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[DaisyB]

Ladies please help - if you can??


Mirena in almost two weeks. Period since last Tuesday - waiting on private gynae contacting me re estrogen.


New symptoms scaring me   last two days I've taken bad headache in one side of head - accompanied by nausea. I've been reading old and new posts about nausea - but I've never had this before. So bad last night I woke with night sweat then cold shivers and bang a headache so bad with nausea I could have cried.
A private gp had prescribed estrogen patch (lowest dose) whilst I was waiting to see private gynae (PG) - PG took me off patch after few days said I needed Mirena first for protection then she would last me with highest estrogen and gradually reduce.


I reckon she will wait 6 weeks to let Mirena settle before sending for me.


Should I get patches back on?? I am so scared - I can't even describe this to my family- it just sounds like I am complaining constantly- lying here this morning  in turmoil.


Please please advise xx DaisyB

[Kathleen]

Hello DaisyB.

 I'm not one of the expert ladies although I'm sure they'll be along soon to advise you. I do understand your situation however as earlier in my meno journey I had constant headaches and my nausea feels like morning sickness, all hormonal I'm afraid.
Sorry I can't be of more help but sending hugs and sympathy to you.
Take care.

K.

[Jenna]

Hi DaisyB - so sorry you are suffering.

You might be interested in this thread (especially Mary G's posts) about Mirena and migraine:

https://www.menopausematters.co.uk/forum/index.php/topic,31605.msg501601.html#msg501601

[Mary G]

DaisyB, I would put money on your problems being related to the Mirena coil coupled with very low oestrogen.

I have had two Mirena coils, one pre-menopause and one post menopause and I can tell you from personal experience, low oestrogen combined with a Mirena coil is bad, bad news and should be avoided.  In theory, the progesterone in the Mirena coil is confined to the womb but it is not and enough of it will get into your overall system to cause side effects and undermine the good work the oestrogen is doing. 

In my case, once my oestrogen levels dropped too low, I started getting silent migraines which I didn't get with the Mirena pre-menopause and looking back, yes, I had nausea too. 

I used oestrogen patches with the Mirena and they were completely useless and didn't provide anything like enough oestrogen - this was confirmed in blood tests.  I even worked up to a 100mcg patch and still it was no good.  I have since had the coil removed and now use Oestrogel and Utrogestan but with the benefit of hindsight, I wish I had tried Oestrogel with the Mirena because I think it would have worked much better.  Firstly, I absorb the gel extremely well and get more oestrogen into my system and secondly, the gel is more flexible than patches and it is much easier to quickly adjust the dose if you need to.  I didn't like wearing patches either but that was a personal thing. 

My conclusion is that the dose of progesterone in the Mirena coil is too high for a lot of women meaning you need a high dose of oestrogen to counter the side effects.  I found that the only time I felt good was when the coil was running out of steam towards the end of its life. 

My advice would be to contact your private specialist and ask to have the oestrogen prescription sooner rather than later and I would also ask for Oestrogel.  In the meantime, I would definitely stick a patch (or two) on - if you start to get any lining build up, the progesterone in the Mirena will make it shed.

I hope that helps and as Jenna says, you might want to read my old posts.  I can't guarantee you will react to each product in the same way but you have nothing to lose by trying.

[Hurdity]

Hi DaisyB

Most of the oestrogen only patches are designed to be changed twice a week. Do you mean by the 6th day you felt bad even after changing the patch mid week? If so I would perhaps try changing them every 3 days instead of 3.5. Also they are not designed to work that quickly so it would not really be advisable to increase to 75 mcg without giving the 50 mcg a chance to settle in. Many of the effects are mediated through changes at cellular level and can take weeks or even months to really make a difference. I can't remember where you are in menopause. If you are still very much in early peri then I would hold back on increasing the oestrogen to three patches just yet, and wait until you've seen the specialist. It may well be that this is advised in due course.

The progestogen in the Mirena gives the highest systemic levels in the first weeks and months so this is when any side effects would be most noticeable. I agree that it may well be overkill for low doses of HRT and is a classic case of one size fits all. There is a newer type of Mirena called Jaydess which is lower dose but unfortunately not licensed for HRT  and I can't recall anyone yet using it (who is posting on here) for HRT off licence through GP or gynae.

Hurdity x

[Mary G]

DaisyB, I've sent you a PM!

[Hurdity]

Hi DaisyB - I need to clarify this now about the patches in relation to your post below.

The amount of oestrogen contained in patch is far greater than the amount that is actually absorbed. They don't run out after 3 days - but when you stick a patch on - on average levels will rise to a maximum after 12 hours and then gradually decline. There is still oestrogen left after 3.5 days so you would still get some. However to achieve the dose stated eg 25 mcg per day or whatever ie optimal levels - then these patches are designed to be changed after 3.5 days. It's better to go for a higher dose and stick to the 3.5 days than changed them too often eg daily. That being said women vary enormously in how much oestrogen they absorb from a patch and the figures stated are an average from a population of women. You will only be able to go on how you feel. So I would say yes - stay with the 50 mcg but change eg every 3 days and see how you feel (or whatever your private GP says!!).

You may well get more spotting initially when you increase the oestrogen dose but this should settle at  the most after six months and depending on how high a dose you are using.

The effects of the Mirena are a different issue - but in some areas of the body some women do find that synthetic progestogens interfere with the beneficial effects of oestrogen - they are designed to do this in the uterus of course, but sometimes elsewhere too.

Hurdity x

[peri]

Just a little aside but I asked for the Jaydess instead of the mirena coil and was refused because as Hurdity says it is not licensed for hrt.  It's a pity because the GP who fitted my mirena told me she'd had the Jaydess herself (for contraceptive purposes) and it was the one she'd felt at her best on I.e., least side effects x