Thanks, Stephane Michelle. I thought someone already mentioned that the Mirena is local. I interpret that to mean that, though a much smaller amount of hormone is released locally in the uterus, this is because it does not have to survive the digestive tract. I have not seen any info comparing the net absorption levels of levonorgestrel released in-utero vs. oral AFTER DISGESTION, and I would be quite keen to see those data!!!
The other main difference is that Mirena is progestin-only and supposedly does not inhibit ovulation, so a woman might experience some normal biological ups/downs /cycle-related differences (in my case, peri-menopause symptoms) vs. combined progestin-estradiol oral pill, which I understand prevents ovulation entirely thereby causing the body to think itself pregnant – a biological state PREGNANT (sorry, couldn’t resist the pun) with all sorts of inherent primal phenomena that might interfere with the desires and processes of a woman seeking and enjoying coitus without resulting in offspring.
I have been charting, and I do think it’s incredibly empowering and elucidating. But please be advised that there is a difference between the Fertility Awareness Method (FAM) Hannah advocates and the “Rhythm Method,” which is an obsolete, outdated method that relies solely on past cycle info rather than current basal temps, cervical fluid and cervix position (see Weschler, Taking Charge of Your Fertility – the bible on FAM). FAM can be pretty accurate if you want to invest the time and double up on barrier methods during conservatively estimated fertile phases.
In fact, it’s a shame that in this country we teach abstinence rather than FAM to teens, who might never learn about the fertility cycle until many years later when a woman wants to ACHIEVE rather than avoid pregnancy. However, I think you are correct that ovulation is still pretty tricky to predict – especially at my age: in the past few months my periods have gotten closer, and I don’t trust my math! MOreover, i’m lazy and I dislike barrier methods.
Many Mirena users don’t appear to notice negative side effects until after 1-2 yrs of use; that’s why I’m curious about some honest feedback from savvy 180 chicks on this site. I recall being a bit flattened and depressed from time to tome on the pill, but I can get that way sometimes off it too. As you say, it seems to truly be an individual issue of weighing risks against benefits.
I”m glad to hear you love it as my mind is pretty much made up to get one. I wish more people who love it were expressing this online! The only downside: if I don’t like it, my insurance won’t cover removal. :(