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[hotstff]

I have been on Evoril patches for about 2 months (the one with both hormones - as I still have a womb).
I'm 52.

Ok, so just had a phone call from my GP practice to say that I have been 'put down to have a Mirena Coil fitted.

I said I didn't know anything about it! 

At the risk of sounding dumb, What exactly is a Mirena Coil?
And why is the GP trying to get me to have one?  (surely the patches cover everything I need?)

Do you think she has made a mistake?  (its happened before - a mistake).

It could be ages before I get an appointment - where I can ask her to explain what's what, so I thought I would
see if anybody on this board has any answers?

Thanks!

[Taz2]

I'm not sure. Do you still need contraception? The mirena stops pregnancy and also regulates your pregnancy. Some GP's prescribe the mirena as the progesterone part of HRT so you would need to stop the patches you are on and just have an oestrogen only patch.

You can read about the Mirena (or IUS) here http://www.nhs.uk/Conditions/contraception-guide/pages/ius-intrauterine-system.aspx

Taz  x

[honeybun]

When I first asked for HRT I was offered a Mirena coil too. She did say it was for birth control which I did not need as hubby has had the snip.

I wanted patches primarily because I like to be in control. With patches I could stop if I wanted but with the coil you are stuck with it until a doctor decides to take it out if it does not suit.

In saying that a lot of women get on very well with it.


Honeyb
x

[Dyan]

I have the mirena and use estrogen gel and have had no problems with it.
As Taz said, you would have to stop the patches you are on and just have something for the estrogen part if you had the mirena.

[Hurdity]

Hi hotstff

The practice cannot put you down for something you have not agreed to and hasn't been discussed with you! Personally I would phone back and make an appointment - no hurry though. Even if you still need contraception - you don't need to choose a Mirena!

When I had a hysteroscopy last year the consultant who knew I was on HRT age 60, and still on a cycle,  asked me if I would like one - they like to ensure the womb lining keeps thin. However I declined and he did not pursue it - but at least I was asked!

If I could tolerate the progestogen (I haven't tried this one) and could be sure that none of it was absorbed systemically - then I would definitely choose this - because it is the best way to keep the lining thin theoretically without any side effects. Unfortunately this is not the case for many women - but you could be one of the lucky ones.

If you like the idea then you could try Femseven patches first which contains the same progestogen and if this suits you then the Mirena probably would. The converse is not necessarily true ie if Femseven causes side effects the Mirena may not - because less should be absorbed through the Mirena if you see what I mean (with patches the hormones all have to be absorbed into the system and then transported in the blood stream to where they are needed).

Also you would have more flexibility with the oestrogen dose - the patches are all in one. You can achieve this same flexibility with other methods of separate oestrogen and progesterone though!

Hurdity x

[hotstff]

Taz, thanks for the link.  http://www.nhs.uk/Conditions/contraception-guide/pages/ius-intrauterine-system.aspx
It seems to give a lot of information about it being effective as a contraceptive, but gives very little information on how it is effective (or non-effective) in the treament of menopausal symptoms 
(even the comments section seems to be mainly from younger women that have had it fitted)

And the more I read about it - it sounds quite invasive:

Can cause pain on insertion, possible infection, cramps, not to mention it might not be in the right place.

And also I'm not sure if I want my body to receive a constant supply of progesterone (its bad enough coping with it every two weeks).

I wonder why the Doc's pushing for me to have it?  Whats wrong with me sticking on the combined patches (or pills?) 

I think if I was still under 50 and I was looking for a good contraceptive, then I might consider it.
But as an HRT treatment? 
At the moment it's a NO.

[Hurdity]

Hi hotstff

The Mirena is not given to treat menopausal symptoms - but if used as part of HRT, it is to provide progestogen directly to the lining of the uterus to prevent it thickening due to oestrogen stimulation from the HRT.

Theoretically very little progestogen is absorbed into the body but this varies from woman to woman and some react badly to the little that is absorbed - those that are sensitive/intolerant to progestogens.

It is entirely your choice. If you want to remain on combi patches or pills then have that conversation with your doc say so!

Hurdity x

[hotstff]

thanks Hurdity!

I've just put in a prescription for another 3 months of Evorel Sequi, so I might cancel my appointment which was made for me to have coil put in.
(I don't like the thought of having something that's in me for a couple of years).  With the patches, I can change at any time - (if something doesn't agree with me.)
I'm pleased that the coil is working out for some women!

[fallingapart]

Have you got very heavy troublesome periods that need regulating? My sister was given the Mirena coil for that years ago, she likes it.

[hotstff]

No, I don't (haven't ever) suffered with heavy periods!

The GP seemed to automatically assume that I wanted to go on it.
Maybe it's standard practice round our way?  Shove them on the coil  (probably cheaper  )

I wonder if it IS cheaper?
Money usually factors in somewhere when it comes to treatment.

[dht240]

I'm in peri at 44 and had the Mirena coil fitted several weeks ago after the doc advised it was the best option for womb-lining and to prevent the type of periods/no periods/flooding that I'd been having. (I've previously had two surgeries for it, but Dr. said 'we don't do that anymore').

WORST. MISTAKE. EVER.

I will caveat that, by saying I have two friends (one younger, one older) with much better experiences of Mirena, but so far, I am not impressed.

Having had norethisterone to stop 'the mother of all periods' (after a long gap with no periods at all), I got Mirena. The procedure was more painful than expected (despite me telling the doctor about my womb problems), she had a few problems with insertion. There were cramps which haven't stopped.  And I'm still bleeding. But, worse than that I've got what has to be the worst PMT I've ever experienced. I'm teary all the time. Like, ALL the time. I've gained weight (with no change at all to diet or exercise), I've gone up a bra size and the spotting/bleeding nonsense makes me feel wiped out. My iron levels are low (no surprise) so am taking 3 x 210 mg of iron a day. :-(

I saw the nurse yesterday whose comments left me feeling like I was forced to agree with her.
'but is it better than the flooding?'
"Yes, it is".
'Well then, you can put up with it can't you'.

Did anyone experience similar with Mirena?
I understand it can take 3-6 months to settle down, but I'm not sure I can cope with 3-6 months of feeling totally rubbish about myself and everything else...

Thx!
D.
x

[Dancinggirl]

Hi dht240 and welcome to MM
I had a Mirena fitted aged 53 and the fitting was very painful for me with quite a lot of pain for a while afterwards.  I was post meno so wasn't getting any bleed but I didn't want a withdrawal bleed because of awful period pains with the withdrawal bleed on sequi HRTs.
I had some spotting for about 3-5 months but after that it was fine.  I did get some fatigue but life was very stressful at the time so it may have been more to do with this.
I do think there is an initial burst of progesterone that can effect many women but, again, this does settle. 
I recently saw a gynae privately for advice and he said that the Mirena is his preferred option for most women as it prevents so many issues around excessive bleeding and is generally well tolerated by most women.
If you want your bleeding to settle then the Mirena may be your best option - I'm afraid you may just have to give it some time. You are stuck between a rock and a hard place.  If you have the Mirena removed at this stage you may be back with erratic floods.  The awful PMT may well just be your own hormones fluctuating - bad PMT is a typical peri menopause symptom.  You do have to decide which is worse - putting up with the way you feel now for a few weeks or go back to possibly years of the erratic flooding bleeds.  If the Mirena settles over the next few weeks and there is a good chance it will, if you start to get to flushes, night sweats etc. then you can start some oestrogen alongside.  A bit of Oestrogen might well help your mood even now.  Perhaps ask for some Oestrogel and just use one pump per day and see how you feel. Many of us love the easy a bit a oestrogen helps mood, energy etc.
BTW - the weight gain could be to do with your thyroid - have you had this tested?
DG x

[dht240]

Hi DG,
Thank you for taking the time to reply. I really appreciate it.

I'm hoping it will settle quickly and no drag on for months. I'm still getting night sweats, flashes and have awful insomnia associated with peri/meno, but the doctor won't test my hormone levels again for a few weeks. I'll bear in mind what you said about the Oestrogen pump when I do get tested again. The doctor didn't mention thyroid specifically when I saw her for my last lot of test results, she said everything but my FSH was normal (or acceptable), I can't remember which.

But, worth checking again - thank you.

I'm very pleased to have access to this site.

Thank you,
D.
x

[Dancinggirl]

dht240
If your FHS was high, which would indicate you are peri menopausal, then it's not enough to just have the Mirena you need some oestrogen to balance things out and get rid of the flushes and sweats. Blood tests are notoriously unreliable in the peri stage as they tend to fluctuate - so one day your oestrogen level will be OK but the next it could have dropped.  This will lead to mood swings and PMT type symptoms as well.  These days the doctors should give oestrogen based on symptoms but the high FSH level should be enough for your GP to prescribe oestrogen.
I personally think your low mood is down to lack of oestrogen.
REad up everything on tis site under the headings to the left of this screen and print stuff out if need be.
DG x

[peegeetip]

Hi HS

Its probably misunderstanding/mistake on the patches your doc has prescribed.

As I said in the past I wanted to go onto the 3 month cycle Tridestra.
Doc thought it was for post menopause and got annoyed when I tried to point out the menopausematters info stated that was wrong (doc had suggested I look at in first place).

The mirena is cheaper when compared with EVOREL SEQUI.
However doc would need to provide an estrogen option to go with mirena.

Just ensure to check you get your EVOREL SEQUI and not EVOREL estrogen only patches just to be safe.