Can I test on the hormonal IUD?

Yes, you can test with FUTURE WOMAN if you’re on the hormonal IUD. However, some important hormone markers may be affected so there are a few things to be aware of first.

Let’s review everything you need to know about testing on the hormonal IUD.

What is the hormonal IUD and how does it work?

The hormonal IUD is a small intrauterine device that is inserted into the uterus for up to 3-5 years. Examples include Mirena, Kyleena, Skyla and Liletta. It works by releasing a small amount of a progestin called levonorgestrel, a synthetic form of progesterone, every day.

The hormonal IUD prevents pregnancy by:

Thinning the lining of the uterus to prevent implantation
Thickening cervical mucus making it more difficult for sperm to reach the egg
Changing the contractions in the fallopian tubes, making it more difficult for an egg to travel into the uterus.

Can you still ovulate on the hormonal IUD?

Yes, unlike other forms of hormonal contraception, it is still possible to ovulate on the hormonal IUD. As we’ve seen above, the main goal of the hormonal IUD is not to suppress ovulation, it has other mechanisms of action to prevent pregnancy.

In fact, because the hormonal IUD contains the lowest amount of synthetic hormones compared to any other type of hormonal contraception, ovulation is still possible. And as synthetic hormone levels wane over time, ovulation becomes even more likely.

Some research suggests that ovulation occurs about 15% of the time in the first year of use, rising to about 85% of cycles after the first year. In our experience, this is much lower.

It’s important to note that the presence of progestins may still suppress the production of reproductive hormones such as progesterone and oestrogen, which can in turn prevent ovulation from occurring. This is likely the reason why at FUTURE WOMAN, we see women ovulating on the hormonal IUD relatively infrequently.

How does the hormonal IUD affect my hormones?

Many women will still develop eggs during the time they are on the hormonal IUD. This means that they can continue to produce oestrogen and testosterone required for egg development.

However, if ovulation doesn’t occur, the hormonal IUD will suppress progesterone levels (progesterone is only made as a result of ovulation) and potentially also the second rise of oestrogen that occurs post ovulation. As a result, many women will find that their progesterone and oestrogen levels when tested are much lower than they would be if they were naturally cycling.

Sometimes, we see clients on the hormonal IUD presenting with symptoms of oestrogen dominance, or unopposed oestrogen, like mood changes, acne and heavy or painful periods. This is because even though their overall hormone levels are lower, their oestrogen is still higher compared to their progesterone, when ideally it should be the other way around. Furthermore, poor oestrogen metabolism may be further contributing to a picture of unopposed oestrogen and this can occur even if oestrogen levels are low.

It is also important to note that many hormonal symptoms such as acne and mood changes can be attributed to the progestin in the IUD. Progestins act more like testosterone than progesterone in the body and can cause symptoms of high testosterone such as head hair loss, mood changes, acne, weight gain and more.

Can I test my hormones with the hormonal IUD?

If you are ovulating on the hormonal IUD, then you can test with any FUTURE WOMAN hormone test.

If you are not ovulating on the hormonal IUD, then just be aware that oestrogen and progesterone levels will be lower than if you were naturally cycling. For this reason, we would recommend the Advanced Hormone Test as it includes so many other markers to understand your full hormone picture.

Aside from oestrogen and progesterone, all the other markers in our Advanced Hormone Test will be unaffected by the hormonal IUD. These include androgens like testosterone, hormone metabolism markers for oestrogen and testosterone, stress hormones, nutrient markers, inflammatory markers and neurotransmitters, as well as the Cortisol Awakening Response.

How do I know if I'm ovulating on the hormonal IUD?

The main way to determine if you’re ovulating on the hormonal IUD, is to track your basal body temperature (BBT) upon waking, using a digital thermometer. If you detect a sustained rise in temperature of around 0.3°C, then ovulation has likely occurred.

Tracking cervical mucus or using ovulation test sticks can also be useful. However, it’s important to note that these methods can only detect if ovulation is imminent, they can’t confirm that ovulation has definitely occurred. This is why we prefer BBT tracking for women on the hormonal IUD.

It is important to note that having a monthly bleed on the hormonal IUD does not necessarily mean that you’ve ovulated.

You can read more about ovulation tracking in our free cycle tracking guide, just sign up to our newsletter using the form below.

When is the best day to test on the hormonal IUD?

We always aim to test 5-7 days after ovulation with the Advanced Hormone Test. If you’ve followed the steps above, and ovulation has occurred, then count forward 5-7 days from ovulation to find your ideal testing day.

If you’ve followed the steps above and you are not ovulating, but you are getting a monthly bleed, then aim to test 7-9 days before your period.

If you’re neither ovulating nor getting a monthly bleed, then you can test on any day.

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what are the benefits of testing your hormones with the hormonal IUD?

There are many benefits to testing on the hormonal IUD.

If you do ovulate then you can get an indication of your progesterone and oestrogen and the balance between the two. This can give you an indication as to why you may be experiencing certain hormonal symptoms such as anxiety, poor sleep, heavy and painful bleeding, mood changes, acne etc.
You can understand your body’s current preference for oestrogen detoxification pathways, even if overall oestrogen is low. This can help to shed light on why you may be experiencing certain symptoms such as heavy and painful periods, weight gain or acne. This is vitally important if you’re on or considering oestrogen HRT, you’re looking to get pregnant in the near future, or you’re struggling with endometriosis.
You can assess your androgen levels (including testosterone) which can contribute to many symptoms such as mood swings, anxiety, weight gain, head hair loss, body hair growth, low libido and more. This can also be helpful if you’ve previously been diagnosed with PCOS.
With the Advanced Hormone Test you will still get a detailed insight into your stress hormones and daily cortisol pattern which can cause many of your hormonal symptoms and reveal insight into why you may be experiencing symptoms such as poor sleep, poor memory, anxiety, low energy and more.
With the Advanced Hormone Test you will also gain insight into your organic acids results such as neurotransmitters, nutrients and inflammation markers. Some examples include melatonin, dopamine, adrenaline, gut health, neuroinflammation, B6, B12 and more. These can be main contributors to many hormonal symptoms but can often mimic hormonal imbalances too.

What are some of the downsides of testing with the hormonal IUD?

Here is an overview of why it can be a bit tricky to test your hormones with the hormonal IUD:

If you are not ovulating, then your progesterone levels won’t be meaningful to take into account. Remember progesterone is only made as a result of ovulation.
If you are not ovulating, then oestrogen can appear suppressed and therefore cannot be taken into account in your test results.
Even if you are ovulating, the presence of progestins may still mean that your oestrogen and progesterone levels are lower than they would be if you were naturally cycling.