Print

Please login or register.
1 Hour 1 Day 1 Week 1 Month Forever
Login with username, password and session length

[cherylks]

Having had a couple of bouts of bleeding heavily on and off for 3 months at a time then a gap of 2-3 months of nothing then a few normal periods and back to 3 months of heavy bleeding etc...., Two scans - one 2 years ago and one recently showed irregular endometrium and this time my gynae wants to do hysteroscopy and fit Mirena.  Have told him I'm not sure I want Mirena so can decide at last minute.  My question is this...  I'm scared of side affects of Mirena - I think i am very sensitive to progesterone.  If I have it fitted and things don't settle down in a couple of months, can Oestrogen be added to counterbalance the progesterone?  or does it not work like that?
Don't really even want hysteroscopy as suffer when given anaethestic, but it's the Mirena coil that is worrying me so much.  Am 51 and apparently estradiol was normal and serum gonadotropins are normal.  Yet i have hot flushes, forgetfulness, missing periods, etc etc etc.

[Dancinggirl]

cherylks - I've had a Mirena and found it fine - I did feel a bit sedated (so slept really well) for the first few months but it was the best option at they time - I then just added some oestrogen in gel form. The idea of the Mirena is to keep the uterus lining thin, therefore reducing and eventually stopping the bleeds.  The advantage is that the progesterone is absorbed locally so any sensitivity is reduced as it doesn't go round the body.   
Blood tests can often come back showing normal range but if you are getting meno symptoms then a bit of oestrogen would help - at this peri meno stage you could start with just one pump of Oestrogel which might be enough to help with the meno symptoms.  I would insist you are given some gel to try for relief of meno symptoms once the Mirena is fitted.
If you find after a few months you feel bad on the Mirena then you can just have it removed -  when mine had out after 4 years it slipped out easily - no anaesthetic needed. Give it a go - you might be surprised how much better you feel and wouldn't it be good to have the bleeds under control? DG xxx

[cherylks]

Thank you Dancinggirl.  Still can't help worrying a little though   Keep changing my mind on what I will do...

[Dancinggirl]

cherylks - Try to think about what you are experiencing now - are these erratic heavy bleeds really reducing your quality of life? Have they offered you an alternative such as Norethisterone (a strong synthetic progesterone) instead - which might be a different way to treat your irregular endometrium. Gynae's are now very keen on women having the Mirena because they help to reduce problematic bleeding which protects the endometrium, it offers contraceptive protection in peri meno and it is generally well tolerated by most women. The Mirena will usually result in no bleeds at all after a few months - which many women love.
You say you are sensitive to progesterone - how do you know this? You may find, like many women, that the Mirena helps things a lot and if you need a little oestrogen to reduce flushes etc then you haven't got to put up with taking progesterone orally which can actually bring worse side effects.
The alternative treatment they may offer you will probably be to have progesterone orally which you could try first to see if you can tolerate these strong oral synthetic progesterones - this would show you whether you are sensitive or not - you may be fine. If you react badly to the oral progesterone then the Mirena would be the better option as less is absorbed around the body.
I can really understand your reluctance about the Mirena as I think we instinctively don't want to have a strange 'thing' stuck inside us but sometimes it's worth trying - particularly if it can be fitted under anaesthetic. I had local anaesthetic and the fitting was quite painful.
I don't want you to feel pushed into this - it is very much your decision. There are a lot of horror stories about the Mirena, however, there a lots of horror stores about HRT in general.
Talk it through with you gynae and ask him/her why they think it is the best option for you.
DG x

[Pollie]

Hi Cherylks

The levels of progesterone in your blood will be miniscule compared to any other form of hrt or contraception. They will also be very stable levels. I came across a diagram proving this the other day and if I can find it again I will post a link. The levels in your uterus will be higher than any other form of hrt or contraception therefore giving you best protection against cancer, which if you have had an 'irregular endometrium' is what you really need to be concerned with.

I think your Gyne may be suggesting mirena to protect you rather than relieve you of your heavy periods.....

Yesterday I had my 2nd hysteroscopy and 2nd lot of biopsies and 3rd mirena fitted (I didn't expect this as I thought I was just going in for a cosy little chat with my Gyne but that's another story..) so ask away if there is anything you want to know whilst it's all still fresh in my mind ! 

[cherylks]

Thank you Dancinggirl and Pollie,
I have been told I am probably sensitive to progeserone because when younger had so many problems with periods (also had endemetrosis), PMT etc that i was tried on various pills and HRT but they would send me either skyhigh or suicidal.   More often than not the latter.  I know HRT has changed since then.  I also prefer to deal with what I know rather than what I don't know i.e. how i will react etc.  Also, because I haven't had a period for 2.5 months again so far, I keep thinking may be I am near the end so won't have more heavy periods.  Obviously that is also an unknown   However, reading your posts I am thinking a little more positive about the idea. 

[Pollie]

Here is the diagram - Fig 7.

- from a link that hurdity gave me   

http://www.mirena.com/en/professional/indications/contraception/pharmacokinetics/index.php#


Click on the 'confirm'  professional tab......do not go to the public site

[Hurdity]

Hi cherylks

Just to add that if you are having a hysterosocopy you don't necessarily need a general anaesthetic if the  gynae is good. I had no anaesthetic at all and felt almost nothing. Just took the recommended painkillers an hour before the procedure. Others though have had different expereinces so maybe find out about the gyane who might do the prcoedure. I didn't want a GA as have never had one but was quite happy seeing it all happen, legs undignified in stirrups!!

Also if you have had endometriosis - are there are deposits outside the uterus - because I think oral progestogen is recommended? Here is what it says on this site:

Endometriosis   
    There is a small risk of reactivation of endometriosis with HRT use and any recurrence of symptoms should be reported. If a hysterectomy has been performed for endometriosis, the choice of HRT use thereafter should be influenced by the extent of endometriosis at the time of the operation. Since hysterectomy often causes a premature menopause, it is often advised to take HRT until the average age of the menopause; 51 years. HRT after hysterectomy usually consists of estrogen only. However, in the presence of endometriosis, estrogen may cause stimulation of residual deposits and consideration should be given to using continuous combined (estrogen plus daily progestogen) therapy, or tibolone, though little research has been done on the effect of different types and duration of therapy. Medical treatment of endometriosis often involves ovarian suppression which, along with ovarian removal, may increase the risk of osteoporosis.

A Mirena as others have said would definitely keep the lining thin and as you thought oestrogen is not given to "balance" the side effects of progestogen - but to alleviate the menopausal symptoms of oestrogen deficiency. Addition of oestrogen is unlikely to affect your experience of side effects from progestogens, but conversely, the progestogen will prevent the womb lining over-thckening as a result of stimulation by added oestrogen!

Hurdity x