In just a few years, the hormonal IUD has become one of the most prescribed contraceptives. Practical, 99,8% effective, and capable of reducing or even completely stopping periods, it seems to be the ideal solution. But since 2017, Thousands of women report side effects that they had never anticipated, such as depression, anxiety, decreased libido, or weight gain. In France, Switzerland, and Belgium, testimonies are pouring in on social media, and reports are exploding to health agencies. So, is the hormonal IUD really the miracle contraceptive we're being sold? This article takes a frank look at its real advantages, its documented disadvantages, and the recent scientific data that calls into question its safety profile.
The main thing to remember
- The hormonal IUD diffuses levonorgestrel (progestin) locally in the uterus
- 3 dosages available : Mirena 52mg, Kyleena 19,5mg, Jaydess 13,5mg
- Contraceptive effectiveness: 99,8% (better than the pill)
- Major advantage: reduced or stopped rules in 90% of users after 1 year
- Recent studies: 57% increase in the risk of depression (dose-dependent effect)
- Common side effects: decreased libido, ovarian cysts, weight gain, acne
- Early withdrawal rate: 28 to 60% before 5 years old according to studies
- The main problem: lack of patient information on side effects
Hormonal IUD: How Does It Work?
Unlike the copper IUD which acts mechanically, the hormonal IUD (or hormonal IUD) combines two modes of action: mechanical AND hormonal.
Levonorgestrel: The IUD Hormone
The hormonal IUD is impregnated with levonorgestrel, a synthetic progestin (a hormone similar to progesterone). This hormone is continuously released, in low doses, directly into the uterus for the duration of the device's life.
Triple contraceptive mechanism
- Thickening of cervical mucus : The mucus becomes hostile to sperm, which can no longer pass through the cervix
- Thinning of the endometrium : The uterine lining becomes very thin (2-3 mm instead of 10-15 mm), preventing implantation of a fertilized egg
- Suppression of ovulation (inconstant): In about 50% of users, ovulation is blocked for the first few months, then gradually resumes
The 3 Dosages of Hormonal IUDs
There are three hormonal IUDs in France, which differ in their dose of levonorgestrel and their lifespan.
Does dosage affect side effects?
Yes. A 2024 Danish study shows a clear dose-dependent relationship: the risk of depression at 12 months is 1,21% with Jaydess (low dose), 1,46% with Kyleena (medium dose), and 1,84% with Mirena (high dose). The higher the dose, the greater the risk of psychological side effects.
The Benefits of the Hormonal IUD
Despite the controversy, the hormonal IUD has real and documented benefits that explain why so many women choose it.
1. Drastic Reduction of Periods
This is the most appreciated and scientifically documented benefit.
- 90% of users noted a significant reduction in menstrual flow after 1 year
- 50% of users have stopped having periods at all (amenorrhea) after 1 year with Mirena
- 97% discount objectively measured menstrual blood volume
- Periods go from 5-7 days to 1-2 days of light spotting or disappear completely
For women suffering from menorrhagia (bleeding periods), endometriosis or simply very heavy periods, this reduction is literally life-changing.
2. Exceptional Contraceptive Effectiveness
The hormonal IUD is one of the most reliable contraceptives available.
- Failure rate: 0,1 to 0,2% per year (1 to 2 pregnancies per 1000 women)
- More effective than the pill (8% failure rate in actual use), condoms (15%) or withdrawal (22%)
- Comparable to definitive methods (tubal ligation, vasectomy) but reversible
- No risk of forgetting like with the pill
3. Treatment of Gynecological Pathologies
Mirena 52 mg also has therapeutic indications beyond contraception.
4. Other Practical Benefits
- No daily intake : Once installed, no need to think about it for 3 to 5 years
- Immediate reversibility : Return to fertility upon withdrawal (1 to 3 months)
- No estrogen : Suitable for women who cannot tolerate combined pills
- Local hormonal dose : Blood circulation less exposed than with the pill (but not zero)
- Compatible with breastfeeding : Can be placed 6 weeks after delivery
Disadvantages and Side Effects of the Hormonal IUD
This is where things get complicated. Since 2017, thousands of women have reported debilitating side effects they never anticipated. Recent scientific data proves them right.
1. Depression and Mood Disorders: The Scientific Data
This is the most serious side effect and the one most documented by recent studies.
Major studies on hormonal IUDs and depression
- Swedish study (2023, 703,157 women) : 57% increase in the risk of depression with the hormonal IUD. Risk multiplied by 2,57 in adolescent girls
- Danish study (2024, 46,565 women) : Dose-dependent relationship confirmed. Absolute risk of depression at 12 months: 1,84% (Mirena), 1,46% (Kyleena), 1,21% (Jaydess)
- British study (2018) : Positive association between hormonal IUD and prescription of antidepressants
- Meta-analysis (2022) : 10 out of 22 studies show an increase in depressive symptoms
- FDA FAERS Base : Of 436,000 reports related to levonorgestrel, 4,517 concerned depression
The exact mechanism remains uncertain, but levonorgestrel is thought to affect the hypothalamic-pituitary axis and brain serotonin levels.
2. Decreased Libido
This is the most frequently reported side effect by users, although some studies find no significant difference.
What studies show
- Prospective study (2019): Women with hormonal IUDs report 5 times more often a negative effect of their contraception on sexual desire compared to the copper IUD
- Odds ratio of 3,5 for reporting low sexual desire (never or almost never)
- Sexual satisfaction also reduced (OR 2,7)
- The effect would be less marked than with the pill, but remains present in a significant proportion of users.
3. Other Common Side Effects
The Mirena leaflet lists a long series of adverse effects present in less than 10% of patients.
4. The "Mirena Crash" After Removal
An emerging and worrying phenomenon reported by many women on forums.
Symptoms of "post-Mirena crash"
After the IUD is removed, some women experience a temporary worsening of their symptoms for several weeks to several months: intense anxiety, panic attacks, mental fog, extreme fatigue, diarrhea, insomnia.
This phenomenon is believed to be linked to abrupt hormonal withdrawal and the gradual resumption of the natural cycle. It is not systematic but frequent enough to be documented in support groups.
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Testimonials: The Reality on the Ground
On forums and in Facebook support groups (such as "Stérilet Vigilance Hormones" which has more than 20,000 members), testimonies are pouring in. We have selected several, both positive and negative, to reflect the diversity of experiences.
Positive Testimonials
Sophie, 34 years old: "I've had a Mirena for 4 years after my two pregnancies. No more periods, no more cramps, no more stress about contraception. For me, it's truly miraculous. I've had no side effects, no weight gain or loss of libido. I'll use it again without hesitation."
Emma, 28 years old: "I had heavy periods that made me anemic. Since the Mirena, I've returned to a normal life. I hardly have any bleeding anymore and I feel so much better. The first 3 months were complicated (spotting), but after that it stabilized."
Lea, 26 years old (Kyleena): "Kyleena is a perfect fit for me. I have very light periods, 2 days a month, and I haven't noticed any changes in my mood or libido. The procedure was painful, but it was worth it."
Negative Testimonials
Julie, 30 years old: "I wore a Mirena for 7 years. At first everything was fine, but gradually I developed dizziness, repeated anxiety attacks for no reason, a total drop in libido and a constant fear of dying. I did therapy, tests... nothing. Those around me thought I was crazy. In 2019 I had it removed and ALL my symptoms disappeared within a few weeks. I discovered entire forums of women who were going through the same thing."
Delphine, 34 years old: "After my Mirena was fitted, after a month I started to feel very unwell. Intense back pain, extreme fatigue, repeated vomiting once a month. My doctor always found something else (gastro, muscle pain). In March 2017 I reread the instructions and discovered ALL my symptoms. The day after removal I no longer had back pain."
Melanie, 27 years old: "My gynecologist sold me the Mirena as a dream, 'no more heavy periods!'. Except that when it was inserted, I bled for 3 weeks, resulting in severe anemia. Then for 4 years I gained weight, lost my hair, had unbearable leg pain, and lost huge clots outside of my period. My gynecologist said it was all in my head. Luckily, my GP sent me urgently to another gynecologist who removed it. No more pain since. Finally, I'm living again."
Audrey, 25 years old: "The worst part was the 'crash' after the removal. While I was wearing it, I just had mood swings and a low libido. But after removing it, I lived through hell for 3 months: anxiety +++, panic attacks, mental fog, feeling like I was going crazy. My gynecologist didn't want to know anything, 'it's in your head'. Three months later, everything is back to normal, but I still have the trauma."
The Common Point of Negative Testimonies
Beyond the side effects themselves, what consistently comes up in negative testimonials is the lack of information before installation and minimization of symptoms by the medical profession.
What women are denouncing
- Failure to provide the instructions or discuss side effects before installation
- Gynecologists who deny the link between symptoms and the IUD ("it's in your head")
- Medical wandering for months or even years
- Refusal to remove the IUD despite the patient's request
- Feeling of having been betrayed by a device presented as "the miracle solution"
Reports to Health Agencies
Faced with the scale of the testimonies, health agencies have been contacted in several countries.
Official Figures
- Switzerland (Swissmedic) : 3,500 reports of adverse effects in 20 years, the vast majority of which were for Mirena
- France (ANSM) : Significant increase in reports since 2016. Preliminary investigation report in 2017
- Belgium (FAMHP) : 500 complaints filed with the Federal Medicines Agency
- French-speaking Facebook group : More than 20,000 women on "IUD Vigilance Hormones"
The Position of the Authorities
Health agencies acknowledge the side effects but believe the benefit-risk ratio remains favorable.
ANSM (France, 2017)
The agency acknowledges that most of the reported adverse effects (migraine, fatigue, anxiety, panic attacks) are listed in the leaflet, but is undertaking increased monitoring.
Recommendation : A follow-up examination should be carried out 4 to 6 weeks after installation, then every year.
Who is the Hormonal IUD Suitable for?
Given this data, how do you know if the hormonal IUD will be right for you? No one can predict with certainty, but some profiles seem to tolerate it better than others.
Profiles Who Can Benefit from the Hormonal IUD
- Women suffering from disabling menorrhagia (hemorrhagic periods)
- Women with endometriosis documented
- Women with iron deficiency anemia linked to heavy periods
- Women who have well tolerated a progestin-only pill in the past
- Women without history of depression or anxiety
- Women who do not present no hormonal sensitivity known
Situations at Risk of Side Effects
- Teens (15-24 years): Risk of depression multiplied by 2,57
- First hormonal contraception : Risk increased by 63%
- History of depression : Absolute risk of depression at 12 months rises to 7-9%
- Known hormonal sensitivity : Women who have had difficulty tolerating the pill
- Women over 35-40 years old : Tolerance which decreases with age according to some testimonies
- Preference for low dose : Favor Jaydess or Kyleena rather than Mirena
Before & After Installation Tips
If you're considering a hormonal IUD or already have one, here's what you need to know.
Before Installation - Ask the Right Questions
- Ask for the full instructions and read it carefully before deciding
- Talk to your gynecologist about all possible side effects, not just the most frequent ones
- If you have a history of depression or anxiety, report it explicitly
- Ask if a lower dosage (Kyleena or Jaydess) might be right for you
- Find out about the alternatives (copper IUD, symptothermal method, condoms)
- Don't accept an IUD "by default" without weighing the pros and cons.
After the Pose - Stay Vigilant
- Write down your symptoms in a notebook for the first 6 months
- Check up at 4-6 weeks inevitably
- If you develop symptoms of depression, anxiety, or a marked decrease in libido, make the connection with the IUD
- If your gynecologist minimizes your symptoms, change your doctor or consult another professional
- You have the right to have it removed at any time, even if "it should improve"
- After withdrawal, give your body a few months to regain hormonal balance
IUD Insertion: What to Expect
Step-by-step procedure, pain management, local anesthesia, what gynecologists don't always tell you before the procedure
Hormonal IUD vs. Copper IUD: Which One Should You Choose?
The two types of IUDs have radically different side effect profiles. The choice depends on your priorities and your tolerance to hormones.
Hormonal or Copper IUD: The Straight Talk
Effectiveness, effects on periods, libido, weight, skin... all the detailed criteria to choose according to your profile
The Hormonal IUD: Neither Miracle nor Poison
The hormonal IUD is neither the miracle contraceptive we are sold, nor the poison that some associations denounce. It is an effective medical device that suits some women perfectly and makes others unhappy. The main problem is not the IUD itself, but the lack of information given to patients before the installation.
If gynecologists took the time to explain that depression, decreased libido, and anxiety are possible side effects documented by scientific studies, women could make an informed choice. And if these symptoms appear, they would know how to immediately make the connection instead of wandering for months. You deserve to be informed, listened to, and to be able to remove your IUD without having to justify yourself if you can't tolerate it. Your feelings are valid. Always.
The IUD from A to Z
Types, application, effectiveness, side effects, testimonials...
Sources & Scientific References
This article is based on scientific studies published on PubMed and official surveys.
Studies on hormonal IUDs and depression
- Stenhammar E, et al. (2023). Levonorgestrel intrauterine device and depression: A Swedish register-based cohort study. Acta Obstetricia et Gynecologica Scandinavica. PMID: 37611669
- Skovlund CW, et al. (2024). Depression risk in users of different doses of levonorgestrel intrauterine systems. The Lancet Regional Health – Europe. DOI: 10.1016/j.lanepe.2023.100813
- Elsayeda M, et al. (2022). The potential association between psychiatric symptoms and the use of levonorgestrel intrauterine devices: A systematic review. World Journal of Biological Psychiatry. PMID: 36426589
- Slattery J, et al. (2018). Cohort study of psychiatric adverse events following exposure to Levonorgestrel-containing intrauterine devices in UK general practice. Drug Safety. DOI: 10.1007 / s40264-018-0683-x
Studies on libido and hormonal IUDs
- Malmborg A, et al. (2019). A survey of young women's perceptions of the influence of the Levonorgestrel-Intrauterine System on sexual desire. Contraception. DOI: 10.1016/j.contraception.2019.06.003
- Bürger Z, et al. (2021). Association of levonorgestrel intrauterine devices with stress reactivity, mental health, quality of life and sexual functioning: A systematic review. Psychoneuroendocrinology. DOI: 10.1016/j.psyneuen.2021.105360
Studies on efficacy and general effects
- Blumenthal P. (2009). The levonorgestrel-releasing intrauterine system: safety, efficacy, and patient acceptability. Therapeutics and Clinical Risk Management. DOI: 10.2147/TCRM.S5624
- Gemzell-Danielsson K, et al. (2012). A randomized phase II study of levonorgestrel-releasing intrauterine systems. Fertility and Sterility. DOI: 10.1016/j.fertnstert.2011.11.024
Health agency reports
- ANSM (2017). Preliminary investigation into the hormonal IUDs Mirena and Jaydess. National Agency for the Safety of Medicines, France.
- The Press (2019). Should we fear the Mirena IUD? Investigation
Note: DOIs and PMIDs provide direct access to original scientific publications.
Medical Warning: This article is for informational purposes only and is not a substitute for professional medical advice. If you are considering a hormonal IUD or experiencing any concerning side effects, consult a gynecologist, midwife, or your primary care physician.
