The progesterone is in Mirena and that will make your periods lighter which may help with the anemia, if that's what's causing the anemia.

My obgyn discussed Mirena with me after I clotted and needed birth control. I opted against it because it contains hormones and I was concerned about clotting again, even though the risk of clots with Mirena are far less than with an estrogen based birth control. However, I know many women on here who use Mirena and really like it.

I've had iron infusions before and they do make you feel better if your anemia is really making it hard to function daily. It sometimes takes a few weeks to feel the effects, but it should help you.

That was my concern with the mirena. The doctor just seemed puzzled that it should bother me because it was progesterone.

That's because most will say the risk is so low that it would be highly unlikely to cause a clot. I get that but it's something you need to feel comfortable doing.

Are sure the anemia is caused solely from your period?

Most likely this is the cause as the only other times I've had a problem with iron levels is is 2 out of 5 pregnancies, and even then only really late into them.
I do have problems with my oesophagus which has affected what I can eat but then I had hyperemisis during pregnancy and couldn't eat and even then the iron was pretty stable.
My immediate reaction to the mirena was not to use it so I will probably go with gut instinct, particularly since I am an excellent clotter.

Are you a lifer on warfarin? Or is it temporary? If you're a lifer, you could take that into consideration as well, just because you SHOULD be protected from clotting even if you have the Mirena.

I mean, I'm skittish of hormones as well (I had my second DVT as a result of a progesterone-only pill) and when I had an IUD, I had a copper one, and not one with hormones. So I get where you are coming from.

But, I do wonder with all the other problems you're having, if it might help you out with the anaemia and etc. It is definitely a situation where you have to weigh the pros and cons. And, even if you're not comfortable with it now, you might be further down the road.

Yes I am a lifer. I had 1 massive PE during pregnancy and then another PE a couple of years later that took up a large part of 1 lung with little clots all over the other lung.
I had a small clot a couple of weeks ago because I clot easily if I'm under 2.5. I now bridge with clexane if the INR drops.
But yes I have many other health issues so it is really difficult when my iron levels drop.
I think the idea of any hormone just really bothers me.
I also read the warnings so the whole perforation of the uterus, peritonitis etc further disturbed me....
But on the flip side I need to keep my iron levels up so my internal debate continues.

I have a nonhormonal IUD which wouldn't work for you because it does make your periods heavier but I wanted to point out I've had it for several years now and haven't had any problems with perforation , infection etc. I really like it. But for sure you have to go with what you're comfortable with.

I clotted because of oral progestrone-only HRT, which is not very common at all--it usually occurs when you are using estrogen. The OB/GYN doc then suggested that I should consider the Mirena. The whole idea scared me to death, so she referred me to Hematology. The hematologist said that she personally had three thoughts: the HRT did cause my clots, no matter what the OB doc thought AND the Mirena contains something like 1/10 of one daily oral dose that is administered over a 5-year period AND I was on warfarin forever, anyway, so I should go ahead and have it implanted to save me from hysterectomy, which was more risky than the IUD. I've had it since May and no problems yet.

I'm dealing with a similar issue. I'll also be on blood thinners for life (I'm on Xarelto now), because they can't find a cause for my PE. I found out in the hospital when I was scanned and had bloodwork done for my PE one month ago, that I'm already anemic from heavy periods. The pelvic scan showed (benign) uterine fibroids that are probably the cause. I'm just starting my first period since being on blood thinners, and my hematologist has me on weekly iron infusions since there will probably be even heavier bleeding now. I'm not a candidate for fibroid surgery or a hysterectomy until I'm farther out from the PE. My gynecologist recommended the Mirena coil to lessen bleeding, and she satisfied me that the risk of clotting due to the hormones is minimal. Unfortunately, we found out then that I can't be fitted with one due to the size and location of the fibroids. So now we are looking into uterine artery embolization, which has less risk than surgery. I had my appointment with interventional radiologists yesterday, and I'm waiting to hear if and when I can have that procedure done. If I can't, I'll have to be put on Lupron until I'm stable enough for surgery. I hope some of this info is helpful to you, and you find a solution. It's a complicated problem. Make sure you have good, specialist doctors and that they share info with each other. Good luck.

I was severely anemic. Taking two 65 mg pills of iron a day with meals did help. So did taking a B 12 pill daily.

My clots were caused by hormone pills.. mini pill and progesterone pills. They were being used to attempt to stop severe bleeding caused by fibroids ( which by the way grow when you take hormone pills and get worse) and as a side effect of menopause, the catch 22 came while I was hospitalized for the clots and PE. if they stopped the hormones I would begin to bleed again and was already at 7 for a hemoglobin level.. if they didnt I would keep cloting. Hysterectomy is the most common way they fix bleeding of this sort. But I was not a good candidate, that surgery is known for causing clots and you cant have major surgery while on blood thinners.. the solution was uterine embolization. They installed a IVC filter to catch clots heading from my legs to my lungs, then went in with a catheter and placed tiny bit of plastic into the arteries feeding the fibroids, choking them off and killing the tumors. I went on warfarin the same day as the procedure. I can not take any sort of hormone again be it pill, shot or IUD.

Thank you so much for all your replies. It has certainly given me something to think about.
For the moment I have decided against the mirena. Mostly because the idea of having something implanted in me is distressing. It feeds into my OCD a bit.
The Dr is now thinking endometrial ablation may help. I am giving this some thought. In the mean time I am waiting on ultrasound results to see if that gives any answers, although the dr did say that the results probably wouldn't change the outcome.
So now I am considering whether this is an option I could live with.
My other alternative is to have iron infusions when necessary . But I also faint a lot when I get a period so I don't know if this will he or not......back to thinking again

I had an appointment today with a really good OB/GYN.
It was very informative. She went through all of my concerns from the progesterone causing a clot to bleeding to death from the mirena going through my uterus. (Not all my concerns were rational but she went through them calmly and was very reassuring )
I am having so many problems with the heavy bleeding and a anaemia and she believes this is simply caused from warfarin & so many pregnancies so the mirena would be a really good option for me.
Anyway, I have booked an appointment and the procedure will be done under sedation.
The most surprising thing is I feel really calm about it. Hopefully it will be a success and my iron levels will pick up.

I'm glad you saw someone you like. And now, you have a plan in place. Sometimes for me, that's all I need- a plan. Otherwise, when I don't know what's going on or what to do, all the stress gets really heightened.

Hope things go well and that it helps you.