I am 45 years old. I have had Mirena out for 3 weeks now (had it in for 9 months). At removal I went right back on the BC pill so there was no break in hormone levels. I have never had problems with the pill. I know some of you cannot use them. But for those who say "I just can't remember to take it every day..." consider the alternative of getting this IUD or keeping it inside you. The side effects alone are not worth it. In 3 weeks time that horrible facial/body acne has cleared up, the bloating is gone and my jeans fit much better although I'm not sure I've actually lost weight. A lot of it was just inflammation. The emotional issues just seem to have "vanished". I feel happy again. Imagine that (sarcasm intended). Libido much much better, with no pain or cramping. I started my period for the first time just this week. I thought it would be the period from "hell", getting revenge on my body for not having one for so long. But so far it is fine, and I'm glad it's back to tell the truth! Instead of spotting all the time or who knows when, I'll go back to light periods 3 days a month. Again, it beats the alternative. And a trick to try for taking the pill: put the pack somewhere around your bathroom sink area (away from kids of course) and just take it every morning after you brush your teeth. I mean you never "forget" to brush your teeth in the morning, so take the pill right after you rinse! It never fails. Also, you can tell yourself that if you did have a serious medical condition that required daily medication, insulin, for example, you would be good to your body and make it a priority. As long as the pill doesn't give you any problems, it's 99.9% effective and makes your periods very short and light, but predictable and right on time. No awful surprise breakthrough bleeding. The reliability of it is great. You just have to TAKE it. I'm only writing about the pill because it is the only other option I've tried and it worked well for me. If it's only a matter of inconvenience, try the toothbrush trick. It really works! Hope this helps some of you who are looking for other alternatives. Good luck!!