Is Weight Loss Possible After IUD Removal? 12 Things to Know

An intrauterine device (IUD) sits inside your uterus, preventing pregnancy for anywhere from 3 to 12 years, according to Planned Parenthood. This time frame varies depending on the type and brand of IUD you choose.

Most birth control types have the potential to cause side effects, including weight changes, and IUDs are no exception.

Many people report these side effects are mild and almost unnoticeable.

Other people, however, find they experience more severe, long-lasting symptoms. Some say these effects persist for months after the IUD is removed.

IUDs are a highly effective method of birth control, and plenty of people find them convenient as well as effective.

That said, anecdotal reports and various online sources suggest it’s possible to experience unwanted changes in weight, not only while the IUD remains in place but also after its removal.

Once your IUD is removed, you might notice:

• weight gain
• weight loss
• difficulty losing weight, even with changes in diet and exercise

Based on the sheer number of stories from people who experienced weight loss or gain after IUD removal, weight changes are a pretty common outcome.

Many people also describe a collection of symptoms commonly referred to as the “Mirena crash.” These symptoms include weight changes.

For the most part, while people who reported weight changes find them frustrating, there’s little evidence to suggest any gain or loss will negatively affect your physical health.

The lack of scientific research on IUD-related weight changes makes it difficult to determine exactly how weight might change following IUD removal.

Though you may notice weight gain listed as a potential side effect of hormonal birth control, medical literature commonly describes this weight gain as “bloating” and “water weight.” Yet many people report gaining weight beyond a few pounds over the course of several months to a year.

Not everyone responds to birth control in the same way, so these effects can vary from person to person. Due to a lack of scientific studies and controlled trials, no specific statistics indicate whether weight loss or gain is more likely after IUD removal.

That said, the Mirena crash (and associated weight changes) is a fairly well-known phenomenon among former Mirena users — one that’s widely discussed online.

Let’s say, after IUD insertion, you notice some appetite loss — a symptom many people have reported. Since you don’t have much appetite, you eat less and lose weight as a result. After IUD removal, your appetite returns to normal, and you gain back the weight you lost.

Here’s another scenario: You experience some fatigue and energy loss while the IUD remains in place. Regularly feeling tired and unwell means you exercise less and gain some weight as a result.

After removal, you notice your energy levels return to normal. This increase in energy may leave some people more motivated to exercise, and, within a few months after removal, they may lose a few pounds.

People also report a weight plateau after IUD removal. In other words, they’re unable to lose weight, despite making changes in their diet and physical activity.

Some other symptoms that can develop following the removal of your IUD include:

• nausea
• fatigue
• insomnia
• depression

Any of these symptoms can play a part in weight changes over time.

To sum up, you could notice you lose a few pounds right away after your IUD is removed. Yet it’s also not unheard of to gain more weight, or have difficulty losing the weight you gained while the IUD was in place.

Two types of IUDs exist: hormonal and non-hormonal (copper).

Copper IUDs don’t release hormones into your body. Instead, they work because the copper acts as a sperm repellant.

Weight gain related to birth control tends to be associated with changes in hormone levels. Since copper IUDs don’t affect your hormones, it stands to reason they wouldn’t cause any changes in weight, while in place or after removal.

ParaGard, the copper IUD, doesn’t list weight gain as a potential side effect.

Hormonal IUDs work by releasing progestin into your uterus. Progestin helps prevent pregnancy by:

• reducing (but not eliminating) the chance of ovulation, or the release of eggs from your ovaries
• thickening cervical mucus, making it extremely difficult for sperm to reach any eggs that are released, much less fertilize them

Four different brands of hormonal IUDs are currently available in the United States: Mirena, Skyla, Liletta, and Kyleena. These brands release different amounts of progestin over time.

Weight gain during IUD use and after removal is more likely to be associated with these hormonal IUDs.

Since the evidence for weight gain (or loss) after IUD removal is largely anecdotal, there isn’t a conclusive scientific explanation for why this happens.

It may relate to changes in hormones, which may, in turn, affect appetite, mood, and energy levels.

Many people notice some weight gain while taking hormonal birth control. When they stop taking birth control, it may take a few months for their hormone levels to return to baseline. Fluctuations in weight could happen as part of this process.

The same goes for the IUD. After removal, the body has to adjust to the sudden drop in progestin. In theory, this hormone imbalance could lead to weight fluctuations and other symptoms of the Mirena crash.

It’s worth noting that other potential Mirena crash symptoms, including depression and insomnia, may also play a part in weight gain.

Existing research appears to suggest that, while a small amount of weight gain could happen when using IUDs and other hormonal birth control, this side effect may relate to other factors, rather than the birth control itself.

These studies also tend to point out that weight gain is normal during childbearing years — the time period during which people use birth control.

To date, no published scientific studies specifically explore weight changes after IUD removal, or other symptoms associated with the Mirena crash.

But then, research exploring gynecological health and related concerns — that includes reproductive health and health issues affecting the vagina, uterus, and ovaries — has always been somewhat limited.

What’s the deal with this lack of research?

You don’t have to search very hard, whether looking online or asking loved ones, to find plenty of stories about doctors brushing aside “female complaints.” This includes those related to unexplained pain, painful periods, and side effects of medication.

Talking about periods or reproductive health, even when using clinical terms, like “menstruation” or “vagina,” still remains somewhat taboo in casual conversation. Case in point: You’ll still often hear people call their period by a euphemism, like Aunt Flo, their monthly visitor, or the curse.

Traditionally, medical research has focused on people assigned male at birth and neglected to adequately explore health and reproductive health concerns for people assigned female at birth.

The large gender gap in clinical trials also means researchers may know far less about how medications and healthcare devices affect those assigned female at birth.

The problems with limited research, not to mention the avoidance of open discussion around reproductive health, lies beyond the scope of this article. In any case, there’s a lot that experts don’t know about the effects of hormonal birth control.

There are plenty of options to consider, but research on these options and their potential side effects remains limited. That’s why most of the support for weight changes following IUD removal comes from the stories of those who experience it personally.

While you’ll almost certainly gain and lose weight over the course of your life, you also know your body better than anyone else.

If you eat and exercise the same way you always have but suddenly experience significant weight changes, it makes sense to consider other factors, such as your IUD or its recent removal.

You might experience short-term side effects, such as cramping, bleeding, or dizziness, after a healthcare professional removes your IUD.

After the removal of Mirena and other hormonal IUDs, some people report additional side effects beyond weight changes, including:

• nausea
• decreased sex drive
• depression, anxiety, and other mood changes
• fatigue and energy loss
• insomnia
• headaches
• hair loss
• acne
• pain during sex
• breast pain or tenderness

These symptoms won’t always happen immediately after removal. You might not notice any changes for several weeks.

The lack of scientific research on the effects of IUD removal means there’s no clear timeline for how long these symptoms last.

Some people report weight changes and other symptoms cleared up within a few weeks. Others say they had a hard time losing weight for months after removal. And still others don’t notice any changes at all.

As the hormones in your body return to typical levels, these side effects will most likely go away naturally. The time this takes can vary, but you’ll usually see improvement within a few months.

Experiencing unwanted weight gain and other side effects after taking birth control can be distressing and overwhelming, especially when symptoms leave you feeling a lack of control over your own body.

Rather than drastically cutting calories or ramping up your exercise routine to the point where you feel exhausted, aim for changes that promote overall wellness and leave you feeling nourished and empowered.

These strategies can help improve both mood and physical health:

• Choose high-fiber, mood-boosting foods.
• Stay hydrated.
• Spend more time outdoors, especially in sunlight.
• Make physical activity a regular habit, if you’re able to exercise.
• Try to sleep between 7 and 9 hours every night.
• Consider wellness practices, like yoga and meditation.
• Reach out to friends and loved ones for emotional support.

If any unwanted side effects linger for more than several weeks after IUD removal, it may be helpful to talk with a doctor or other healthcare professional.

Healthy weight loss can take time, but if you’re making an effort to lose weight and see no results over time, a healthcare professional can offer more support.

When these symptoms involve depression, anxiety, and other mood changes, a mental health professional can help you explore possible causes and offer guidance on treatment approaches.

It’s always a good idea to reach out sooner rather than later if your side effects or symptoms begin to affect your everyday life or cause significant distress.

To date, the research on IUD removal doesn’t support the existence of any long-term side effects, including weight changes. Of course, one possible explanation for this is that almost no controlled trials have explored IUD removal.

Future research examining the possible long-term effects of IUD removal would go a long way in understanding potential symptoms and their causes.

For now, just remember: You know your body. Connecting with a healthcare professional is always a good idea if you notice any unusual changes in physical or mental health.

Crystal Raypole has previously worked as a writer and editor for GoodTherapy. Her fields of interest include Asian languages and literature, Japanese translation, cooking, natural sciences, sex positivity, and mental health. In particular, she’s committed to helping decrease stigma around mental health issues.

Differences, similarities, and which is better for you

Drug overview & main differences | Conditions treated | Efficacy | Insurance coverage and cost comparison | Side effects | Drug interactions | Warnings | FAQ

Skyla and Mirena are intrauterine systems used for contraception. These devices are placed in the female uterus to help prevent pregnancy. They are commonly referred to as IUDs (intrauterine devices). Hormonal IUDs are just one type of contraceptive method. Other forms of birth control include barrier methods (male and female condoms), oral contraceptive pills (OCPs or birth control pills), and spermicides. 

IUDs have an interesting history. Dating back to 1909, the first IUDs were very crude. Various formulations of the early devices did not have persistent use due to their association with infection risk, ectopic pregnancy, infertility, and early hysterectomy. Prior to Mirena and Skyla, Paragard was the most common IUD on the market. Mirena came to market in the year 2000 as the first of its shape and kind. Skyla followed in 2013. Both release the contraceptive hormone, levonorgestrel (LNG), though in different amounts. This is why they are referred to as hormonal IUDs. There are non-hormonal IUDs that do not release any hormones such as the copper IUD. There are also other hormonal IUDs on the market such as Kyleena and Liletta. Skyla and Mirena are good hormonal birth control options for patients who are looking for estrogen-free, long-acting birth control.

There are many differences and similarities between Mirena and Skyla detailed below.

What are the main differences between Skyla vs. Mirena

Skyla (levonorgestrel) is a contraceptive method available by prescription only. It is an intrauterine device containing 13.5 mg of levonorgestrel. Once inserted into the uterus, it begins releasing at a rate of 14 mcg/ day for the first 24 days. By one year, the release rate slows to 6 mcg/day. By year three, the rate typically slows to 5 mcg/day. Skyla should be replaced at the end of the third year. Skyla should only be placed by trained healthcare providers. There are multiple mechanisms by which Skyla prevents pregnancy. First, it causes a thickening of the cervical mucus which inhibits sperm passage to the cervix. It also inhibits sperm motility and function. Finally, this method of birth control alters the endometrium (the lining of the uterus). 

Mirena (levonorgestrel) is also a contraceptive device only available by prescription and can be used to prevent pregnancy for up to five years. Mirena also carries an additional approval by the Food and Drug Administration (FDA) to be used to slow heavy menstrual bleeding (menstrual periods). When used for this purpose, it can remain inserted for up to seven years. Like Skyla, it should only be inserted by a trained healthcare professional. 

Mirena contains 52 mg of levonorgestrel in each device. Initially, Mirena releases 20 mcg a day for approximately three months. From there it declines to 18 mcg/day after one year, 10 mcg/day after five years, and 8 mcg/day after seven years. It should be removed and replaced after five years for pregnancy prevention, or removed and replaced after seven years if utilized to slow heavy menstrual bleeding. Skyla and Mirena share common mechanisms of action.

Conditions treated by Skyla and Mirena

Skyla and Mirena are each a type of intrauterine system used to prevent pregnancy. Mirena also has an approved indication to be used to slow heavy menstrual bleeding. Mirena has been used off-label for endometriosis patients to ease symptoms. 

It is important to note that while most emergency contraceptive pills are also composed of levonorgestrel, IUDs are not to be used as a type of emergency contraception. 

Is Skyla or Mirena more effective?

Skyla and Mirena were studied in thousands of subjects in clinical trials prior to coming to market. The manufacturers of Skyla report a 0.9% pregnancy rate and therefore a 99.1% success rate of preventing pregnancy when used as intended. The manufacturers of Mirena report a 0.7% pregnancy rate and therefore a 99.3% success rate of preventing pregnancy.

When considering Mirena to treat menorrhagia, there are comparisons of it to hysterectomy or endometrial ablation. One systematic review suggests that satisfaction overall is higher with hysterectomy. However, Mirena is more cost-effective than either option, and may be a good first choice when considering the other methods are much more invasive. 

This is not intended to be medical advice. Only your doctor can help you decide what is best for you.

Coverage and cost comparison of Skyla vs. Mirena

Skyla is a prescription-only device that is typically not covered by Medicare. It is covered by some commercial plans. Commercial plans must have at least one type of hormonal IUD in their coverage formulary, though which one they choose may vary. The average retail price for Skyla is about $1322. A free SingleCare coupon can lower the cost to approximately $872.

Mirena is also a prescription-only device that is typically not covered by Medicare. It is covered by some commercial plans. The out-of-pocket cost for Mirena is about $1300. A Mirena coupon offered by SingleCare can provide a discounted price of $1043.

Common side effects of Skyla vs. Mirena

The most common possible side effects of both Skyla and Mirena are pain, cramping, and bleeding after placement, changes in menstrual bleeding, missed menstrual cycles, and ovarian cysts. Less common side effects include abdominal pain, acne, headaches, and inflammation of the vaginal area. 

Both Skyla and Mirena can cause rare, serious side effects as well including ectopic pregnancy, pelvic infection, other serious infections, pelvic inflammatory disease (PID), and perforation.

Source: Skyla (DailyMed) Mirena (DailyMed)

Drug interactions of Skyla vs. Mirena

Because the contraceptive effect of hormonal IUDs is mediated by the direct release of levonorgestrel into the uterine cavity, the mechanism is unlikely to be interrupted by drug interactions. Bayer Healthcare Pharmaceuticals, the manufacturer of both Skyla and Mirena, have not done drug-to-drug interaction studies.

Warnings of Skyla and Mirena

Skyla and Mirena both carry a risk of ectopic pregnancy. While the risk is very low, if you suspect you become pregnant while having an IUD in place, you should contact your healthcare provider immediately.

If a woman does become pregnant with an IUD like Skyla or Mirena in place and it isn’t removed immediately, it can lead to sepsis, premature labor, and premature delivery. Unfortunately, there are risks associated with removal including spontaneous abortion.

Cases of Group A Streptococcal sepsis (GAS) have been reported shortly after insertion. This is why aseptic insertion technique by a trained healthcare provider is necessary in order to reduce this risk. GAS can be fatal if not treated quickly.

Women with a history of pelvic inflammatory disease (PID) should not have a hormonal IUD placed unless there has been a case of a successful intrauterine pregnancy.

Perforation or puncturing of the uterus is a risk with Skyla and Mirena. This can lead to migration of the device, perforation of the intestine, and abscesses.

Partial or complete expulsion from the body can occur. If this occurs, the risk of getting pregnant goes up immediately, and not everyone is aware when this happens. This can be confirmed by ultrasound. It should be suspected if you notice an increase in bleeding.

Women with a history of or suspected case of breast cancer should not use any hormonal contraceptives, including hormonal IUDs like Skyla and Mirena. These patients should inquire about birth control options that are hormone-free.

Skyla and Mirena may lead to irregular bleeding or menstrual periods.

Skyla and Mirena will not prevent sexually transmitted infections (STIs) or HIV/AIDS transmisson.

Frequently asked questions about Skyla vs. Mirena

What is Skyla?

Skyla (levonorgestrel) is a hormonal intrauterine device contraceptive method available by prescription only. It contains 13.5 mg of levonorgestrel, and is approved to prevent pregnancy for 3 years.

What is Mirena?

Mirena (levonorgestrel) is a hormonal intrauterine device contraceptive method available by prescription only. It contains 52 mg of levonorgestrel, and is approved to prevent pregnancy for 5 years. It can also be placed for the purpose of slowing menstrual bleeding and is approved to be placed for this purpose for 7 years.

Are Skyla and Mirena the same?

Skyla and Mirena are both hormonal IUDs approved for use in preventing pregnancy. They each release the same hormone, levonorgestrel, but the amount of hormones is not the same and is not released over the same period of time.

Is Skyla or Mirena better?

Skyla prevents pregnancy 99.1% of the time with proper placement. Mirena’s success rate is slightly higher at 99.3%.

Can I use Skyla or Mirena while pregnant?

No, you should not have an IUD placed while you are pregnant. Your healthcare provider is required to check your pregnancy status prior to insertion.

Can I use Skyla or Mirena with alcohol?

It is safe to consume alcohol in moderation while you have a hormonal IUD in place. Side effects like nausea may be compounded by alcohol.

Does Skyla have fewer side effects than Mirena?

Skyla and Mirena have similar side effects, though some are more or less common with each choice.

Does Skyla make you gain weight?

Weight gain is not expected with Skyla, and Bayer does not report this as a side effect. There is little to no systemic absorption of the levonorgestrel to cause weight gain.