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Q. I am using Mirena and have been spotting every day. Is this normal?

Answered by
Dr. R Balakrishnan Menon
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Mar 20, 2017 and last reviewed on: Jul 28, 2021

Hi doctor,

I had a Mirena IUD inserted before 18 months. I used to spot for a day or so in every few months. But, for the last two weeks, I have been spotting every day. Is this normal?

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Hi,

Welcome to icliniq.com.

It is one of the complications of LNG-IUD (Levonorgestrel-releasing intrauterine device) or Mirena. The Levonorgestrel being released by the IUD makes the inner lining of the uterus or the endometrium so thin that it will just give way.

Let me give you a few facts. By 50 or 52 every lady reaches menopause. After this age, there is no significant healthy follicle in the ovary, and so the estrogen level is extremely low. It will not allow the inner lining of the uterus to increase.

To add on to this, the progesterone or LNG makes the lining even thinner, and it will spontaneously tear causing fresh spots every day or intermittently.

I wonder what the indication was to have Mirena at age of 54 years. I hope they had ruled out any surprises by taking PAP smear or liquid base cytology, the ultrasound scan of the pelvis and necessary blood tests.

If all the above mentioned tests were normal, then spotting is due to hormone deficiency.

Reconsider whether the IUD has to be continued. Once removed you may enter menopause and will not have periods anymore. Otherwise, meet your gynecologist, and you will be started on the hormone estrogen cyclically to improve the thickness and bleeding, so the spotting will not occur.

For further information consult an obstetrician and gynaecologist online --> https://www.icliniq.com/ask-a-doctor-online/obstetrician-and-gynaecologist


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