Have there been any links between Mirena IUDs and hair thinning or falling out? I am experiencing this and am certain it’s from Mirena use. Thank you for any information you can provide or point me to.
— Jessie from Canada
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Short Take
Hair thinning can have many causes. It is possible that a Mirena Interuterine System (IUS) may play a role, as hair loss is seen in approximately 0.33 percent of women who use one. However, more information and testing may be indicated before concluding the Mirena or other hormonal IUD has a role.
Tell Me More
Hair goes through phases where it is growing (the anogen phase) and resting (the telogen phase). During the resting phase, hair falls out and the follicle becomes dormant. After a period of time, the hair follicle becomes active again and begins another cycle of growth and rest. It is normal to lose between 50 and 100 hairs a day as part of this cycle.
Sometimes a life event, such as stress, medical conditions, certain medications and, most notably for women, hormonal changes postpartum, can trigger an event called telum effluvatum, basically a mass rest phase. During this time, more hair than normal gets the “go to sleep signal” and women will notice significantly more hair loss than normal. The hair loss can be very dramatic, even affecting more than 50 percent of hair follicles. Medical conditions or events that can trigger this kind of hair loss include iron deficiency, thyroid disorders, extreme diets and even surgery. If you take certain supplements they too could have a role, so that should be considered as well during an evaluation about hair loss.
Polycystic ovarian syndrome can also be associated with hair loss, but that hair loss will occur only at the front hairline (similar to male pattern baldness). And there is female-pattern hair loss, which is a change in the hair follicle that affects the thickness of the hair as well as how long it spends in the resting phase. This condition affects up to 6 percent of women under the age of 50.
Hair loss can be caused by a Mirena device, although there aren’t many studies that thoroughly evaluate the risk. So the first step is to make a proper diagnosis of the cause of the hair loss and then decide on an appropriate therapy. If no cause for a woman’s hair loss can be identified by a primary care provider or gynecologist, the next step should be to see a board-certified dermatologist. They are the experts in hair loss. If all other causes of hair loss have been ruled out (and there are several not mentioned here), then it may be appropriate to consider removing the Mirena.
On a Personal Note
Hair loss can be very upsetting for many women, and the emotional impact should not be underestimated. Some women feel their concerns are dismissed when they mention hair loss at an appointment. If no health care provider offers a better explanation, patients may resort to IUD removal, even if it is not medically justified. Focusing on the IUD could cause patients and their doctors to miss other important health conditions. And if a woman later decides to get another IUD, she may face the expense of a replacement and the discomfort of reinsertion.
Dr. Jen Gunter, often called Twitter’s resident gynecologist, is teaming up with our editors to answer your questions about all things women’s health. From what’s normal for your anatomy to healthy sex and clearing up the truth behind strange wellness claims, Dr. Gunter, who also writes a column called The Cycle, promises to handle your questions with respect, forthrightness and honesty.