TIA and Mirena

Hi ~ I had a TIA when  I was on birth contol pills many years ago and was told back then that I should never go on birth control again due to the risk of having another TIA however my gynecologist suggested that I try Mirena which is an intra-uterine device that releases a low dose of hormone.  She said the risk of stroke is minimal because of the type of hormone released.  I am looking for a neurologists opinion on this. I am not using this for birth control but rather to help with painful/heavy periods.  Thanks so much for your time.

[Christopher R Newey, DO]

Thanks for using the forum. I am happy to address your questions, and my answer will be based on the information you provided here. Please make sure you recognize that this forum is for educational purposes only, and it does not substitute for a formal office visit with a doctor.

Without the ability to examine and obtain a history, I can not tell you what the exact cause of the symptoms is. However I will try to provide you with some useful information.

Contraceptives, typically those that contain estrogen, place women at a higher risk of TIA or stroke. The contraceptive your gynecologist is offering is a progesterone based contraceptive which has a lower risk of stroke or TIA but the risks are still present.

Since you have had a TIA in the past, your risks of future events are higher. Also, if not already addressed, you should address modifiable risk factors such as tobacco abuse, hypertension, hyperlipidemia, diabetes, and heart disease.

You should carefully weigh the risks and benefits of starting any medication and discuss these further with your prescribing physician.

Thank you for this opportunity to answer your questions, I hope you find the information I have provided useful, good luck.

[Jeanierdh]

Thank you so much for the information.  I just wanted to know if the risk of TIA was still a factor with Mirena and your explanation has helped me make an informed decision.  Thanks again!  I really appreciate your time. ") ~JJ