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Birth Control/menstrual cycle after Mirena


QUESTION: Hi there,
I am going to give you a quick background on me:

I had regular uneventful cycles after onset at age 12. I had my first child at age 20. I breastfed for 14 months, my cycle returned around month 3 and was somewhat abnormal at first but straightened out.

After weaning I became pregnant with baby two 8 months later. I breastfed him as well. My cycle returned around month 3 again and remained pretty regular. I got the mirena placed when he was 6 months old (April 2012). I bled for 6 weeks, then continued to have a very regular 5-6 day period throughout the time I had the mirena in place.

I had recurrent ovarian cysts that were resolving, but new ones forming and decided to have the IUD out October 2015, I had a neg U/S then. My cycles since:
30 days
34 days
30 days
29 days
36 days
My cramps precede my period by 12-36 hours. I spot brown x1-2 days before it as well. My periods have been VERY heavy and very painful for the first couple of days but bleeding lasts 5-7 total. LH surge has been detected between CD 16 and 20 (20 on the longest cycle). My breasts have been incredibly tender between LH surge (or before) and day 3 of period, except this last cycle (when LH was CD) they seemed hurt all month (neg breast exam CD 17 of that cycle)

Currently on CD19:
very tender breasts x3 days and no LH surge yet, spotting brown/pink x3 days as well.

Is it likely that my hormones are still imbalanced due to the IUD removal? I have mentioned the heavy painful periods to my CNM and she did not seem concerned, I don't really want to call back to c/o breast pain and spotting if its just run of the mill.... Also, I did have a breast exam and pap within that last 6 months.
I would be very appreciative of any advice that you have to offer.

Thank you

ANSWER: How old are you?
Do you use anything for birth control now?
Do you wish to become pregnant again?
Do you have much stress?  Thank you.

---------- FOLLOW-UP ----------

QUESTION: I am 27 years old.
I am using OPK's and tracking my cycle to take calculated pregnancy risks.I am not consistant enough with myBBT to utilize it. We aren't trying, but would be ok with another pregnancy.
I graduate from an RN program in 7 weeks, I guess I have a considerate amount of stress. However, I don't feel overwhelmed or over stressed.
I would prefer not to take birth control to "fix" issues. I believe intervention breeds intervention and would consider it a last resort.
Thanks again

I don't think that you hormones are unblalanced.  Assuming that you're ovulated monthly, I would expect that your hormones are blalanced, but your body is reacting differently to the hormones than when you were younger.  It may be partly due to stress, since I would guess you have at least some, and stress can affect how your body reacts to hormones.
The best treatment we have for heavy painful periods is the pill.  Other than that, taking ibuprofen can be helpful.
I'm not sure what to think about the spotting.  If it continues or happens again next month, I'd probably see your doctor to figure it out.
Breast pain and PMS symptoms are both more common as a woman ages.  Your still young, but still your body will tend to react different to hormones than it did 10 years ago.
Breast pain is common.  Decreasing caffeine and stress can be helpful.

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Norman Solberg


I am an OB-GYN physician. I can answer almost any question related to women's health.


35 years in an active OB-GYN practice.

Fellow, American College of Obstetrics and Gynecology

MD OB-GYN specialist

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