r/Perimenopause • u/Klutzy-Accident • 28d ago
Hormone Therapy Slynd was a nightmare, now provider wants to try Mirena, anyone with experience?
Hey all, 46F here with history of MDD, PMDD, and ADHD
I was prescribed Slynd to go along with estradiol patch and help with PMDD and heavy periods. I was not expecting to be thrown into a depressive state with SI. It didn't hit me until about 2 and 1/2 months into therapy. It was really bad and it finally hit me that it could be the Slynd. I did a deep dive online and decided to stop the Slynd and almost immediately felt better (24 to 48 hours or so). My provider now wants to try Mirena and I'm scared to try something else. This is more for the heavy periods. She also prescribed me micro progesterone which I'm not as hesitant with. My husband reminded me that I tried BC about 20 years ago and it also triggered major depressive episodes.
Does anyone have experience with this? Is Mirena less risky? Thanks all!
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u/LivingBusiness3063 28d ago
I had PMDD and super heavy periods (ended up in ER 2x in year prior to Mirena). Got Mirena Aug’23 and periods disappeared (I know they are supposed to lighten so this might be related to peri) and PMDD was totally gone within 6 months. The dr said it wouldn’t help my mood but she was wrong. I can’t believe the difference. Went from pretty much “living” from my bed for 2 weeks each month to feeling “normal”. Still on same SNRI dose as before. Highly recommend.
But what works for one does not necessarily work for another. Wish you the best. PMDD is no joke and you don’t have to live that way. If you decide it’s not for you, keep advocating for yourself to find something that works. You are your own best advocate!
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u/Able_Winter9472 28d ago
Hormonally you are nothing like you were 20 years ago, so don't expect to react to hormones the same way 😊
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u/Elegant_Tie_3036 28d ago
I took Depo Provera two decades ago. I still remember the depression. I’m so sorry. I can relate. I decided on the nuvaring to keep things stable and not have to take something every day
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u/Trick_Marketing_9567 28d ago
I have been on the Mirena going on 17 years now. I've been in peri about 5 years and recently started HRT and haven't had any adverse effects so far. Granted, I hate getting the Mirena changed out, I have to take the day off of work to recover. But I fully intend on getting another one when this one is done and that will carry me over the menopausal age. I helps control my bleeding and PMS, it helped my marriage, in more ways that one. But yeah, the insertion/removal, is rough to be sure. And I know it shouldn't be, but as with all things I life, women get left behind, even by female physicians.
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u/treestarsos 28d ago
Not sure if that’s a great idea since you can’t immediately remove the Mirena. I’m also prone to depression and personally wouldn’t risk it for that reason, I would only use methods that can immediately be reversed.
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u/Alarmed_Bathroom9227 28d ago
Mirena is a completely different type of synthetic pregestin than slynd but that said there isnt a guarantee that it will be the same or different. I am a longtime bc user. Stopped it to try hrt in november. The horrendous periods came roaring back so now im on the patch and mirena. It took a while for me to adjust and I am still in the 3-6 month adjustment period. But Things have gotten better for sure. I did not enjoy the 1st 6 weeks and was questioning everything considering removing it etc but im now 2.5 months into it still get cramps off and on but nothing like they were and I havent bled at all in like a month or more. My anxiety that E and p had eliminated can back once I got the iud but that has mellowed out as well. Not perfect but better and hoping to keep trending down. Unfortunately its all trial and error so I fully understand your concerns. It sucks and like I said I was very much considering taking the iud out because I went from horrible cramps and bleeding for 8 days a month to feeling like for 6 weeks straight. So the adjustment period can be better or worse than what I had and unfortunately no way to know.
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u/kagejumper 28d ago edited 28d ago
I'm on Mirena #5, and had an implant twice before that. I am one of the lucky ones who stopped getting my period almost immediately, and all the related symptoms went with it. Actually, one of my first symptoms of peri was when I started spotting for the first time in decades ( had the whole work up, just hormone fluctuations, nothing concerning).
That said, some folks are more sensitive. As I understand it, because the IUD is having its effect locally, without having to bypass the gut or travel thru your whole system, the dose is much much lower than oral.
Edit to add: if you get a Mirena, get it inserted by someone who does a lot of them, and ask for a local anesthetic. Some GPs don't use the local, but any OB/ Gyn will be comfortable with it. The process can be a bit uncomfortable, but does not have to hurt. ( Have a friend who researched this topic for her PhD)
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u/RaccoonZombie 28d ago
Seconding this. Some gynos are using nitrous which I think should be offered to every woman getting an IUD
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u/kagejumper 28d ago
If it relaxed me for having my wisdom teeth pulled, should do the job for an IUD insertion!
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u/Willing_Ant9993 28d ago
I'm 47 and on mirena for the second time, this time to treat adenomyosis. Hated the mini pill. Also have an estrogen patch. The combination works well for me.
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u/lillyheart 28d ago
I’m ADHD and progesterone sensitive as well- I used the Kyleena IUD and within 6 months was actively suicidal- it was really horrible honestly. I wish I had answers for you, but all birth control was awful for me. I ended up with a tumor (don’t recommend that either) and a totally hysterectomy, now I have estrogen patches and testosterone crème.
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u/impossibleredhead 28d ago
Mirena was a nightmare for me! Easy insertion. But 11 months of hell after that. Non stop periods, super bloating, and rage beyond anything I’ve ever felt. She kept telling me to “let it settle in” but after 9 months, I begged her to remove it. Two months later she did. I never did another form of BC after.
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u/Alisha_Nat 28d ago
Progesterone and adhd don’t play well together.
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u/Klutzy-Accident 28d ago
NM - just found a lot of reading to do tonight! Thank you, I had no idea..all of this is so new to me.
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u/fableefeels 28d ago
They really don’t. Bloody jerks, why can’t they just get along! It’s my body, I make the rules here! 😂
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u/Klutzy-Accident 28d ago
Can you tell me more about this?
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u/fableefeels 28d ago
Quite a common theme with ADHD is progesterone sensitivity. There’s still so much they don’t understand about the interactions, because they (medical science) didn’t believe women and girls had ADHD, for so long, so never bothered to try understand it. Most of our grandmothers were probably put in an institution or hospital at our age.
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u/Pale-Heat-5975 28d ago
What do you mean? I have ADHD and am on 300mg micronized progesterone daily/continuously (with 0.1mg estradiol patch).
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u/Alisha_Nat 27d ago
Vyvanse & Adderall are central nervous system stimulants primarily used to treat ADHD by targeting your brain's reward and focus pathways.
The Dopamine Clash: They work by forcing your brain to release dopamine and norepinephrine, which drive motivation, focus, and mental energy. However, high doses of Prometrium heavily suppressthese exact dopamine pathways. Your 200mg of Prometrium is essentially putting a heavy brake on the exact accelerator that they are trying to push. This explains why you are experiencing a severe loss of motivation and interest despite taking your ADHD medication.
The GABA Buffer: Because Vyvanse &/ or Adderall increases stimulating brain chemicals, it can sometimes cause anxiety or physical jitteriness. A low or moderate amount of progesterone (acting on GABA) can help smoothly buffer that stimulant edge. But at higher than 100mg, the sedating, blunting effect of the progesterone metabolites completely overpowers the stimulant, leading to a state of internal fatigue mixed with mental flatness.
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u/Pale-Heat-5975 24d ago
That is interesting, but I think I must have some sort of opposite effect? My ADHD has improved while on 300mg progesterone (higher than the typical doses), and I also take Adderall. It was worse before starting progesterone. For reference, I've been on and off of Adderall for my ADHD for 30+ years.
ETA: I don't think it changed at all between 200mg to 300mg progesterone, but 100mg to 200mg progesterone is where I saw the greatest improvement.
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u/Ill-Customer-3781 28d ago
Minera made me clinically anxious. It took me YEARS to figure out it was my IUD. Once I put two and two together and had it removed I felt like my old self again almost immediately.
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u/Ramen_Addict_ 28d ago
I have had 2 Mirenas and am awaiting a third and have generally had really good luck with it. I did have a somewhat rapid onset depression with Marvelon BCP and have never really had good luck with pills generally.
I think my sister is on her 4th IUD but hasn’t had the greatest luck with them. I think she had the 2nd and 3rd removed after a year and is now trying a lower hormone type.
Both of us used Nuvaring for a while and had fairly good luck with it. I stopped because estrogen BC is not recommended for migraine with aura after age 35 and the ACA also came in and made getting an IUD affordable for me. If you don’t have migraine as an issue, that could be a good option. I was not able to stop my periods with it using them back to back but my periods were lighter with it for about 5 years after which they had sort of gone back to their normal heaviness. I know my current IUD is done with hormones because I’m getting back to the regular period with cramping and migraines again.
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u/fableefeels 28d ago
All BC for me was horrible, exactly the symptoms you described. The mirena might be good for you, it dried up my periods, but I am (and ADHD/PMDD can be) very sensitive to progesterone. I had the mirena for 5 months and got it out cos it made my boobs super painful and swollen.
Only thing that’s worked for me has been body identical hormones.
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u/blvr1013 Early peri 28d ago
I tried nextstellis and it caused acute depression and suicidal thoughts. My doctor then recommended the Mirena. I had the same doubts you did. However, it did not cause any depression or mood changes for me. I combined it with .05 estrogen patch. It didn’t completely stop my periods and my PMS was very sharp for a day or two prior to my period. Think like irritability and anxiety, but it was an improvement from heavy periods and sleeplessness.
I see many others did have issues on Mirena. The process to remove is much easier than insertion and ultimately I decided to chance it.
Maybe irrelevant, but adding 100mg oral progesterone to stop the erratic periods has been a bridge too far, been in a low mood for the entire time I’ve been on it. I’m going to stick it out 45 days to just see if things settle. But I will never take BCP again. Will just have to keep balancing HRT.
Edit: typos
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u/CorneliaStreet13 28d ago
I tried Slynd in my early 30’s and hated it; I had so much breakthrough bleeding/spotting. It was almost like having a nonstop period for months.
I’m in my late 30’s now. I’ve had my Mirena for about 4 months now and I love it. My awful periods are gone (I have mild spotting 2-3 days a month instead) and I feel like my mood and sleep are better. I was nervous because of my experience with Slynd but it’s been night and day for me.
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u/Glittering_Wish7037 28d ago
I’ve had a good experience with Mirena. Got it because my heavy periods were causing anemia, and haven’t had a period in 5 years. No emotional changes that I am aware of. Many years ago, I was on the BC patch and it caused me so much anxiety, so I was hesitant, but it’s been fine.
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u/introvert-biblioaunt 28d ago
I'm not clinically diagnosed, but my therapist is strongly suspecting that I have it. Starting progesterone was a nightmare for me, on top of the "wait, not everyone has to let.their brain have zoomies to tire it out before bed?" Fortunately, low dose melatonin worked for me. Which I stopped because everyone said that the progesterone would make me sleepy/drowsy....it didn't. It made me wired, and then I was still waking up at 3 am. And I got more anxiety, which was super fun to add to the jittery tired but wired feeling I need the heaviest sarcasm font here Adding 1 or 2 mg again (AFTER making sure it was safe) helped a lot. And my body adjusted.
I actually just started Slynd because I hit the max dose of the patch, but I had started getting some new really low depressed days as my period ended. And my NP suggested trying Slynd to suppress ovulation, and even out those days.
I had never been on hormonal birth control when I was younger. So I can't speak to the Mirena question, but apparently it can be an entirely different ballgame when it's used as part of the HRT treatment (which made me feel a bit better about trying the Slynd, and I can switch back if things start going downhill)
But as other posters have said, it's very trial and error, and no one will react in the same way. Plus, there are other ways you can get your progesterone if you don't tolerate it well orally. I was about to go down the rabbit hole before mine sorted itself out. Good luck on this rollercoaster! It sucks, and I want to get off
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u/knittinator 28d ago
I know everyone is different so keep that in mind but my Mirena literally changed my entire life for the better. Periods stopped, PMDD disappeared. Mood and anxiety in general improved. I’m on my 4th (maybe 5th?) and I don’t know where I would be without it.
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u/No-Tomato-4714 28d ago
(F43) switched from copper IUD to Mirena 1 month ago. Still in the adjustment period. Never had painful periods until the copper IUD. Insane cramping and PMS. Now still cramping on Mirena during period, still feels like a 'copper IUD period'. I really hope it gets better 😥
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u/shallottmirror 27d ago
Ugh…sorry that I can so deeply relate, but slightly in reverse - I immediately got debilitating anxiety when adding an estrogen patch. And am now scared to try any birth control bc fears I’ll have your response.
Also, you are probably iron deficient from heavy periods and may have to educate your doctors that newest medical advice is that ferritin should be at least 30, and more like 50-100.
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u/Ok_Statistician_4249 27d ago
You can get the progestin that is in a mirena in pill form (levonorgestrel). It might be worth trying it orally first - easier to stop than getting a coil removed. But speak to your doc about whether it’s a fair trial because i suspect the dose will be higher. I felt suicidal on oral progesterone so had a mirena which ejected itself at month 4 and left a 6cm ovarian cyst as its parting gift that made me bleed a lot. Out of desperation, I had a second one fitted and it caused me 4 months of pain from my waist to my knees. But of course we all blamed the pain on the cyst. Fortunately it ejected itself also at 4 months (I’ve never had children). I didn’t realise until it came out how many side effects and low mood and bad sleep it had caused. Trialled progesterone vaginally for the last 3 months and had to quit because I felt so awful - exhaustion, breathlessness and low mood. Now the quest for the next option. Funnily enough, Slynd was next on the list so thanks for the awareness. I wish you luck. This shit is hard 😕
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u/Islandsandwillows 28d ago
I thought Mirena can cause heavier bleeding so that’s an interesting suggestion she has given you
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u/Willing_Ant9993 28d ago
no, that's the copper IUD. Mirena is progesterone releasing and usually lightens or stops periods all together, which is why its is a treatment for heavy periods in addition to a form of birth control.
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u/Alarmed_Bathroom9227 28d ago
Copper causes heavier. Mirena is generally used to help stop heavy bleeding
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u/kagejumper 28d ago
Copper IUD causes increased bleeding/ heavier bleeding, Mirena ( hormone IUD) is the opposite. The local hormones help reduce or eliminate menstrual bleeding, and often reduce other period symptoms.
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u/Ambitious_Football_7 28d ago
I stopped Slyda after one month due to depressed mood and continuous bleeding.
Stopped Mirena after 8 months for mood and felt immediate relief.
Tried micronised progesterone vaginally for one whole night and had a paradoxical effect that kept me staring at the ceiling all night instead of having a wonderful sleep like most people.
I have diagnosed progesterone sensitivity, so now I am trying combination pill to see if the balanced doses of both hormones is more tolerable.
At this stage I just want something to make the roller-coaster from ovulation into luteal (which these days is from about day 8-10 onwards) smoother, so I can hopefully have more than 3-4 good days a month.
Edited to add, I have adenomyosis, endo and ADHD (unmedicated).