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Mirena & Triglycerides

Sep 2, 2011 | By Mary Krane Derr

Mirena, the Bayer company's hormone-releasing intrauterine device, was introduced into Scandinavia during the 1990s and the U.S. in 2000. Sometimes prescribed to treat menstrual disorders like endometriosis, Mirena mainly serves as a reversible but long-term contraceptive. It can remain in place up to five years, with a pregnancy prevention effectiveness rate of over 99 percent, similar to that of female sterilization. If you have abnormal blood lipids, especially triglycerides, you may wonder if Mirena is safe for you. Some evidence suggests that synthetic progesterone hormones such as the one in Mirena can adversely affect triglycerides and other blood lipids.

How Mirena Works

Mirena, also called the levonorgestrel-releasing intrauterine system, shortened as LNG-IUS, is a T-shaped plastic coil that a trained health care professional must insert into or remove from the woman's uterus under sterile conditions. This device emits 20 micrograms daily of the synthetic progesterone hormone levonorgestrel. According to evidence presented in a 2009 “International Journal of Women’s Health” review, Mirena prevents conception by inhibiting sperm function and transport. Contrary to a widespread belief, it does not interrupt a very early embryo’s implantation in the uterine wall.

Contraindications and Cautions

A woman using, or considering using, Mirena should make sure her doctor has her complete medical history. According to Bayer, Mirena is not for women with a number of conditions, including possible or confirmed pregnancy; any impairments, including fibroids that “distort the uterine cavity”; cancers of the breast, womb or cervix; tumors or other diseases of the liver; and vaginal and reproductive-tract infections such as vaginosis or pelvic inflammatory disease. A woman who has certain cardiovascular disorders, is on insulin or long-term corticosteroids, has clotting disorders or takes anticoagulant drugs, suffers from focal migraines or other headache disorders, or who is breast-feeding might be able to use Mirena “with caution.”

Concerns About Lipids

Risk for cardiovascular disease is often monitored through blood tests for three lipids, or fatty compounds: high density lipoprotein, or the “good” HDL cholesterol; low density liporotein, or the ‘bad” LDL cholesterol and triglycerides. Any undesirable elevation in blood lipids is called hyperlipidemia. The contraindications and cautions listed in Mirena's prescribing information do not mention any kind of hyperlipidemia, including elevated triglycerides. According to two Asian studies, Mirena does not raise triglycerides or otherwise negatively impact blood lipids. However, as of 2011, the evidence about synthetic progesterone drugs and blood lipids is mixed and inconclusive. Thus Drugs.com cautions: “Patients with preexisting hyperlipidemia may require closer monitoring…and adjustments made accordingly in their lipid-lowering regimen.”

Other Options

If you have any concerns about starting or continuing with Mirena, including its possible effects on your triglycerides or other blood lipids, discuss all your possible alternatives for contraception or gynecological treatment, both hormonal and nonhormonal, with your physician. If you decide to discontinue Mirena, please be aware that fertility can return with “no delay,” according to “Family Planning: A Global Handbook for Providers.” If you wish to prevent pregnancy after Mirena removal, have another family planning method or methods lined up beforehand.

References

Article reviewed by Knuckles Last updated on: Sep 2, 2011

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