QuestionI am 38, have had 4 pregnancies, 3 living children, a miscarriage. I had a Mirena IUD for 5 years, the first 4 with no issues at all, but in the last year of it had some irregular periods. About 6 months after that I started gaining weight and having hot flashes, dry skin, still irregular periods. I had a new Mirena placed at 5 years (Decm 2008). I have now gained 20-25 lbs since Aug. I have had lots of tests done. Thyroid normal. My estrogen on day 9 was less than 20, but my FSH was not elevated, it was low. My Vit D is low, as is my cortisol level. I had MIrena removed last week to get rid of all artificial hormones to see if that resolves my levels and symptoms. I am going in Aug 21 for cystectomy (5.7 x 3.5 cm cyst on left ovary), ablation, and probable tubal. If my levels are still "off" after that and being off hormones, I will see reorpductive endocrinologist (have seen regular endocrinologist). Do you have any thoughts/suggestions?
Thanks so much!
AnswerHello,
It is possible that your weight gain is attributable to hormonal issues, but I doubt that to be the case. Mirena, which is mainly progesterone, can increase the weight slightly at the beginning but it does not continue to increase. Most weight gain is due to many factors such as age (increases with increasing age because of a decreasing metabolism), and a negative metabolism/caloric intake balance. That is we take in more calories than we burn off. Unfortunately, you need to get to a positive Metabolism/Caloric balance by increasing the burn of calories i.e. exercise. The only other hormonal structure that could cause this negative balance would be if there was hypothyroidism (low thyroid). The thyroid is responsible for our metabolism.
I don't think that a "reproductive" endocrinologist can help with this, but you can certainly see one. This is not a reproductive issue. An endocrinologist, as you have been seeing is the right person. If he/she cannot help, then it may not be a hormonal issue.
Sincerely,
Edward J. Ramirez, M.D., FACOG
Executive Medical Director
The Fertility and Gynecology Center
Monterey Bay IVF Program
www.montereybayivf.com
Monterey, California, U.S.A.
