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[StillMe]

Hi everyone, so glad to have found this site!  I'm 47 and have been told by my GP that I am now post menopause.

I've had a mirena coil for a number of years and was due to have my current one replaced. I had an FSH test in September 2015 and was told I was definitely menopausal and given HRT as I was struggling with hot flashes, moods, etc etc. I stopped taking it after one month as it made my moods worse. So I take nothing.

GP I saw Weds to discuss replacement coil looked up my Sept test and said oh, you are already post menopausal you have a level of 90!

So no need to replace coil. I've also stopped having symptoms in the last 3 plus months. No idea about monthlies as coil stops those anyway. 

She's done another test, hopefully get results today. So does this mean I am no longer fertile? Can I dispense with birth control completely?

I'm pretty sure my menopause started about 10 years ago and I've been lucky with symptoms because of coil.  Sorry for long winded post!

[CLKD]

   browse round.  Make notes!  I'm sure someone with HRT knowledge will be along.

[Dancinggirl]

Hi StillMe and welcome to MM
You are too young to be oestrogen deficient so some HRT will be a good idea.
You may still be peri meno as this would explain your meno symptoms disappearing - in the peri stage the hormone levels fluctuate so oestrogen levels rise and fall, the Mirena stops the cycle and this means you don't know what is going on in terms of periods etc. However the progesterone in the Mirena wouldn't stop flushes, it's oestrogen that controls most meno symptoms. If you were good with the Mirena then I'd definitely have another fitted - not for contraceptive purposes but simply to protect your uterus so you can use oestrogen as pill, patch or gel alongside.  Many women have the Mirena as part of HRT as it often brings fewer side effects than conventional combined HRT.  You haven't told us the HRT you have tried? Did the GP give you a combined HRT with both oestrogen and progesterone?   You may have been given one that has a synthetic progesterone that lowered your mood.
Do tell us more - read up all the info on this site and get back to us with questions.  DG x

[Mary G]

Welcome to MM,

That is exactly what happened to me although I was already on my second Mirena coil when my periods suddenly stopped completely.  I always had periods with the Mirena but they stopped once my oestrogen levels dropped too low and this also caused me to start having silent migraines but luckily this does not apply to you.

You obviously get on well with the Mirena coil and I agree that it would be a good idea to get another one fitted.  From my own personal experience, I would strongly urge you to use Oestrogel with the Mirena and not pills or patches and this is why.  Although the progesterone from the Mirena is mostly confined to the womb, enough of it gets out into your overall system to affect you and in order get the best out of the oestrogen, you need maximum flexibility and you can only get with with the gel.  I found the patches didn't work well with the coil and I could never get enough oestrogen out of them to get the feelgood factor.  I didn't find oral oestrogen to be very effective either and that is partly because much of it gets lost in your digestive system. 

As DG says, the Mirena coil would not mask menopause symptoms and you are too young to be oestrogen deficient and I would not take the risk if I were you.  Chances are, you are still producing some oestrogen and that is probably why your symptoms have temporarily gone away. 

[Hurdity]

Hi StillMe

  from me too!

Firstly I agree with what's been said -  if you have a Mirena coil, then the doctor cannot say from periods or a blood test whether you are post-menopausal. FSH levels can go into the post-menopausal range during peri-menopause - and one member on here was told she was post-menopausal when she had only missed one period - which was rubbish. Similarly - if your periods stop with the Mirena - they do this with many women - then it just indicates that the progestogen in it is preventing the womb lining from thickening, and your oestrogen levels are falling (often during peri-menopause if not before). Any woman whose periods stop with the Mirena, would find they resumed at some point, if the Mirena was removed (obviously after a certain period of time they would not return when you did become post-menopausal - but this length of time is uncertain). If you use a Mirena - you cannot determine the date of your menopause!

If you still had the Mirena in when you started HRT - if this was continuous combined HRT - then chances are that some of the progestogen from the Mirena was also getting through into your system - so giving you too much progestogen. If it was oestrogen only - then ?

Anyway I agree that if the Mirena suited you why not get another one? As Dancinggirl says you can then take tablet patch or gel HRT. Which type you try is down to individual preference and which type your absorb well. With Mary G it's the gel. Many of us ( myself included) use patches successfully for many years and many women achieve perfectly good and sometimes very high levels oestrogen with them - and they do come in a range of doses.

As well as how well a particular type absorbs through your skin, it is also a question of preference - tablets are taken daily, gel is applied daily and patches stuck on twice a week.

Hope this helps and good luck!

Hurdity x

[StillMe]

Thank you ladies  I've probably missed out important info,head is mashed lol My GP is saying no need for another coil because of my FSH levels being 90 and because my current coil is no longer releasing progesterone and hasn't for about a year  - when she checked my records she saw it should have been removed last year.  The HRT was Esterelle? I remember it was oestrogen only.  My peri menopause started around 10 years ago.

She hasn't offered any advice about or suggestions for HRT though, just said I need to increase calcium and Vitamin D.  She was pretty adamant that a level of 90 was very high and indicative of being post menopausal.

[Mary G]

If you have been peri menopause for 10 years then you are probably post menopause by now.

You don't need another coil for contraception purposes but if you get on well with the Mirena then it is a good option as part of your HRT regime. 

You have had quite an early menopause and as you are only 47, I would consider HRT if I were you because you are facing many years without oestrogen.  There is no way that calcium and vitamin D alone will protect your bones, bladder and heart from the effects of oestrogen deprivation and your doctor really should be talking through HRT options with you and explaining why you need it. 

I haven't been on that type of HRT but I was on something similar with the Mirena coil at one point and it didn't work very well.  I ended up on 100mcg patches and my oestrogen blood levels were still way too low hence my recommendation of Oestrogel.  I wish I had tried the Oestrogel with the Mirena but I had already had it removed by the time the gel was prescribed and don't want to risk having another coil now because my migraines are triggered by synthetic progesterone but I do I think it would be a good option for you to try. 

[Dancinggirl]

I would ask for a referral and full assessment at a meno clinic or with a gynae. I would ask for a another blood test for FSH and oestrogen levels to really see what's going on. Perhaps have your existing Mirena out as well just to see if your periods return.  If you were really peri 10 years ago then you would have been getting symptoms and they should have given you oestrogen alongside the Mirena years ago - it would have been negligent to let you go into meno at such young age without some oestrogen. 
I still think another Mirena would be a good idea - particularly as you might still be peri and could possibly still get pregnant.  Oestrogel or oestrogen patches would be your best option alongside. 
It's not enough to be told you just need calcium and Vit D - these will not replace the oestrogen you need. DG x

[StillMe]

Thanks Mary G.  I shall definitely raise concerns with her about HRT and will ask about the gel option.  I'm already high risk for osteoporosis as I have Coeliac and the increased risk in heart disease is really worrying. I will post after my follow up appointment. 

I agree Dancing Girl, I found it very difficult to get the GPs to take me seriously when I went to them in my late 30s, despite family history. It wasn't until I was around 42/43 that they finally conceded that I may well be in menopause but they didn't want to put me on HRT, said something about increased risks of breast cancer. Last year I was so fed up of the night sweats and hot flashes she finally agreed to let me try it but sadly the side effects meant I stopped it.

I'm in UK and they don't tend to refer to a gynaecologist for menopause it's all dealt with by a GP

[Mary G]

StillMe, it was very wrong of them to frighten you scare stories about HRT and breast cancer, that is old news and on the back of two completely discredited and deeply flawed studies using outdated forms of HRT, laden with synthetic progesterone and carried out on women who were way past menopause.  Why is this rubbish still being peddled?

I forgot to say in my last post that you might need to have fairly high levels of oestrogen to get good results because you will be having a permanent supply of progesterone via the coil that will get into your overall system so it's worth bearing that in mind. 

If all else fails and you get fobbed off again, why not have a consultation with Professor Studd.  He is a fan of the Mirena coil and many of his patients use it along with Oestrogel and sometimes testosterone. 

I think the time has come to take the menopause and HRT out of GPs hands and to merge Family Planning Clinics and Menopause Clinics with well qualified specialists who know what they are doing. 

I do hope you get some help soon. 

[Hurdity]

I agree - how appalling that your doctors were so out of date. The slight breast cancer risk anyway does not even start to take effect until the natural average age of menopause of 51-52. Before this your body is only replacing what it should be making naturally - as all women should be. It is negligent of them not to offer you HRT  when you first went to your doctors in your late 30's.

The NICE Guidelines now recommend two blood tests at this age, but you would have had to come off the Mirena coil for a bit, and if an early/premature menopause was likely then you should have started on oestrogen back then.

It is your right by the way to be referred to a menopause clinic for further specialist treatment if your doctor refuses to prescribe you HRT at your request or has insufficient knowledge, although even if there is one nearby there is usually a waiting list. From what you have reported your GP defo doesn't know enough if she is not offering HRT at your age and talking about cancer risks! Most of us on here are in and from UK as it's a UK based website.

Please start something as soon as possible (have a think about Qlaira).

By the way I would say your doc is also being reckless in suggesting you don't need contraception based on your FSH test and your Mirena coil having run out because if your last period occurs when you are under 50 then you need to continue with contraception for 2 more years.

http://www.menopausematters.co.uk/contrastop.php

The general rules are to continue contraception for:

One more year following the last spontaneous menstrual period if aged 50 years or over
Two more years following the last spontaneous menstrual period if aged under 50 years


You may well be post-menopause but you just might not be.

Hurdity x

[Taz2]

Lots of good advice.

I had an FSH reading of 120 and still went on to have more periods despite being told by the GP that I would never have another one. I then went onto HRT to combat the flushes. It's interesting that your meno symptoms have now disappeared. Many of us on here find this happens leading up to a period.

Taz x