Whenever the rainbow appears in the clouds, I will see it and remember the everlasting covenant between God and all living creatures of every kind on the earth." Genesis 9:13

Monday, July 09, 2012

Bipolar Women/Mirena IUD

11 months ago I had multiple gynecological procedures to try to determine the cause of very heavy bleeding every month leading to just about needing iron infusions and making me feel generally horrible and pelvic pain that felt like I was being jabbed in the right ovary by an ice pick.

There were various issues that were treated but one of the causes was that I do not ovulate.  I probably do every once in a while, but it's not routine.  Best guesses are early menopause (so early the hormones were normal 18 months ago) and the effects of years of meds that cause issues with ovulation.  fficNot ovulating means that a chemical imbalance develops and the uterine lining is not efficiently removed each month, leading to thickening that causes bleeding.  In addition I had a polyp in my uterus.  They thought I was probably have cysts on my ovary but in surgery nothing was visible although I did have cysts of fallopian tubes that were removed and might have been part of the pain.

But overall this was difficult as I couldn't just go on birth control pills which would have helped regulate cycles and stabilize hormones.  However we already knew because I tried it once for a year that birth control pills make me moodier than I already am.  The Mirena IUD is an excellent choice in this situation because it releases very low doses of progestin which keeps the uterine lining from building up.  Most women have very light or no periods on it and it stays in for 5 years.  It comes out very easily and you can try to get pregnant immediately.

We knew there might be some reaction when it was put it, but since we knew it could come out we tried.  Nobody, and this decision included not only gynecologists at one of the top 5 hospitals for gynecology and one of my 2 doctors is one of the top gynecologists in the world, had experienced a bipolar patient unable ot tolerate it.

When I started operating out of control soon after it went in we didn't blame the Mirena.  Other doctors were consulted and my psychiatrist and gynecologist kept in touch about how my mental illness had taken over everything.  Eventually we decided it may need to come out.  I saw the gyn. and she said she usually has a hunch what to do in a situation but in this case she didn't. She'd never seen anyone react but I have so much drug sensitivity and the fact that I had been suicidal for months made us decide to remove it.  Removal is nothing.  It feels weird because as it comes out you feel the top and bottom of your cervix but it doesn't hurt.  The only pain I had was that they had to use an adult speculum and usually it's all about the smallest possible.

It wasn't the cause of everything.  But it was making things worse, sort of taking what I was feeling and making it seem much worse to me and impairing my cognition so that it felt like suicide was a good decision, especially considering the frustration of not being able to remember anything or think through problems without help.  The last time I was actively suicidal was just about the time it came out.  I haven't gone so long with feeling suicidal in a year.

Even then it seemed like it was me.  Until my psychiatrist had a new patient who had some of the same issues, beginning with the placement of a Mirena.  So, this is my public service announcement:  If you are bipolar, have a mirena and are less stable it DOES seem to effect some people badly.

Copyright 2006 www.masterofirony.blogspot.com


Michal Ann said...

I'm sure it helps to know that you're not alone AND you're definitely helping others by sharing your experience. Who would have imagined that there seems to be a connection?

I thought about you when I saw a program about ministry to elderly Jews in former lands of the USSR. One bed-ridden lady was wearing a little knit cap like the hats you make and donate to String of Pearls.

One city shown in the program was Tashkent, Uzbekistan. My father used to be president of the Seattle/Tashkent sister city program because he took a number of vacations around the world. He was a very gregarious guy. He passed away of a sudden staff infection exactly 10 years ago when it seemed like he was a healthy active 75 year old--digging fence post holes following a winter of skiing!

It's a small world in so many ways...especially "small" when the Lord makes connections.

I hope some words that I found about "the path" encourage you today, Jen.

Love, Michal

Ephesians 2:10 Amplified Bible

For we are God's [own] handiwork (His workmanship), recreated in Christ Jesus, [born anew] that we may do those good works which God predestined (planned beforehand) for us [taking paths which He prepared ahead of time], that we should walk in them [living the good life which He prearranged and made ready for us to live].

Proverbs 3:5-6 Amplified Bible

Lean on, trust in, and be confident in the Lord with all your heart and mind and do not rely on your own insight or understanding.

In all your ways know, recognize, and acknowledge Him, and He will direct and make straight and plain your paths.

Jenny Summer said...

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Stacey Heusmann said...

I have bipolar disorder (type II) & only this afternoon had my mirena removed. I inly had it 2 months and that was enough for me. Ive experienced crazy mixed episodes (ironically triggered about a wk after its insertion!). Feeling not so much suicidal (yet) as opposed to "wouldnt care if I didnt wake up/hit by a bus" type of feeling..I have felt spacey, experienced pain in my uterus and stabbing pains in my right ovary and cervix. Ive suffered migraines..one migraine attack last 5 days and my hubby said he'd never seen me so sick..bled everyday since it was put in.. overall just felt yuck & cannot tolerate even myself atm so cant imagine the feelings of my hubby and 4 kids :'( upon removal I immediately felt better-not emotionally but relieved in there somehow..like the pressure and heaviness completely disappeared immediately. Now my psychiatrist is keeping an eye on me..but he and 3 gps were concerned about its affects on me..some were suprised and 2 were not..go figure. Tomorrow im seeing a gynie to get a tubal ligation instead.
on another note I had tried this device yrs ago and not only was I extremely emotional then (wasnt diagnosed with bipolar at that stage) and ended up in a psych ward at hospital till deemed safe to myself to leave, it had also expelled and I miscarried at 10wks gestation. I would never ever recommend this device to anyone ever again.

Just me Jen said...

The number of women I have heard from both from this blog post and from posting on the hysterectomy forum I used for support during that time of my life has shown me that there is a definite link. It's not common yet it is common enough for plenty of women to have contacted me. My suicidal response was more extreme than some others but there have been a number of people who were hospitalized during the early months of having one or whose bipolar became significantly more severe. It's scary because it is rare enough to not be well known or even for someone to necessarily do research, but for those it affects it's serious.

One way that I know that this is an issue is simply that a search for "bipolar mirena" shows a few comments on healthcare sites and then this post. Not much is out there.

I don't blame anyone and I don't blame the Mirena. For many people it works well. Honestly if it had physically done more than just making my periods not hurt but causing me to bleed 18-20 days per month I might have decided to keep it longer. As it was I was pretty sure I would be having a hysterectomy eventually because I was losing too much blood every month and so taking it out mainly just meant that I probably would be doing that sooner rather than later. Which happened. But the hysterectomy was a good thing and so I'm glad I decided to try and see if removal would help. I'd love to say that if I hadn't had it I'd still be working and doing well but in my heart I know that's not true.

It's truly amazing what tiny changes can cause bipolar issues.

Anonymous said...

It's terrible to hear of such awful experiences that "Bipolars" have had with Mirena. The worsened effects of an already difficult mental illness aren't something anyone wants to go through.

But, I wanted to offer a positive experience with Mirena. I'm BPII and have been on dozens of meds from antidepressants to antipsychotics, anticonvulsants, anxiolytics and more. Nothing helped. My depression started around puberty, then it became cyclical. Every year, which kindled into irritability/paranoia and eventually BPII. Then I had Mirena "installed" two years ago. Before I realized it, I no longer had suicidal depression every few months. And, my sleep issues had improved. I no longer had anxiety and panic attacks which would sneak up on me and eventually make me paranoid.

All of this is not to say that Mirena is a "miracle cure." There are still some bad times had. But, it's like night and day. I spent over two decades being miserable and resigned myself to thinking no doctor or meds could ever help me and that I'd have to suffer through irritability and suicidal depression for the rest of my life.

It makes sense for me that Mirena helped my BPII disorder, since my mood disorder began in puberty, and no history of severe mental illness exists in my family. I think some mood disorder genes were "activated" when I was born, since I was premature and underweight. My older brother died in an accident while I was in womb, and I know that my mother must have been severely depressed during her pregnancy. It's not too hard to assume that depression can literally be passed on in this way.

This is just my personal story and experience with Mirena. I wish that I could know that Mirena has helped other women with mood disorders, instead of making things worse. But, so far, I've not come across any positive experiences in that respect.

But, I think all of this goes to show that while you should fully research anything you take or have put into your body, you can never know what the outcome will be good or bad. It;s just too bad that Mirena's been bad for some with mood disorders. :(

Anonymous said...

I have the mirena, actually this is my third, used this type of birth control method for 13 years. The first 5 years was wonderful! I came out of depression had tons of energy. Never bled, no PMS. The 2nd iud put in I started having a few drops of blood, here and there. Still felt good mentally, physically. Until about the last 6 months before time to replace it. I started having these fits of outrage toward my fiancé and anything would set me off. I was diagnosed with extreme rapid cycling bipolar disorder. I couldn't understand what was going on, I was sucicidal and just a horrible person. It was time to have it removed and a new one put in. Went to have it remove and the dr. Couldn't take it out in the office so I had to have it surgically removed. When the new iud was put in everything got worse! My moods became horribly worse! I couldn't stand myself. I just figured this is how I was and had become that there was nothing I could do to change it. But I wasn't like this before. Until I started researching the side effects of this iud I had no clue the mirena could have such effects. Especially with this being my 3rd one and not really having side effects until the end of having the 2nd removed. I still question if it's the iud or me. Considering taking it out but not sure what to do for birth control. Any ideas?

Just Me Jen said...

Based on my experience I would get the thing out and see if you feel better. I am not an expert nor a doctor but I do know how severely the thing affected me.

As for birth control I don't know much. I had it for controlling cysts rather than birth control and when it didn't work I had a hysterectomy because we already knew that I had severe mood reactions to the pill and without the Mirena my periods were beyond all description in terms of pain and absolute gore. I think I would ask about the copper IUD which has NO hormones because I personally would be scared of hormones if I had reacted to a tiny dose of just progestin in the Mirena. I wouldn't go near hormones again if I could help it. But I don't know if I would feel that way as much if I didn't have very bad memories of birth control pills (they made my mood crazy AND I threw up every.single.day at 10 AM for 12 months and the only reason I was on them was to let me know when to expect mood-changing PMS; it didn't work very well).

If you had no or minimal symptoms of bipolar before the Mirena I would be suspicious of it.

I'm sorry you are going through this. A lot of things happened with the surgery that included placing mine and I wound up with cognitive problems that in combination with the problems from Mirena trashed my life. The good news is that the Mirena effects did go away, rapidly and in a way that it was quite clear that was the problem, within days of removal. If I remember correctly I started feeling better within hours. But that 9 months of my life were horrible and while some of it wasn't the Mirena at all (another drug caused the permanent damage and combined with my bippolar becoming more out of control and worse in general that cost me my career) are ones that I would never live again. I had another very long suicidal period that began several months after the Mirena was out and I'd had the hysterectomy and it was horrible but not nearly as bad as the Mirena one. The Mirena put me in the psych unit for nearly 2 weeks including Christmas. The second long suicidal period where I was in some ways more dangerous to myself I did not require hospitalization. And I am positive that the difference was the itty-bitty dispenser of hell-hormones. (When it came out and they showed me how tiny it was I couldn't believe something so tiny had caused so many problems.)

I don't have proof that this exists. To my knowledge there hasn't been anything published in a medical journal because it is rare. But it DOES happen and as I wrote in the post once it was clear that it happened to me my psychiatrist and gyn both saw other cases and I've found that I'm like the online clearinghouse for the problem. Both here and at a site for people undergoing hysterectomies I've had people come and say "that's me" once I've posted about my experience.

I'm sorry this has happened to you. So very sorry because I know how awful I felt and I absolutely was bipolar before it and was therefore used to mood swings.

Please let me know if I can give you any information that might help and I'd love to know if you get it out and are doing better. I keep hoping that this will become well enough known to be a known phenomenon.

Just Me Jen