There have been very few studies on the impact of hormonal IUDs on premenstrual mood symptoms, and unfortunately none examining the use of hormonal IUDs specifically in women with PMS/PMDD.
In a 2014 case study, a woman reported PMS symptoms after having a levonorgestrel (Mirena) IUD inserted. There have been reports of women discontinuing the levonorgestrel IUD due to mood-related side effects, but a review article didn't suggest associations between the levonorgestrel IUD and depression in women *without* PMS/PMDD.
As there are currently no studies on the Mirena IUDs impact on mood specifically in women with PMDD, it may be helpful to monitor your symptoms and see if you notice a change from pre- to post- Mirena insertion to determine if it is suitable for you. If you and your provider discuss and decide that a non-hormonal IUD is an option you want to try, there are copper versions that do not contain hormones. Other contraceptive options for women with PMDD include Yaz, which has been shown to reduce PMS/PMDD symptoms in clinical trials.
-Liisa Hantsoo, PhD, July 18, 2019