Hello, * As per my clinical experience, the Mirena removal crash syndrome is not mentioned in medical literature and hence the symptoms are of subjective phenomenon. * The mirena contains Levonorgestrel which is synthetic form of female hormone Progesterone. * The various features of crash symptoms include moderate to severe, mood swings, lethargy, irritability, insomnia, depression, lack of mood, altered menses pattern * Following are the modalities to cope up with the symptoms - mild symptoms resolve on their own within a period of 1 month or so - moderate to severe symptoms do require particular attention as @ deep breathing exercises, meditations, YOGA, regular aerobics @ analgesic as ibuprofen with acetaminophen @ black cohosh, chasteberry, evening primerose oil * If the above measures do not show up with the regression of the symptoms, it is recommended to consult your OBGY in this regard. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr. Bhagyesh V. Patel