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[aseamark]

Good evening .
I have just had an appointment with an urologist regarding frequent urine infections especially after sex.
He wants me to have my mirena coil removed as he thinks this doesn't help matters. However , my coil is part of my HRT alongside estraderm patch.
So I assuming I would have to change to a different method of HRT or come off it all together ! Scary thought .

Has anyone heard of a link between mirena coils and urine infections please ?

[Mary G]

Yes, I had a similar problem with the Mirena coil once my oestrogen levels dropped.  I had a Mirena coil for contraception purposes but I started having vaginal and bladder infections once menopausal.  My gynaecologist said that when you stop producing enough oestrogen, the progesterone in the coil can cause dryness and irritation which can lead to infections.  I did try topical oestrogen but that made matters worse.  Although I was using an oestrogen patch at the time, I was still not getting enough oestrogen out of it and the endless irritation got me down (plus the synthetic component in the Mirena triggered my migraines once menopausal) so I had it removed and the vaginal/bladder irritation/infections and migraines went immediately. 

Obviously once I went back onto HRT (Oestrogel this time)  I had to find an alternative form of progesterone so I now use Utrogestan which is much better but I do have to limit its use otherwise I get migraines.  I don't have any bladder irritation with Utrogestan even though I use it vaginally.  The one thing I don't know is how well I would have got on with the Mirena coil and Oestrogel (a much better product in my opinion) but because of my migraines, I would not want to risk it. 

You definitely don't need to come off HRT altogether, you just need to find a suitable alternative and I would recommend Oestrogel/Utrogestan.

I hope that helps.

[dahliagirl]

Is it worth trying vaginal oestrogen, like estring (equiv to the old 25mcg vagifem).

It seems a shame to have the mirena removed if it is suiting you otherwise.

Things with lots of progestogen (think POP and LARC contraceptives do seem to induce menopause-like dryness).

[Hurdity]

Can you actually have an Estring along with a Mirena? Personally I wouldn't want to have two physical devices stuck up there - one would be enough! Maybe you need to increase your oestrogen patch size although you haven't said what dose you are taking? Why not try Estradot as they are really tiny. As you have a Mirena I presume you don't know whereabouts in menopause you are as your periods probably stopped long before menopause due to the progestogen, as expected?

Hurdity x

[aseamark]

Thank you for your replies -
I'm currently on a 50 estraderm patch and have been for 4 years. 
If I kept the mirena and stopped the patch , could I use a vaginal gel to ' soften ' up downstairs

[Ljp]

I have mirena and estring and use oestrogel, over active bladder was unbearable prior to any treatment, estriole vaginal cream helped, but I had a light post meno bleed after five months of using.
That resulted in hysteroscopy, estring, and oestrogel, and I do feel things have improved a lot, I still can go from not needing to pee, to desperately needing to, but generally my bladder is better behaved than it was.

Re having mire than one gadget up there! I really don't feel it, and after two weeks of trying without estring, I found soreness during sex returned, so seems it most definitely helps.

[Tinkerbell]

What about upping your patch dose? I am on Estradot 75 and use a Mirena, Vagifem and Ovestin cream.

I am also thinking about the Estring as well...doesn't bother me what is up there as long as I am comfortable 

[Hurdity]

Thank you for your replies -
I'm currently on a 50 estraderm patch and have been for 4 years. 
If I kept the mirena and stopped the patch , could I use a vaginal gel to ' soften ' up downstairs

It's not a good idea to have Mirena without the added oestrogen - if you are anywhere near or post-menopause as it can cause overthinning of the endometrium (womb lining) and sometimes bleeding/ulceration. You can use vaginal cream (not gel) to deal with VA - there is Ovestin, or Estriol cream listed here: http://www.menopausematters.co.uk/dryness.php

Depending on your sensitivity and your age, you may well experience a return of menopausal symptoms if you stop the oestrogen patch (and Mirena).

Hurdity x

[aseamark]

Okay ,
Think I am getting somewhere...
I would like to keep the mirena for as long as possible as I am scared that by removing it I will be opening the flood gates so to speak !
I have been reducing my patch strength down slowly with the aim of coming off altogether .
So my question is ... If I keep the coil and add a vaginal cream , will it help towards flushing , palpitations etc as the patch does or does it just work on the VA?
Thanks

[Mary G]

aseamark, keeping the Mirena coil without any oestrogen is the last thing I would do after all the problems I had.  Admittedly I am one of those people who don't need very much progesterone to keep the lining thin but nonetheless, you can run into all sorts of problems if you have that amount of progesterone pumping out into your womb without any oestrogen.  Why not try the gel instead, you will probably find it more effective. 

I don't think topical oestrogen alone would help and it certainly won't keep things like hot flushes at bay or protect you from all the other health problems caused by low oestrogen.