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[Waterdaggers]

I've been using utrogestan 100mg vaginally for 7 days (was supposed to be 12) but have been struggling even on this low dose. Consultant at menopause clinic says I will need to have an endometrial biopsy on day 5 of my period in order to determine whether my womb lining is shedding sufficiently to carry on at this dose. If not then he says an option would be to have a Mirena coil fitted or to go ahead and have a hysterectomy that has been offered to me for another reason. I am totally averse to having any kind of synthetic progestin as have previously reacted quite badly to Evorel Sequi, however he tells me its a low dose and not systemic so therefore not likely to provoke the same reaction. So was just wondering if anyone else who has struggled with utrogestan or synthetic progestins has had a Mirena and been ok with it? I'm really quite scared to try this option after how almost suicidal I felt before.

[Tinkerbell]

I hated utrogestan, couldn't get past a week with it!
I have had the mirena for a year now and apart from spotting for 4.5 months, settle now but occasionally get the odd spot I am very happy with it.
No bloating, mood swings...nothing!
Hoping it doesn't give me any trouble in the future.

[Waterdaggers]

I had the mirena fitted because I felt suicidal when using 100mg utrogestan for 7 days a month, I then tried Cyclogest but I was very aggressive for around 5 days after stopping it every month. For me personally the mirena is a no brainer and I'm so glad I don't get any mental upset from it.

Oh that surprises me! I've been feeling so reluctant to try it after my experience with Evorel Sequi. I had been thinking a hysterectomy would be a better option! Utro doesn't make me feel suicidal it just makes me so unbelievably tired its like I'm battling through mud every day and hard to function and then headaches when I stop taking it. But I would take that over the progestin effect, it made my life a total misery. Glad you have found something that suits you... you've given me hope.

[Waterdaggers]

I hated utrogestan, couldn't get past a week with it!
I have had the mirena for a year now and apart from spotting for 4.5 months, settle now but occasionally get the odd spot I am very happy with it.
No bloating, mood swings...nothing!
Hoping it doesn't give me any trouble in the future.

Hi Tinkerbell,

Thats great you find the Mirena so side effect free! I can take a bit of spotting. Did you try any other synthetic progestin before you tried utro?

[Noheroicsplease]

I just posted about changing from mirena to utrogestan!

I don't know how much better the mirena is making me feel. I still feel weepy and flat. BUt I'm scared that utrogestan will make me feel worse!

[Mary G]

Waterdaggers and noheroicsplease, this might be an idea for both of you. 

I was wondering if it would be possible for some women who have had problems with the Mirena/Utrogestan to try the lower dose Jaydess coil under supervision?  I know it isn't licenced for use with HRT in the UK but I would put money on it being enough progesterone for most women and if you have regular scans, you could monitor it.  Of course there is a chance that it would not work or give enough protection in some cases but what is there to lose by trying it?

If I wasn't so severely intolerant to progesterone, I would be prepared to trial it at my own risk.

I am severely intolerant to all types of progesterone used in HRT preparations and don't get on with the Mirena post menopause and to a lesser extent, Utrogestan but you are unlikely to be as intolerant as me so don't go by my experience.

It's just a thought.

[Waterdaggers]

I'm almost certain I won't get on with the Mirena either. I hate the fact that once its in it's stuck in until you can get an appointment to have to removed. After my extreme reaction to the norethisterone in Evorel Sequi (not only did I feel almost suicidal and terrible acne but I could not sleep at night with my body itching all over) I don't want to try something I have no control over. I've never heard of the Jaydess coil.... can you get that through the NHS? I know I have to do something because at the moment I've been skipping odd months of the utro just so I can focus (in my final year of a degree).... which is a risky thing to be doing I know!

Mary G are you not using HRT at all now? Because of my age (42) I'm reluctant to stop HRT totally and feel totally lousy without the oestrogen.

[Mary G]

Waterdaggers, you definitely need oestrogen for many years, you are far too young to be without it.  I am 55, about 10 years post menopause and on HRT for life. 

I have never had any problems with my own progesterone but can't tolerate any progesterone used in HRT products (my body says don't give me this stuff, I don't like it) and for that reason, I have been told I should have a hysterectomy.  I can't have the operation now due to work commitments so in the meantime, I am under supervision on a very low dose of 100mg vaginal Utrogestan.  I can't take Utrogestan for 7 days either but I have regular scans and so far, so good. 

The next stage is deciding exactly what type of hysterectomy to have and which method of surgery.

Why do you need a biopsy?  A uterine scan would be enough to know whether or not you are getting adequate clearance/thinning.  You can definitely get a Jaydess coil via the NHS and it might be worth a try.  They will tell you that it is not licensed for use with HRT but you could say you are prepared to try it at your own risk - you could point out that the Jaydess will give you more progesterone protection that you are currently getting with your very low dose of Utrogestan.  This might not be a long term solution but it could tide you over until after your exams.

[Hurdity]

Re the Jaydess - this has been discussed in detail a few months ago - so you might like to see the thread on it here:
https://www.menopausematters.co.uk/forum/index.php/topic,33744.15.html . I did some basic comparisons with Mirena and maybe HRT products containing levonorgestrel (I didn't read the thread completely). It is licensed for contraception though so perhaps that is a starting point?

Someone on here recently asked at her practice to be prescribed this and was refused - so it might have to be a private consultation or a NHS meno clinic - perhaps phone them beforehand to see if this could be possible?

By the way your consultant is quite wrong to say that it is not systemic - as I may have mentioned on that thread  - it is only relatively non systemic by comparison with birth control pills that contain the same progestogen, and which are taken orally in large doses. I did work out that the Mirena at some point during its life would give rise to systemic levels of levonorgestrel of roughly the same order of magnitude as the Femseven HRT patch.

I agree you should not need a biopsy unless a US and TV scan have showed thickened endometrium and possible irregularities or you have had abnormal bleeding - however different gynaes may have different approaches?

If you have been skipping the utro and don't have a cycle of your own ie are post-meno then your lining is likely to have built up and therefore at some point you are likely to bleed as it sheds - even with continuous progestogen from eg the coil.

I presume your degree is almost finished as exams are usually over by the end of May/early June - so at least hopefully you can get back on track with the right HRT?

Hurdity x