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[Ljp]

Hi me again! 😊

I am feeling much better on my HRT regime, mirena and estring fitted last Monday, oestrogel started Thursday.
Been having dull ache off and on, a kind of dragging discomfort, which I had presumed was mirena, but am now wondering if it's the estring? Does anyone have any idea if it could be the case?
It's difficult to know as I have both, and now adding in the oestrogel too, I don't know if it's estring, oestrogel or both that have really helped my overactive bladder and slight VA

Part of me is tempted to remove the estring, to see if the dragging ach diminishes, and either go back to using my estriol cream or even just see if the oestrogel is enough on its own to help my symptoms, or just reinsert the estring to see if it's the position it's in that's not helping comfort wise.

So difficult to know what to do

[Dancinggirl]

lisajp - the discomfort is more likely to be the Mirena still settling down.  I got cramps and even some bleeding and spotting for several weeks with the Mirena.  The Estring could actually help to with settling in of the Mirena - the added oestrogen will plump up the vaginal tissues making the whole area more likely to adjust - there is a school of thought that this 'plumping up' could reduce systemic absorption of the progesterone which might reduce side effects - I must stress this is just a theory and nobody has proven this but to me it would make sense.
I do understand this is all very new for you and there will be other strange effects e.g. tender breasts etc. for a time.  Do just stick with things as they are -  it is very early days.  In about a month you can then decide to take some action regarding removing the Estring. DG xxx

[Mary G]

DC is right, it would be better to give the Mirena a fair run before deciding to change.  I had that dragging sensation when I first had my Mirena fitted and yes, it does affect how your breasts feel too - it's all normal and nothing to worry about. 

With Christmas on the horizon, I doubt you will want to change things now so why not give it until the end of January and then decide?  You may find you get used to it and decide to stick with it. 

One more thing... I doubt you will need the Estring once the Oestogel kicks in - it's fantastic stuff and works far better than any other HRT I have tried and hopefully you will feel the same benefits very soon. 

[Ljp]

Thank you, I'm not going to rush into changing anything yet, just trying to figure what's causing the dull ache/dragging sensation. It seems to come on mid day most days, into the afternoon, I do sometimes have to take paracetamol.

Hope you're right re not needing the estring eventually Mary, and hope the one pump of oestrogel proves sufficient, just prefer to use minimal amount ideally to control things if possible.

One more question, how necessary is a six week check on mirena, If I can easily feel the strings myself?

[Ljp]

Can't say I'm looking forward to possible breast issues either! At the moment I'm feeling pretty good, my head and mood feel best in a long while, and urinary frequency has really settled down.

Is it inevitable I will have breast symptoms? Also am I likely to get any bleeding? And if I do, should I notify my GP?
I've not had any periods for over a year, except the light PMB at the end of October

[Dancinggirl]

lisajp - the slight cramps/dragging feeling is quite normal.  It is also normal to get some bleeding or a bit of spotting in the first few weeks so you shouldn't need to see you GP unless this is really heavy or continues for more than a few weeks. After about 3 months you should feel things have all settled - possibly even before that.  I suspect, as your periods stopped some time ago, that your oestrogen levels will be quite low and any spotting you get will settle quite quickly. If you are already feeling benefits from the Oestrogel then it sounds as though the one pump is going to be good for you.  One pump per day is not going to raise your oestrogen levels that high so should result in fewer side effects anyway - I'd try without the Estring at the end of January as others have suggested.
The breast tenderness is also common at first when going on HRT as this is all part of the body 'waking up' and again this will settle. I didn't mean to make you anxious about these things but merely to prepare you so you didn't worry unnecessarily. Do try to relax and enjoy the benefits.  It's great that urinary urgency is already better.
I didn't have a 5-6 week post fitting check of my Mirena - I think this would only be necessary if you were having problems. I do wonder if that slight spotting you had, that triggered all this in the first place, was perhaps your own hormones having a final gasp!!!!
Take it easy.  Dg xxx

[Ljp]

If it were my own hormones having a final gasp, then could all this have been avoided? Could I have merely continued as I was, using just estriol twice weekly?

Guess I wont know now, but despite my anxiety (apologies if I'm driving you mad, it's very much heightened due to menopause) and constant fluctuations in thoughts, I have felt better in myself since starting the oestrogel, and I do feel quite emotional that my body has been deprived of oestrogen for so long, I'd forgotten what it feels like to feel optimism, and clearer in my head.

I am struggling with a feeling that I've somehow let myself down by giving in to HRT

[Dancinggirl]

Oh lisajp - don't feel bad about using HRT - it is certainly not giving in, it's about getting your life back.  Remember it's not just you that will benefit if you are feeling generally better but your partner, family and friends will have a happier person to be around. When I mentioned the 'final gasp' of hormones that would not have meant you could have avoided what has happened now - the bladder problems would have continued and I really think you may well kick yourself that you didn't use HRT before.
I think this has all happened in a rush for you and it is a lot to take on board and accept. I hope you can tell from all those responding to you on this site that we feel you have taken the right road.
Do also remember that 100 years ago the menopause wasn't really an issue as a women was lucky to get beyond 50 in the first place.  If a women did have bad meno symptoms in the past (and it is reckoned that around 60% suffer quite sever symptoms) then there was a good chance you either ended up permanently on valium or in Victorian times might be put into an asylum!!!
The new guidelines on treating the meno has recently been issued and GPs are now supposed to offer HRt as a first line treatment for those women needing it. Dg x

[dahliagirl]

It is good they are treating your bladder symptoms properly.

In hindsight, I wish I had tried mirena, but it was not the right time for me.  I also thing the estring is a good idea.  I have vagifem which is the same dose as the cream and it just gives you a hint of what might be.

I am trying a higher dose hrt tablet now and it makes a big difference to my bits and bladder.  The prescribing nurse at my new surgery seemed keen to get me to try something like oxybutanin instead which has made me reluctant to go back.  Oxybutanin relaxes your bladder, but also gives you other side effects and oestrogen works.

I have tried comparing the dose of progestogen you get with mirena, which is easy as a lot of preparations use levenorgestrel.  It is by far the lowest amount in your system if you compare it with tablet hrt, progestogen only pills, and combined oral contraceptives.  I have not looked at patches (femseven contains L)

I hope it all settles down nicely for you.  I have found that hormonal drugs take three months, or four months to be sure.

[Mary G]

Lisajp, there is no need to apologise for your anxiety, it is not your fault, it is the fault of the idiots out there in the media who perpetuate all the out of date, misinformation about the so-called dangers of modern day HRT and it makes me very angry indeed.  If anyone reading this is in any doubt and needs reassurance, go a see a real professional who actually knows what they are talking about like Professor Studd, who has made this subject his life's work. 

I'm going to turn this on its head.  Far from seeing the use of HRT as giving up, I see it as a positive way forward and a vital form of preventative medicine.  Whether we like it or not, oestrogen works like a control centre for many vital functions and without it, our health and quality of life will deteriorate.  I have come across women who end up taking about 5 (or more) different forms of medication for post menopausal issues when a simple dose of oestrogen would deal with the whole lot in one fell swoop.

One thing I have learned is that the menopause is not just about symptoms, it's about the negative effects and consequences of long term hormone deprivation on health in later life.

It is important to make a distinction between the old style, heavy duty HRT and the bio identical HRT which is used today.  All risks associated with HRT are linked with the synthetic oestrogens (rarely used now) and progestin element but the Mirena coil does not release enough of them into your system to be a problem. 

I know it's easy to say but try to stop worrying.  Give the Mirena a chance and if it doesn't work out, you can always get it changed.  When the benefits of the Oestrogel really kick in, you will wonder why you didn't take it sooner. 

[Ljp]

Thank you once again for helping to calm my anxiety, and reassure me that I am doing the right thing.

It is so sad that HRT has scared so many if us, and it makes me apprehensive to mention it to anyone.

I teach line dancing, Zumba and Fitsteps, all classes full of women, most of whom I've known a long time, they were aware of my hysteroscopy appointment as I had to cancel a class. I have explained to a few of my older ladies what's occurred and one said "oh you are brave" and I noticed uncomfortable glances from a few others. Silly maybe, but it's that kind of reaction that sparks my self doubt and anxiety.

[Ljp]

Dahlia girl, I was originally prescribed vesicare for my bladder several years ag when it first became a problem. But I wasn't happy to take it, the side effects listed, namely dry eyes etc scared me, especially as dry eyes is another meno problem for me x

[dahliagirl]

Yes - I have dry eyes too.  I had to stop wearing contact lenses quite a long time ago as my eyes got drier and the optician said it was just age   I think I was about 40.

If you have to take things long term then the side effects like this are quite important and affect your health in other ways.

Vesicare seems to cause constipation, like the oxybutanin, which is not desirable.  Progestogen does too, but at least it is cyclical.