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[Dollydream]

Hi ladies

I've been reading past mirena experience posts and found them really helpful and having been unsuccessful with my last 2 HRT experiences, I'm willing to try the mirena and separate estrogen.  I've spoken to the doctor today to arrange for my fitting in a couple of weeks time.  She advised that I should expect to take the day off of work (appointment is first thing and she only works mornings).  She also said that I was to take ibruprofen before I came in.  I wasn't expecting it to be that bad and now I'm getting a bit worried.  Am I likely to be able to drive home afterwards? Any advice would be appreciated.

Thanks xx

[walking the dog]

Hi dollydaydream
I had the mirena fitted about seven weeks ago I took no pain killers before hand and though it wasn't the most pleasant of experience it wasn't the worse, no worse than a filling at dentist! It was a few seconds of cramping and it was over. I rested for five minutes on the bed at Dr advice and left, I was fine. I think its up to you if you want to take a,day off work but I can't see the necessity.
However, if that's what you have been told to do she must have a,reason for saying it so perhaps heed her advice ?
Sorry I haven't been much help xx

[Dancinggirl]

Everyone is different. It takes only a couple of minutes to fit. I found the fitting quite uncomfortable and had cramps for a couple of hours afterwards.  It would probably best best to have at least the morning off and get someone to drive you home or get a taxi.  I wasn't told to take Ibuprofen but if i had it might have been less uncomfortable.  Mine was fitted post meno so I had some atrophy that probably didn't help.   The Mirena is a good option though - go for it. Dg x

[Tinkerbell]

I drove to the supermarket and did some shopping after I had my Mirena fitted.
I took 2 paracetamol and 2 ibuprofen before my fitting, it was nowhere near as bad as I anticipated and at the time I was 13 months post meno.

[Dorothy]

Are you extra-sensitive to pain?  Just wondering if you are, your GP may think you will find it harder than average to cope with - or maybe she has had someone else react badly recently so is being extra-cautious.  If you are worried, you could always ring your surgery and talk through your concerns.

[elsie001]

I found the fitting absolutely fine and drove myself home straight afterwards.  Hadn't taken any painkillers beforehand, but everyone's different.

[Lindyruns]

Hi Dollydream,
I think how you feel afterwards and any pain during depends on how easy it is to get through the cervix, if it can be done easily you'll be fine. I had to have mine done in hospital by gynae as cervix wouldn't dilate. I had a local anaesthetic into cervix and it took ages to dilate and was uncomfortable and took a long time. I felt faint when I stood afterwards but mine was tricky so perhaps not the case for most. The lightheaded feeling may have have been due to legs raised up for half an hour more than anything.
Dont let that put you off, I think Mirena is brilliant and for me was worth all the hassle and once it's in it's fine for 5 years.
I have had 3 children so I was surprised cervix wouldn't budge, just my luck!
Take the day off or at least plan a quiet day if you can in case you feel lightheaded. I had some cramps later but nothing too bad.
Good luck x

[Dancinggirl]

Just - add to what Lindyruns has said.  The Mirena is only licensed to be kept in place for 4 years for HRT purposes - I assume because the progesterone may run out after 4 years.  Once menopausal the natural progesterone will not be there to help keep the lining thin as it would be in fertile years. When the Mirena is used for contraceptive purposes then it can be left for 5 years - many have it in place for longer during fertile years!!!! DG x

[Hurdity]

Although I have never had a Mirena fitted - I presume the procedure is on a par with hysteroscopy and biopsy in terms of how invasive it is? For hysteroscopy you have your legs in stirrups and they poke a thin camera into your uterus through the cervix, take a look around with it, and snip a bit of tissue off if they need to take a biopsy.

If so then definitely you should not need a day off and can drive yourself. With my procedure as above I took the two ibuprofen and paracetamol as directed an hour before. Drove myself there, had the procedure (only took a few minutes) and then drove myself home. I could have had a Mirena fitted at the time as the gynae asked me there and then, and didn't mention anything about driving home or needing to rest. I could easily have gone to work if I needed to (although if manual work I would suggest having an hour's rest or so) - but if necessary a couple more painkillers might be necessary in case of cramping.

I am really surprised doc said take a day off - please don't worry - it can't be more invasive than hysteroscopy and that wasn't at all worrying for me anyway

Hurdity x

[Dancinggirl]

I'm afraid your GP may well be wrong Menopause sucks.  Do look this up - Maybe the guidelines have changed recently . 
Here is the link from this site that shows very clearly that 4 years is the licensed length of time for HRT purposes - maybe you should print this off to show the GP??? Do stress that this site is recommended on NHS choices website and Dr. Heather Currie (a leading gynae) set this site up to support women in meno - so the info on this site has to be accurate.
I had mine in for a bit over 4 years, when used for HRT, and I noticed that I got cramps and some spotting at the end of year 4 as I think it had begun to run out of progesterone. You simply have to have it changed every 4 years.
Good luck - the Mirena can be a great option as part of HRT.  DG x

[Tinkerbell]

For HRT the Mirena is licensed for four years, the doctor who fitted mine mentioned that and gave me a card with a reminder date for the four years ....mind you I will never find the card then

[Hurdity]

Dancinggirl and Tinkerbell are right (unless there are some very new recommendations that means we're all out of date!). The GP is thinking about Mirena and contraception.

That study that Menopause Sucks linked to refers to contraception not HRT. The Mirena does not run out of progestogen after the given time but the release rate is such that it is much lower year on year so that it cannot be guaranteed to keep the lining thin after this period of time has elapsed. Obviously if you have a very low dose oestrogen then it will last longer – other things being equal – although in post-menopausal women very low dose of oestrogen and Mirena are probably not advised due to potential for overthinning and endometrial atrophy.
I posted recently with the published release rates of levonorgestrel of the Mirena and Jaydess so you can see for yourself:

"For anyone that wants to look up the data and info that I quoted the SPCs (detailed product info) are here:
https://www.medicines.org.uk/emc/medicine/28672/SPC/Jaydess+13.5+mg+intrauterine+delivery+system
http://www.medicines.org.uk/emc/medicine/1829/spc/mirena/

You can see that from the start the Jaydess contains approx a quarter of the total amount of levonorgestrel that the Mirena has (13.5 mg vs 52 mg).

Mirena delivers Levonorgestrel initially at 20 mcg per 24 hours, reducing to 10 mcg after 5 years and extrapolated to be approx 12 mcg after 4 years (when it is recommended to be renewed for HRT purposes).

Jaydess delivers 13.5 mcg per day initially reducing to 5 mcg after 3 years.

Systemic concentrations with Mirena are approx: 276 pg/ml after 1 yr, 196 pg/ml after 2 yrs and 177 pg/ml after 3 years. With Jaydess the data give 162 pg/ml after 7 days and 59 pg/ml after 3 yrs - so much lower, but there is a wide variability in these levels amongst the women measured. All this info is from the Summary of Product Characteristics (SPC) on the web and possibly the company website ."

Posted on this thread:
http://www.menopausematters.co.uk/forum/index.php/topic,33744.msg541447.html#msg541447

Hurdity x

[Dollydream]

  Thanks for all your replies.  I'm going to take the day off, just in case and hopefully it will turn out OK and I can spend the day relaxing - doctors orders   .  Maybe she was just warning me of the worst outcome xx

[dahliagirl]

The mirena can be used for 7 years (off licence) if it is inserted after age 45 for contraception - Menopause sucks' doctor may have been conflating this information with the hrt use.

I remember my GP extolling the virtues of mirena, saying that if I had one, it could be used until I was 57 ( * ) and I could use it with oestrogen if I had any hot flushes etc..... but no mention was made of the 4 years for hrt use 

*  At this point, I thought (a) my periods had probably stopped and (b) that I would not need contraception longer than a year. How deluded can one be 

[dahliagirl]

Dollydream - hope the fitting goes well and you have a fun day off