Educational and Clinical

Can Mira be used with an IUD?

Yes. Many users choose to track with Mira while an IUD is in place to understand their hormone activity better. Hormonal IUDs primarily exert local effects within the uterus and do not reliably suppress ovulation. Many women continue to ovulate regul

Where can I find a provider training course about monitoring women’s hormones?

We are developing a provider course, but for now, you can explore these resources:

I’ve observed occasional drops and fluctuations in my patients’ PdG levels. What could be the reason for this variability?

Fluctuations in progesterone, including dips and spikes in urinary PdG, are not uncommon and can be influenced by several physiological factors, such as the timing of collection, hydration, or recent activity.Progesterone tends to be more variable th

What medications, supplements, interventions are contraindicated with Mira?

To ensure accurate results when using Mira for testing, it’s important to understand how the following medications and supplements may affect the data:. Other medications and supplements may also affect Mira data. If you'd like specific information a

What other factors can affect Mira data?

Fluid intake and hydration status can influence data, as well as medications like Clomid. Kidney disorders may alter urine composition and affect accuracy.

Is Mira creatinine corrected or is the urine normalized to urine specific gravity?

Our testing is designed to use a naturally concentrated urine sample (first-morning urine, FMU), which is considered the standard approach for assessing urinary hormone metabolites. Because of this, and because results are intended to be interpreted

What is the reliability and validity of Mira?

Mira is reliable and valid when used correctly. It tracks hormone trends accurately and align well with serum hormone levels, as demonstrated by clinical research. Internal checks and calibrations ensure consistent performance. Additionally, Mira’s c

Does Mira track testosterone or cortisol?

Mira does not currently measure testosterone or cortisol; however, both markers are actively being researched for inclusion in future testing.

Can Mira be used while on birth control?

Hormonal birth control typically suppresses ovulation, but some women may still ovulate and have menstrual cycles. Combined oral contraceptives typically suppress ovulation, which can result in non-ovulatory, non-menstrual bleeding cycles, breakthrou

Is Mira applicable to post-menopausal women at all?

Yes. In postmenopausal individuals, estrogen and progesterone are typically low and stable, but FSH often remains elevated and variable. Routine cycle tracking has limited utility here, but tracking FSH remains a clinically meaningful biomarker, as p

Is there any data for perimenopausal women?

Yes, several pilots and studies are currently underway related to perimenopause. Our perimenopause use case resources are here.

Does it track xenoestrogens? Does this only detect natural estrogen or if there is a woman with high xenoestrogens from outside sources, would it show estrogen high?

Mira does not track xenoestrogens directly. However, if xenoestrogens lead to an increase in serum estradiol (E2) levels or contribute to estrogen dominance, Mira’s E3G levels will reflect this increase.

How do urinary metabolites correlate with serum levels?

Serum labs and Mira measure related—but not identical—signals, so some divergence is expected and usually not concerning. Serum LH and FSH reflect a single time-point circulating concentration (a snapshot). Mira measures urinary LH and FSH, as well a

How does urinary PdG relate to serum progesterone, and is it normal for PdG to fluctuate?

Urinary PdG (Pregnanediol Glucuronide) is the primary metabolite of serum progesterone and provides a delayed reflection of progesterone activity. Because serum progesterone itself can fluctuate dramatically—studies show up to an 8-fold change within

What does it mean if PdG is elevated in the follicular phase?

It is important to note that PdG is highly sensitive to improper testing techniques, so we strongly recommend that clients carefully follow the provided instructions to ensure accurate results. Anecdotal observations suggest that abnormal PdG levels

Is there a threshold of PdG that is confirmatory for ovulation?

To manually confirm an ovulatory event using Mira PdG, you can look for one of these two patterns:

How does Mira compare to Dutch?

Mira offers several advantages over traditional dried urine testing, such as the DUTCH test. By utilizing laboratory‑grade immunofluorescence technology, Mira provides immediate results and enables remote, real‑time monitoring of hormone levels and t

How do I test if I am using vaginal estrogen?

The impact of vaginal estrogen on Mira results depends on the type and dose:. Low-dose vaginal estrogen (typically used for local symptoms such as vaginal atrophy or urinary discomfort) is minimally absorbed and usually does not affect serum estradio

Does Mira integrate with CGMs?

At this time, CGM data cannot be viewed directly within the Mira app or provider dashboard. However, Mira has integrated with platforms like Biocanic and Heads Up, and additional integrations are planned to support more comprehensive data viewing in

I commonly see a progesterone spike BEFORE ovulation or LH surge. Can you help me understand this?

How does Mira compare to ZRT?

Mira offers significant advantages over ZRT’s Menstrual Cycle Mapping by providing real-time, lab-grade hormone tracking with AI-powered immunofluorescent technology. ZRT uses saliva samples collected at specific times and requires lab processing. Mi

Can Mira be used with HRT?

Mira can be used to monitor patients using HRT, but it is important to understand how different types of HRT affect Mira data. Effective monitoring of hormone therapy requires more than symptom improvement or interpretation of a single hormone value.

Can Mira be used in perimenopause?

While Mira is widely recognized for fertility tracking, it’s also a very valuable tool for perimenopause management. We have significantly expanded our educational resources for perimenopause care over the past several months. Mira provides real-time

How can I better understand Mira’s technology to educate my patients?

Explore our education center, which offers resources designed for healthcare providers, including guides, protocols, webinars, tutorials, and case reports. These materials will help you get started with Mira, interpret hormone data, and confidently i

How does Mira compare to other tracking devices such as Clearblue, Proov, Oova and Inito?

Mira uses fluorescent lateral flow immunoassay technology, which is more accurate and sensitive than the nano‑gold technology used by other trackers (such as Clearblue, Proov, Oova, and Inito). Mira’s fluorescent analyzer provides quantitative, lab‑g

How can Mira help if I’ve had a hysterectomy?

If your ovaries are still intact, you may continue to have coordinated hormonal fluctuations and ovulation even without menstrual bleeding. Mira can help identify your underlying hormone patterns, determine whether ovulation is occurring, and detect

Do you recommend completing a baseline cycle before beginning interventions?

A baseline cycle is very helpful, but it isn’t mandatory. If symptoms are significant or time is a concern, you can begin interventions in the first cycle of testing and use subsequent cycles to monitor response and refine the treatment plan.

Are there normal reference ranges for Mira users?

Yes. Mira provides reference ranges within the app for users, and clinicians have access to more detailed ranges in the provider dashboard and interpretation guide. We are also in the process of enhancing these reference ranges by breaking them down

Can Mira help during menopause or while adjusting HRT?

Mira can help perimenopausal users observe cycle irregularity, anovulation, and hormone fluctuations. Mira provides quantitative data that can help clarify whether HRT is supporting more coordinated hormone activity. Mira data can also help validate

Could you please speak to the approach to women who are already on HRT but don’t feel like it’s going so well?

For women already on HRT who feel their therapy is not working optimally, Mira can provide objective insight into how hormone patterns are responding. It allows clinicians to assess whether estrogen exposure is producing expected physiologic changes

How can Mira be helpful for patients with EDS/POTS/MCAS?

For patients with EDS, POTS, or MCAS, hormone fluctuations can significantly influence symptom burden — including autonomic instability, mast cell reactivity, fatigue, pain, and inflammatory responses. Many of these patients report heightened hormona

For women that had surgical menopause, what value can Mira provide?

For women in complete surgical menopause (bilateral oophorectomy), Mira can provide value primarily by monitoring longitudinal FSH trends and assessing physiologic response to estradiol therapy. This includes tracking symptom patterns, observing E3G

Can Mira be used for young women (e.g., 14 years old)?

Yes! Mira is useful for any woman with cycles, from menarche through perimenopause. However, Mira does not have specific reference ranges for women younger than 18.

Would women with unstable, unpredictable, or frequent bleeding benefit from Mira?

Yes, tracking over a few months can help the user (and provider) identify and understand the hormonal patterns that may be triggering the irregular bleeding.

Does diet impact daily Mira results? If so, how?

Diet does not directly change hormone levels within hours in a way that would immediately alter Mira results. However, nutrition patterns over time can influence insulin sensitivity, inflammation, stress physiology, and overall metabolic health — all

LCMS vs ECLIA - How does this translate to the immunoassay tech that Mira uses?

LC-MS/MS generally has higher specificity and accuracy than immunoassays such as ECLIA in hormone detection, especially in reducing Deviations caused by cross-reactivity. Mira also uses immunoassay technology, so, from a methodological perspective, i