03/02/2026
I’m seeing this come up again and again in women I work with.
Many have been told that because they have a Mirena, their progesterone is “covered” alongside oestrogen HRT.
The reality is more nuanced 👇
• The Mirena releases progestin, a synthetic hormone - not natural progesterone!
• Progestin does not behave the same way in the brain, nervous system or in any body tissue.
• The dose is very low and local to the uterus, designed for contraception and endometrial protection.
When oestrogen is fluctuating (or being added via HRT), this can leave some women effectively under-supported on the progesterone side.
I commonly see this show up as anxiety, poor sleep, breast tenderness, bloating and a general sense of being “wired but tired”.
This isn’t anti-Mirena.
It isn’t anti-HRT.
It is about understanding hormone physiology properly and individualising care.
If this resonates, you’re not imagining it 🤍
