I used to be a regular on this forum. I had the usual problems with the Mirena, notably weight gain and extreme PMS. I believe it was the synthetic progesterone which caused these problems for me: essentially, it pushed me into perimenopause. Now that I'm off, things have improved considerably (that's the good news), but the less good news is that, at 45, fluctuating hormones pose a not dissimilar set of challenges. Through exercise and not having the damned Mirena, I've lost 15 pounds. Micronized progesterone cream for half the month has proved tremendously helpful as well. I can understand hesitation after terrible side-effects with the mirena progestin; but, basically, a lot of us seem to be suffering from estrogen dominance. You need to be careful about the brand you get --Better Health Naturally, Moisture Treatment Creme is the best I've found -- but progesterone creme can be very helpful with this syndrome and with recovering from the Mirena.