(Cross-posted in the meds section, but since Lamictal's a bipolar thing, figured it was more likely to be seen here. Hehe, I read this forum WAY more than any other and there are probably others like that too...)

I've been trying to research some info about this, but coming up with little info. I am considering going to an iud. Here are the relevant pieces of the puzzle... There seem to be 2 iud choices, ParaGard (12 years, no hormones at all) and Mirena (5 years, a bit of progestin). As I am 47, 12 years seems a bit much, what with menopause upcoming and all. Soooooo, the Mirena would seem the more appropriate option, BUT I know there are issues about hormones in interactin with Lamictal. (I'm just on Lamictal for BP II, no cocktail.)

So really, my question is, is the small amount of progestin in the Mirena an issue with Lamictal or not?

[Anneinside]

I would go ask a pharmacist about this.

[gravyyy]

It's not so much an interaction with the Lamictal as it is that hormones are a no-no in bipolar disorder as they can trigger mania. I have gone back and forth about this with people at work. Essentially the docs are divided. Some avoid it in favor of the Paragard b/c of the risk with the hormone, others say it's a small amount and can't possibly have much of an effect. (FYI... Paragard can cause more cramping in the beginning than the Mirena... but know that you can remove the Paragard before the 10 year mark.. you could put it in one day and take it out the next without an issue). In the practice where I worked, we did not use it in people with a history of bipolar disorder but know that if you get it and have a problem then it can always be removed (but who wants to voluntarily cause a bipolar cycle). I would discuss with your pdoc and with your OB/GYN and see if they can talk or what they think and then go from there. I knoe people with bipolar disorder have the Mirena and have no trouble at all, but there is always that chance. Good luck and hopefully whatever you decide it will be fine.

Thanks for the thoughts thusfar... Gravyyy, do you happen to know if they feel this way about all the hormones...ie. progestin being as potentially problematic as the others? One of the other things that occurs to me, and I don't know if this is an issue or not, but on my skin, copper gets a big reaction, not allergic or anything, but boy do I turn green, and fast...

Cost will very likely figure into this too... having recently made an out of state move, with a shorter one in the near future and, well, unemployed, finances are a huge consideration right now. Related to those factors... I don't have a pdoc or even a regular doc right now, so... research and good self-monitoring are my best option at the moment.

Keeping a good eye on the moods. They've been very stable for a few months now, and I'm getting quite a bit better at recognizing signs. Not quite so worried about if some hypomania were to kick in but the other side of the rollercoaster concerns me far more.

And thanks, Anneinside, I'll try that too!

[Moreta]

I was thinking about an IUD as well. Previously I have been on most types of BC (pills, shot, implant) for 9 years, but back in October when I had an emotional meltdown, I stopped taking my BC. Since then I have noticed how much better I have felt by not taking it. I really don't understand why the OBGYN would strongly suggest some pharmalogic form of BC to people with BP.

[gravyyy]

I'm just a little bit confused... how are you going to get the IUD if you don't have a doctor... or did you mean you have a GYN but not a family doc? Regardless, there wouldn't be an issue with the Paragard like with the copper on the skin... you're right that that's not an allergic reaction but happens to everyone at varying rates depending mostly on the moisture of the skin where the metal is contacting. So I don't think that would factor into the decision.

From my understanding it's any synthetic hormone (even some topical steroids.../ skin creams, hydrocortizone) can trigger mood swings in people with bipolar disorder. Again though, different docs have different opinions about this specific to using the Mirena, not about the steroid/hormone thing in general.

Originally Posted by gravyyy

I'm just a little bit confused... how are you going to get the IUD if you don't have a doctor... or did you mean you have a GYN but not a family doc? Regardless, there wouldn't be an issue with the Paragard like with the copper on the skin... you're right that that's not an allergic reaction but happens to everyone at varying rates depending mostly on the moisture of the skin where the metal is contacting. So I don't think that would factor into the decision.

From my understanding it's any synthetic hormone (even some topical steroids.../ skin creams, hydrocortizone) can trigger mood swings in people with bipolar disorder. Again though, different docs have different opinions about this specific to using the Mirena, not about the steroid/hormone thing in general.

Aha. Thanks, good to know. To clarify, no doc of any kind at the moment. Was thinking of Planned Parenthood.