if things might get WORSE for me). And change is hard, but I finally found an integrative gyno in Denver and had an appointment set for April. 

And then coronavirus came crashing in and wrecked all my plans. So, I waited until we relocated to Arizona and found someone in June/July who could see me right away. I didn’t even care who it was, as long as they were semi-credible and had good reviews, I just needed ONE appointment where they would go in there, grab those strings and yank that monstrosity out of my body.

IF ONLY it had gone as planned.

IUD REMOVAL NIGHTMARE 

OK before we get into this part, let me say that I do not share my story to scare you, but to educate and empower you to think about how hormonal birth control may be negatively impacting your health if you are struggling and do not have answers. 

Everyone reacts differently to birth control, but issues with these IUDs are becoming increasingly more prominent. 

So, on my first visit (which I had assumed was my last), I went in and the gyno couldn’t find my strings. She tried to use a few different tools to feel around inside my cervix, but no luck. It was a little painful, and there was definitely some light pinching during the attempt and cramping afterward but nothing unbearable. Removal of an IUD is supposed to be much easier and less painful than getting it inserted. 

Not for me. She recommended I get an ultrasound to ensure that the IUD wasn’t dislocated or embedded into my uterus wall where it didn’t belong. Yes, that happens. The medical term for it is “malpositioned,” and it’s more common than you might think. One study found that of 130 patients with a history of failed IUD removal, 128 among them were embedded. Half of the patients were asymptomatic and the remaining 50 percent complained of pain and menstrual disorders.

Another risk with IUD is expulsion, which is where the body quite literally rejects the device and tries to push it out of the uterus. This is perhaps less common, but happens. The same study above found that it occurs in about 5 percent of women.

During my second visit, I got my ultrasound and it showed that the IUD was in the right exact place it belonged. I was told it’s likely that my strings were twisted up inside my cervix, and that they would bring in an IUD specialist to remove it under the guidance of ultrasound instead of driving blind. I was also peppered with questions about why I wanted it removed (in a very disapproving tone I might add.) 

Third visit rolled around and I was feeling hella nervous. I was so scared that they weren’t going to get this thing out and that I’d have to go under anesthesia to have surgery. The doctor was no more reassuring, as the first thing he said was that “we have about a 50/50 percent chance of getting this out today.” And also that he was going in blind, with “different tools” because the ultrasound wouldn’t be helpful. I’m sorry, what? Didn’t we already try this once? 

So he started fishing around and this time it lasted for about 10 minutes and was much more painful than I had expected. There was lots of stabbing and pinching pains and I was definitely scared. Eventually he stopped and said he didn’t want to keep torturing me (thanks…) and I’d have to come back, again, to get my vagina numbed with localized anesthesia so that he could go in with a telescope and some water to fill up my uterus and make room for him to see the strings, and eventually grab them. I was in pain, terrified and bleeding. But I also did not want to be put all the way under (general anesthesia is very harmful to your CNS/brain functioning and gut) so I said fine, let’s do it.

Three days passed before I was back in the office. I got four hours of sleep the previous night and was an absolute wreck. Despite what he said, I had a feeling it was going to hurt like hell, and also I was more worried that he still wouldn’t be able to get it.

He injected me 3-4 times with needles to administer the numbing gel and then I waited for 10 minutes for it to kick in. This was a whole ordeal. They had two doctors, a nurse and a cart full of tools and swabs. I hardly felt the needles, so I was feeling optimistic. Until about five minutes into the procedure when the pain started. Having water flushed into your vagina isn’t comfortable but it also wasn’t painful, just felt like severe menstrual cramps, but I could feel the telescope and the tools he was using to dig around in my cervix and find the strings. I was literally bleeding all over the table and it felt like I was being stabbed in my uterus (because I was), over and over for 20 minutes. I was in tears, tensed up, legs shaking muttering “why is this happening to me,” over and over. 

Eventually he gave up and said, “Sorry I know this has been torture, our next option is to refer you out to a hospital to have it surgically removed,” and that’s when I lost it. I started convulsing in tears and was like “NO WAY, that can’t happen. Let’s take a break and then keep going.” So we did, and then he let the doctor who was assisting him take over this time. She was a female and she grabbed some device to hold my cervix in place. It was painful but only for about 5 more minutes and then I heard the most beautiful phrase ever: “it’s out.” 

I couldn’t even move or feel relief at that point though, I was in so much pain, crying and bleeding all over the place, shaking and snotting everywhere. Even when I left, I got into the car and burst into tears for the 20 minute drive home with my husband. I was feeling ALL the emotions, and I just let them run their course. 

The nightmare was over. Whatever happened next with my hormones, I knew this was what my body wanted and needed. 

THE RISKS OF HORMONAL & NON HORMONAL IUDS

Despite what many women may believe, there are certain risks associated with IUDs. We’ve touched on a few already, but let me list it out more clearly. 

For hormonal IUDS (Mirena, Skyla, etc.), risks can include:

• IUD perforation or expulsion 
• Missed, unpredictable or light/weird periods
• Spotting in between periods
• Increased risk for cancer (one study in the New England Journal of Medicine shows a 20 percent increase in risk for women using hormonal BC, both the pill and IUD)
• Increased risk for mood disorders, depression and suicide (studies show women using hormonal birth control are three times more likely to commit suicide)
• Migraines & headaches
• Ovarian cysts
• GI disturbances, including constipation, bloating, indigestion, SIBO, yeast/candida overgrowth, leaky gut and bacterial dysbiosis.
• Unexplained skin issues like eczema, psoriasis, flaky skin/dandruff, hair growth and hair loss
• Increased risk for pelvic inflammatory disease (PID)

Before we talk about the potential risks of a copper IUD, let’s first look at what it is and how it works. Similar in shape/design, the copper IUD, also known as the ParaGard, is made of copper (instead of plastic). It contains 380 mm2 copper and can be left inserted for 10 years of use. 

The copper coils in the ParaGard create localized inflammation that is toxic to sperm. This essentially stops the sperm from swimming and prevents egg fertilization. Another way this is hypothesized to work is that it prevents implantation, which means, sperm and egg meet but the embryo cannot make your uterus its home. It can also be used for emergency contraception if inserted within five days after unprotected sex

But let me tell you, forcing inflammation on the body is NOT A GOOD THING. Inflammation is meant to serve a very specific purpose in the body and it is not meant to be constant, even if low grade. Over time, chronic inflammation can contribute to the development of autoimmune diseases.

For non-hormonal IUD (copper IUD), risks include:

• IUD perforation or expulsion 
• Heavy bleeding and painful periods with lots of cramping
• Copper toxicity
• Increased risk of pelvic inflammatory disease (PID) 

Copper toxicity is the most overlooked (and important) health risk associated with this type of birth control. If you want to read more about copper toxicity in the body, this is an excellent resource. 

Also check out my blog on how environmental toxins, including heavy metals, can impact hormonal health for more information on that. 

FINAL THOUGHTS

From a very young age, girls are encouraged to go on birth control to manage their periods. We are never taught any other way and we are hammered with messages about the pill being our saving grace from pregnancy and painful PMS. 

What we don’t consider are the long term health effects that occur, both in and outside our uteruses: mental health issues, digestive, thyroid, adrenal issues, chronic fatigue, skin rashes, acne, sleep issues, increased risk for breast cancer, Polycystic ovarian syndrome (PCOS) and endometriosis. 

If you don’t believe in the risks of an IUD (hormonal or copper) please do your research! Women are increasingly having to have surgeries to remove these devices, which have become embedded into their uterus or displaced. Yes: a DEVICE. That does not belong in your body.

I am not even a week post-IUD removal at the time this article is published, however I am already noticing a few improvements. I did bleed afterward, both from the procedure and from the “progestin” withdrawal. I forgot how beautiful it was to watch my body do what it was supposed to — BLEED! I am also having some cramping and bloating as my body adjusts.

My breast tenderness dissipated, and I noticed I was having less constipation and food sensitivities. Time will continue to tell as my body learns to make its own progesterone again and I will provide more updates on this, but for now, I feel at peace with myself and my body even if things still aren’t back to normal just yet.

The good news? I PREPARED for this. I have a full protocol on how to support my body during this time with the right nutrients, movement and supplements. I plan to publish an article on how to balance and support your hormones post-birth control removal and how to plan for something called “post-hormonal birth control syndrome,” which isn’t actually as scary as you might think! I will also share how I am tracking my fertility naturally using a fertility tracking device and other forms of natural birth control I plan to use moving forward.

But if you want to read how to reduce your PMS right now (whether you use birth control or not), check out this article.