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[lizzog]

I've been on hrt for about three years now I've dropped down to 25 patch, with a view to weaning off the hrt. Since I've been menopausal I've had more migraine type headaches, and have had this sort of headache since Saturday, combined with tummy pains and have been hungry too. All this things seem like an exaggerated type of pmt that I always used to get before a period. I get no periods with the mirena now, so have no idea where my natural cycle falls....
When I spoke to my GP she basically said that I should look at the positive side of no periods (which is great), and accept the migraines. I've been give Imigran (??) for migraines, but firstly they say use with caution if on antidepressants which I am, and I'd rather try and get to the bottom of the cause of the migraines. My GP also said it was unlikely to be he mirena causing this (even though on the side effects headaches and abdominal pain are listed...).
Not sure what to do now.  I'm wondering whether this is a reaction to reducing my hrt and whether I need to step back up to a 50 patch, or whether to tough it out...?
Sorry for lengthy post!

[Sarah2]

I'd say the likelihood is that there is too much progesterone in your system compared to oestrogen which is why you are having the PMT type symptoms.

The Mirena is a funny thing: it's only supposed to work locally, in situ, but so many women find it gives them side effects as if the hormones were getting into the blood stream.

The other option is to consider the lifespan of the Mirena ( it's supposed to last for 4 years as HRT) and if yours is on the way out! How close to the 4 years are you with it?

If you are lacking in progesterone it may be giving you migraines ( lots of women get these when their progesterone levels fall.) But if you have only had it for 3 years then I'd say the odds are you are on too low a dose of oestrogen.

Hope this helps.

[lizzog]

Hi Sarah2. I thought this too. I have had the Mirena in for two years. I've been having night sweats again, headaches, hungry, nausea and so it sounds like the oestrogen is the problem.
As you say, the Mirena is supposed to work in situ, but I feel like the hormones are in my bloodstream!!! 

[Dancinggirl]

Hi Lizzog and welcome to MM
How old are you? Why do you feel you need to come off HRT? If you have only had the Mirena for 2 years you could continue with the high dose oestrogen patch for another 2 years and then have the Mirena removed at the end of it's life and do a break from HRT to see how you feel.
It sounds as though you were still peri meno when you started this regime (you say you don't know when your natural cycle would be!!). If you were peri meno then you don't know when your natural periods will stop completely and over the last 2 years your natural oestrogen levels will have dropped.  Dropping to a lower dose patch will be depriving your body of oestrogen and it is likely that meno symptoms will return.
I think Sarah is right - you sound as though you have too much progesterone.  DG x

[Hurdity]

Hi

I'm a bit confused by the discussion - but if you are having night sweats again then this is likely to be due to reducing your oestrogen to a 25 mcg patch.

Headaches can be due to all sorts of things - but yes it could be due to the Mirena. There is some systemic absorption and therefore some women react badly to it. Premenstrual headaches as in pmt just before a period are not due to the progesterone itself but due to the sudden drop in levels and the associated physiological changes, but not due to low progesterone per se (once the excess progesterone has cleared from the system most women feel great!).

Some women (progesterone intolerant) get headaches from the progesterone itself ( ie the whole of the second two weeks of the menstrual cycle).

So I would say not that it's too much progesterone - but that you could be reacting to it, as it is a synthetic type. As well as this you are probably affected by the low oestrogen as Dancinggirl said below.

Hurdity x