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[Vanessa52]

Hi
I'm new and i have a question about progesterones.

I had the Mirena coil and it had Levenogesterel. Now I have Everol Conti and it contains Norethisterone.

My question is, does the Mirena coil give a higher dose of progesterone that the patch?

I ask because of side effects which I suffered moderately with the coil. My doctor told me that HRT is much lower dose that the coil, but I don't trust his judgement all the time.

If anyone could help with this 'd be very grateful x

[Dancinggirl]

I was under the impression that the Mirena used a continuous lower dose of progesterone - I may be wrong on this. I believe the benefit of the Mirena is that the progesterone is absorbed more locally so, in theory, you shouldn't get so many side effects.  However, many women still get some side effects.  Other benefits include: no breakthrough bleeding(apart from the early few weeks) and through peri meno you don't need to use a contraceptive.
I'm afraid Norethisterone can also give some PMT type symptoms but again this varies from women to women - we are all different.  It is true that the trans dermal route of HRT such as Everol is preferable so is well worth trying.
I'd sees how you do with Everol and if it doesn't suit you then try Oestrogel or an oestrogen patch with Utrogestan as the progesterone part.  Look under the HRT Preparations section to the left of this screen for info.  Many GPs don't know about this combination - it's the closest HRT combo to the bodies natural hormones - so you need to print of the details to show the doctor.  DG x

[Vanessa52]

Thank you, that's what I thought too.

I have looked at the preparations an when I go back I will talk to him about it.

Thank you for your reply, I'm still getting used to all this and it's great to talk about it x

[Hurdity]

Hi Vanessa52

I agree with Dancinggirl.

Because of the local action of Mirena then I would have said that serum concentrations of progestogen likely to cause side effects would have been greater from the patch than the coil. You cannot compare Evorel with Mirena though, as you know they contain different progestogens.

Femseven (HRT combi patch) also contains levonorgestrel, though so anyone who wants to look into it can look up the serum concentrations obtained through trials from Mirena and Femseven... I don't have time to do this right now!

As Dancinggirl says some women suffer side effects from norethisterone, and as the hormones in Evorel conti are designed to be absorbed systemically (whereas Mirena isn't - although you did experience the effects of this) you could suffer continuous low grade side effects just as in the Mirena.

Re what to do - just as Dancinggirl says!

(I use oestrogen patch and utrogestan - "natural" progesterone)

Hurdity x

[dahliagirl]

Mirena releases 20mcg levenorgestrel per day, reducing by half over 5 years according to their website.

Femseven releases 10mcg per day

Norgeston (pop) contains 30mcg

ovranette (coc with 30mcg oestrogen) contains 150mcg


Just some comparisons.  I have no idea about absorption rates.