Can a hormonal I.U.D. cause hair loss?

Q: Have there been any links between Mirena I.U.D.s 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

A: Hair thinning can have many causes. It is possible that a Mirena Interuterine System may play a role, as hair loss is seen in approximately 0.33 percent of women who use one, though 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.

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.

If no cause for a woman’s hair loss can be identified by a primary care provider or gynaecologist, 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, then it may be appropriate to consider removing the Mirena.

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 I.U.D. removal, even if it is not medically justified. Focusing on the I.U.D. could cause patients and their doctors to miss other important health conditions.

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