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What to Know About Mirena and Depression

Medically Reviewed by Traci C. Johnson, MD on August 11, 2020

Mirena is a brand of birth control called an intrauterine device (IUD). Your doctor places it inside your uterus (womb). The small t-shaped piece of plastic can stay in your body for up to 5 years to help prevent pregnancies.

Mirena is made with a version of the human-made hormone progestin called levonorgestrel. It may not give you as many side effects as regular birth control pills, which contain progestin and a second hormone called estrogen.

Mirena, Depression, and Your Mood

The link between depression and birth control isn’t clear and researchers disagree. Most studies suggest there is no connection, but more evidence is needed to be sure.

That also goes for Mirena, the implant, the mini pill, and other progestin-only contraceptives. Some studies found that women using Mirena were more likely to show signs of depression. But other research has concluded that there is no connection.

One large study of women ages 25-34 found that those who were on any form of hormonal birth control had fewer depressive symptoms than those who used other types of contraceptives or none at all. The study didn’t look at hormonal IUDs specifically, but did look at other progestin-only forms of birth control.

Another study found that women who used progestin-only contraceptives were no more likely to have mood swings or changes than when using other forms of hormonal birth control.

Every woman reacts differently to hormonal birth control. So it’s hard to predict how your body might respond to Mirena.

When to Talk to Your Doctor

If you’re concerned about how Mirena might affect your mood and emotions, ask your doctor if you can try another contraceptive. One possibility is a copper IUD, a hormone-free long-term birth control.

Call your doctor if your mood shifts more than normal, or if you have the symptoms below for more than 2 weeks:

  • Feel guilty, sad, anxious, or “empty”
  • Can’t sleep
  • Lose your appetite or eat more than usual
  • Have less energy and move slowly
  • Don’t enjoy your favorite activities and hobbies anymore

Your doctor can screen you for depression and suggest a different birth control method if needed.

WebMD Medical Reference

Sources

SOURCES:

Mayo Clinic: “Hormonal IUD (Mirena).”

Bedsider: “All about hormones!”

Harvard Health Publishing: “Distinguishing mood swings from depression in teenagers.”

Hormone Health Network: “Progesterone and Progestins.”

UpToDate: “Intrauterine contraception: Management of side effects and complications,” “Progestin-only pills (POPs) for contraception.”

Current Psychiatry Reports: “Hormonal Contraceptives and Mood: Review of the Literature and Implications for Future Research.”

Contraception: “The relationship between progestin hormonal contraception and depression: a systematic review.”

JAMA Psychiatry: “Association of Hormonal Contraception With Depression.”

American Journal of Epidemiology: “Association of Hormonal Contraceptive Use With Reduced Levels of Depressive Symptoms: A National Study of Sexually Active Women in the United States.”

UpToDate: “Combined estrogen-progestin contraception: Side effects and health concerns,” “Progestin-only pills (POPs) for contraception.”

International Journal of Environmental Research and Public Health: “Do Progestin-Only Contraceptives Contribute to the Risk of Developing Depression as Implied by Beta-Arrestin 1 Levels in Leukocytes? A Pilot Study.”

Open Access Journal of Contraception: “Contraception counseling for women with premenstrual dysphoric disorder (PMDD): current perspectives.”

American Journal of Epidemiology: “Association of Hormonal Contraceptive Use With Reduced Levels of Depressive Symptoms: A National Study of Sexually Active Women in the United States.”

National Institute of Mental Health: “Depression in Women: 5 Things You Should Know.”

U.S. Department of Health & Human Services: “Intrauterine Device (IUD).”

Familydoctor.org: “Progestin-Only Birth Control Pills.”

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