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[anais]

It's been a while since I posted about my HRT regime.

My consultant at KCH increased my Estrogel to 3x doses per day. I was on Utrogestan 100mg and Vagifem on alternate days.  I started to get light bleeds every 2 weeks for about 5 days on this regime so I had a TV-US scan. Lining was 2.9mm (2.4mm before HRT) and ovaries small, so the bleeding was put down to an imbalance in HRT regime.

At my most recent appointment the consultant recommended a Mirena coil as the best option so I had one fitted on Monday. Apart from the pain during the procedure and for the rest of the day and a some bleeding immediately afterwards, so far so good. (I think.)

I know it's early days. I've had some spotting but it's pretty minimal now. I haven't had sex either. Cramping hasn't been a problem after I recovered from the fitting. I can't tell if I can feel it or not. I'm prone to constipation and and that can cause a bit of achiness when I'm "full" so I can't tell, but no period-like pains, so perhaps it's business as usual.

Still on 3x Estrogel and 3.5 Vagifem per week. The consultant wants to prevent the bleeds otherwise he says I'd be repeating the scans every 6 months. He suggested Mirena as a better alternative to 200mg Utrogestan. There was another doctor sitting in with him that day and she came after me in the corridor when I left my appointment, saying she would fit it. She works locally in the sexual health clinic so it worked out pretty well. She was very good, I must say. She used a smaller size speculum which really helped too. I just hope it solves the bleeding problem. I've only had it in for 4 days but I know you need to give it time to know if it's going to suit you in the longer term.

[Stillsearching]

I had a Mirena, originally for heavy periods but after a few months as part of HRT with Climeval. It was great but for HRT purposes it's only used for 4 years so I had it taken out about 12 months ago. Since then my GP's have tried various regimes of pills, all of which have left me bleeding continuously    Just over 2 weeks ago I stopped taking HRT( I'm 59 now) and am planning on giving it about 3 months to see how I feel.  Whether or not I decide to go back on it I'm planning to change my GP. If I decide to go back on I will be asking for the Mirena and Climeval again.

A tip for having the coil put in or removed, or having smears if you find them painful, take a couple of ibuprofen before you go. I find that really helps.

[Dancinggirl]

anais - I do hope the Mirena works well for you - it is popular with most gynaes as it often sorts problematic bleeding. I had one for 4 years post meno and used oestrogel alongside - it was so little hassle and after the first few weeks  had no bleeding over the next 4 years (some bleeding and or spotting are normal for the first 3-6 months) .  Sex was fine but I also used plenty of lubrication for sex.  I just checked I could feel the strings now and again.  I still used Sylk daily to help keep things moisturised around the lady bits. Keep using the Vagifem.
Good luck.  DG x

[anais]

Stillsesrching, if only I knew to take painkillers BEFOREHAND!  They actually injected a local anaesthetic into the cervix which was probably the most painful part of the procedure. The clinic gave me two paracetamol after the fitting and I had some Ibuprofen in the evening, and that was all I needed so I did better than I thought I would. Mind you, after I left the clinic I bought myself a bar of chocolate for the shock to the system, which helped enormously   


DG, I've had some spotting most days, but it's only day 5 with the Mirena and I suspect that my body has to adapt. I hope it does the trick because it was PMB that sparked off the referral to the meno clinic and being prescribed HRT although it was osteoporosis that was the main reason for systemic HRT. The bleeding has never really been resolved and increasing the Estrogel dose seemed to trigger these very light "periods" every two weeks, hence the Mirena. So I'm really hoping this does the trick but spotting for 3-6 months? Groan. It never ends!

The doctor who fitted the Mirena said to make a follow up appointment in 3-4 weeks to check all is OK so I can raise any issues when I see her. She works in the local Sexual Health clinics and they can do a lot more during an appointment. I think she mentioned something I can use externally for dryness but I was in a state of mild shock after the Mirena was fitted and anything else on my mind just evaporated. 

Thanks for your replies. I'm hoping it works out, but I know that some love it and some hate it. I need to wait and see if it works for me.

[Dancinggirl]

anais - some local oestrogen e.g. Vagifem, may be a good idea.  Vaginal moisturisers/lubricants are also a good idea e.g. Sylk - I use Vagifem 2-3 times a week and Sylk every day.   It will take 4-8 weeks at least for any bleeding and spotting to settle but I'm sure the Mirena could be your best option for controlling the bleeding.   
Be patient.  DG xxx

[anais]

Thanks, DG.

Well, my fortnight "breakthrough bleed" as they described it started right on cue on Sunday (day 6 of the Mirena), just as it would have happened if I was on the Utrogestan. I suppose it's because the Mirena has a cumulative effect. The amount of bleeding, a very light flow, is about the same as I would get on Utrogestan. It lasted around 5-6 days so I'd have a bleed free week or so and then it would start again. If the Mirena could stop these bleeds it would be ideal.

I had some mild discomfort on the day the bleeding started which I hadn't experienced with the Utrogestan, but I don't know if it was to do with the bleeding or whether it was my was my womb adjusting to the Mirena. Could be a bit of both. I needed to take Paracetamol twice but since then I've not really been aware of that very low abdominal ache.

The alternative was to take 200mg Utrogestan instead of 100mg but the consultant thought that the Mirena was the best option. I have to give it a try. 

BTW, I'm on Vagifem which I use on alternate days. My practice nurse recommended aqueous cream to wash with and to apply if required. I don't use it as a moisturiser but it's a good alternative to soap or shower gel. The doctor who fitted my Mirena said she could give me something but in my "traumatised" state I forgot all about it! I will ask next time.

[Dancinggirl]

anais - some spotting and bleeding on and off over the first few weeks after the Mirena is fitted is quite normal - this should settle and it is highly likely that you won't get any bleeding after about 3-4 months. 
Sylk is a good vaginal moisturiser - I use it every day after the shower - a small amount goes a long way.

It is also normal to get some cramping in the early weeks.  DG x

[anais]

I've now had the Mirena for 2 1/2 weeks and I've had some bleeding every day, which I suppose is "normal" but it's more than I was getting on Utrogestan 100mg. Not in terms of volume but at least on Utrogestan I'd have had at least a few days without bleeding.

Besides the bleeding I started having pain on one side and during sex at the point of orgasm I experienced what felt like a sharp, thick knitting needle stabbing into my groin. The previous week I'd had sex and wasn't aware of the Mirena at all.

So after that I was aware of this grumbling pain on one side for the following few days, but not as intensely as the sex/orgasm experience. I made an appointment at the local sexual health clinic yesterday and they assured me its in place and it's just my body adapting. Obviously the strings are visible etc, so they feel confident all is well.

They actually explained that they tell their patients that the first 6 months (!!) of having a Mirena can be difficult – pain, irregular bleeding, etc. Well..... doesn't exactly inspire confidence, does it?

I've made an appointment at the clinic where I had it fitted for next week anyway. I was told I needed to go back to have it checked 3-4 weeks after fitting so I'll stick with that appointment, and besides its better to be reassured than not.

So that's the story so far – bleeding everyday from spotting to a light flow; pain during sex on one side; and a grumbling low grade pain on the same side over the following days, and possibly beginning a day or two before I had sex. I'm told all is well with the Mirena from a medical point of view. I'm having a follow up appointment next week.

[Dancinggirl]

anais - What you are experiencing is all quite normal - the sexual health clinic are quite right but for most women things settles within the first 3 months.  I'm afraid you need to be patient. The point is that, for some women, Utrogestan is not good at controlling bleeds so ongoing breakthrough bleeding problems are more likely to happen - once things settle on the Mirena you will hopefully get 4 years of HRT without the bleeding.  Try not to worry and try to be positive. DG x

[Tinkerbell]

I got cramping and odd feelings for nearly three weeks after my mirena was fitted, but it settled and I haven't had any discomfort since.
I also had daily, albeit very light spotting for 4.5 months.

[anais]

Last night I was in agony, like being stabbed on the inside with a knitting needle. I had waves of these stabbing pains on one side. I couldn't sleep with the pain. It was nothing like menstrual cramping. I took ibuprofen and codeine, which did nothing. I'm bleeding heavier today. It's not spotting, it's more like a period. I've been in pain all day. More ibuprofen and codeine this evening which hardly touched the pain. Its still all on on side. Same place. It's getting me down big time. I have an appointment the day after tomorrow. I'm sure this isn't normal. It's over 3 weeks since I had it put in and the pain is worse than it was a week ago. I can't honestly be expected to endure this for 3 months, or 6 monhs, not if I'm in agony all day and can't sleep at night. If heavy duty painkillers don't work then I don't think this can be normal.

[Maryjane]

I no of ladies from other forums , were it was stuck in the uterus wall and had to be removed , they had to demand a MRI / scan can't remember which to have it confirmed and then removed.

[Dancinggirl]

Anais -  To get some proper bleeding is normal at around 3 weeks post fitting but to be in this sort of pain 3 weeks on isn't right. However, I do believe there is an initial hit of progesterone in the first few weeks and perhaps this is encouraging a good ‘clear out'.  Strange that it is just on one side - I think this needs to be checked out so do pop to the GP  - might be something else causing the pain but you need reassurance anyway.
Over the 4 years I had the Mirena I did get the occasional bout of cramping but it was often a bit of upset tummy or trapped wind.  I suspect your uterus may be responding to the progesterone and this should settle.
Keep us posted.  DG x

[Hurdity]

I have no experience of Mirena - but from what you have said I would definitely go for same day appointment with the doctor - that's not the sort of thing that should wait if you are in agony and the pain is not relieved by the strong painkillers that you are taking. If you still have it today (severe pain not relieved by painkillers) please go tomorrow and don't wait another day or phone NHS direct if it's that bad...if it has subsided then fine to wait until your appt the day after I presume.

Hurdity x

[anais]

Thanks for your replies. I was definitely worried. The pain subsided  and then bizarrely I came down with flu like symptoms so yes, I was beginning to worry at that stage. Anyway, I had to cancel my follow up because of the  flu-like viral symptoms but then pain stopped. I've gone from miserable agony to being completely unaware of the Mirena's presence.

I went to my appointment last week and I was told all was well, she did a swab for infection and that was clear, as expected. She looked at my bleeding pattern and said it was typical for first few weeks of the  Mirena.

Over the past 7-10 days the bleeding has been lighter. A couple of days here and there it was very scant but overall it seems lighter but then I'm sort of prepared for unpredictability at least for a while. ive had sex twice since the pain has stopped and I wasn't aware of the Mirena at all.

So, I still have the Mirena. The pain is much improved and I hope it stays that way. The bleeding hasn't stopped but it's fairly light spotting at the moment. I'm expecting some degree of unpredictability with pain/physical discomfort and bleeding. So far there's improvement on both those aspects, so I will persevered for the noo.