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[Sarah H]

Hi
I am 47 and started using the Mirena Coil a year ago for heavy periods; my periods seem to have stopped now- they just faded away.

A few weeks ago I started getting very sore, needed to go to the toilet often and had urgency so I went to the doctors; they tested for cystitis and gave me antibiotics which did not help; I have had cystitis before and this felt very different - I had no pain on urinating. I went back and they gave me more antibiotics but said no infection was showing up and tested me for STIs which came back clear. I still had the same symptoms and I thought I might be dry so I tried out Replens which has improved my symptoms a lot- I've also been doing more pelvic floor exercises.

I have another doctor's appointment in a couple of weeks. I have looked around the Internet and it seems that much younger women than me have dryness from the coil so I don't know if this is because of the coil or the menopause- I've also read that with the coil it's hard to test my hormone levels.

If my symptoms are due to the coil I'll just have it removed.

If it's the menopause I'm not sure as apparently the coil plus estrogen is a good way to go. Having said that if the dryness is my only symptom and can be managed with cream then maybe I should  still have the coil removed.

I'm sort of coming at this as a total newbie - I don't know why as my mum had an early menopause so I should have been better prepared but I'm floundering here.

Any input gratefully recieved
Thank you

[Mary G]

Sarah H, I had a Mirena coil for contraception pre-menopause but once my oestrogen levels started to drop (aged 42) I started to have endless problems with what I thought was thrush and cystitis.  By the time I was 47, I was post menopause.  To cut a very long story short, my problem was vaginal irritation and dryness caused by the strong synthetic progesterone in the coil and lack of oestrogen - in my case, it also caused overthinning of the womb lining but don't worry too much about that.

My advice is to get started on systemic oestrogen replacement as soon as possible.  You obviously get on well with the Mirena coil so don't have it removed, just add in some oestrogen.  I started by adding oestrogen patches but they didn't give me a high enough dose and I ended up having the coil removed.  With the benefit of hindsight, I wish I had tried the Mirena with Oestrogel (a gel you rub on your skin everyday) because it is flexible and you can adjust the dose up or down to suit your needs.  I am now on the Oestrogel/Utrogestan regime. 

From my own experience and from what I have read on here, it would seem that you need a fairly high dose of oestrogen to get symptom relief if you have a Mirena because progesterone in the coil is strong and can become over dominant. Although the progesterone in the Mirena is supposed to be mainly confined to the womb, enough of it can get into your overall system to cause some side effects. 

I hope that helps. 

[Hurdity]

Hi Sarah H

 

The Mirena coil does often stop periods because of the high progestogen dose which keeps the womb lining thin but it means you can't tell when you get to menopause naturally! In some women it also prevents ovulation so I've read.

It sounds like you definitely need to use some local oestrogen to keep  vaginal atrophy at bay - have a look at these links (on this website):

Top tabs pale green banner - Menopause/Vaginal problems (various tabs)
https://www.menopausematters.co.uk/vaginalsymptoms.php

Treatments:
https://www.menopausematters.co.uk/local.php

Articles:
https://www.menopausematters.co.uk/article-vaginal-atrophy.php
https://www.menopausematters.co.uk/pdf/article-gsm-issue44.pdf

Blog:
https://www.menopausematters.co.uk/blogpost-vaginal-dryness.php
https://www.menopausematters.co.uk/blogpost-lube-or-hormones.php

Also look at Maryjane's posts and links as well as the Burning Club thread (in Private Lives section). There is a lot of info on various lubes and moisturisers that women find beneficial.

If you start to experience flushes and sweats then you may benefit from systemic oestrogen - especially as you are still young.

Do have a read and then go to your doc and get some relief asap before it gets any worse.

Hope this helps

Hurdity x

[nearly50]

Hi Sarah? Had your cycles got shorter before you started the coil? That would at least give you some sort of clue as to whether you were in perimenopause at the time. Do you have any other symptoms like joint pain, difficulty sleeping etc?

[Sarah H]

Firstly thank you all for replying; I really appreciate your help.

Mary G
Thank you for sharing your experience and hindsight. I'm only just learning about this but the gel option does sound attractive.

Hurdity
Thank you for all those links - I will start going through them - I need as much info as I can get right now.

I am going to the doctors in about a fortnight but I'm a little alarmed at your suggestion to get this resolved before it gets worse - I hope if it does get worse the gel or tables could still help and I'm not taking some sort of risk by waiting 😕.

Nearly 50
Thank you too. That was a question I'd not even thought of and is a really good point. I used to have a pretty regular 26 day cycle but the months prior to the coil were all over the place 26, 40, 30, 26, 40, 17, 28, 31, 29, and 17 again - those 17s and 40s were really unusual for me.

At the moment I'm leaning towards this being the menopause rather than an odd side effect of the coil. I'm a bit shocked 🙂

[Hurdity]

Hi Sarah H - not meant to be alarming - just telling you as it is! Vaginal atrophy is a long term condition due to oestrogen deficiency and therefore to alleviate symptoms and keep things comfortable treatment needs to be ongoing, continuous and forever. It returns once treatment is stopped. You will see this from the links. No need to worry . No harm will come to you by waiting a few weeks but the sooner you are treated the more comfortable you will feel - if your symptoms are due to low oestrogen.

From what you say about your cycle you were in the very early stages of peri-menopause when you started the coil so are unlikely to be post-menopausal yet - although you can't really tell.

If you have no other symptoms then maybe wait a little while before starting systemic HRT but  see what the doctor says at your visit. Some women need both even for vaginal symptoms.

Hurdity x

[elsie001]

Hi Sarah, I'm very similar to you - got the coil fitted aged 49 (am now 51) to treat ridiculously heavy periods.  After approx 6-9 months, my periods tailed off altogether.  A couple of months ago, I was diagnosed with a uti (something I've never had before).  At my GP appointment for the uti results, I mentioned that I felt a bit dry and raw.  GP examined me and said it was looking a bit menopausal down there and prescribed some vagifem pessaries.  Am feeling much more comfortable now and will continue with the vagifem twice weekly.

Like you, because of the coil, I had no idea where I now stood in the menopausal journey. Since starting the pessaries, I have noticed that the brownish viscous discharge has started again and I can only assume that the added oestrogen has possibly woken up my hormones a bit. 

[Sarah H]

Hi Hurdity - thank you for the reassurance - I wouldn't want to risk damage by waiting.

[Sarah H]

Hi elsie001. Thank you for replying. I'm wondering if like me this is the only symptom of the menopause you have. It's useful to know an examination can be used to show whether or not this is the menopause.

[kwaddilove]

sorry ladies, dont like to talk to family, mates about menopause as they dont get it and i feel i am burdening them, so I am afraid you get it all.   Since having my Mirena coil removed 10 weeks ago my menopause symptoms have escallated badly. hot flushes all through the day, no sex drive, feel like I am in my own bubble world, dont want to do much but still want to conquer the world.  depression worse, i am on tabs for that already. I think I am dying as I feel so weird more often than not now.  Please is there others who feel this way? Any tips?

[Sarah H]

Hello Kwaddilove. I'm really sorry to hear how much you are suffering and that you don't feel supported. I am new to this and have no tips but thought I'd just say hi anyway.

[Hurdity]

Hi kwaddilove

 

Sorry to hear about your symptoms.

If you are peri-menopausal and experiencing flushes then have you thought of HRT to help with this? Was there a reason to have the coil removed because if not, you could have another one put it in and then try a low dose oestrogen preparation alongside (tablet, patch or gel). This would then help with your hot flushes. Patch or gel oestrogen would be better for sex drive as oral oestrogen can suppress it.

Did you suffer from depression before or did it just appear along with menopausal symptoms? If the latter then HRT is recommended anyway rather than tablets such as anti-depressants. If you have experienced this for some time then even so it is better to start HRT than to increase your AD medication since low oestrogen and hormonal fluctuations can all cause depressive symptoms.

I hope that doesn't sound confusing and that you manage to find something to suit you so that you feel better.

Hurdity x

[Sarah H]

Hi there.
Any comments/ thoughts appreciated but I'm not really expecting solutions as there are probably too many variables. I'm posting in the hope that I'll be set straight if my information hunting has misguided me.

So; I manage to bring my doctor's appointment forward. He said that a blood test could show where I am with the menopause even with the coil which is different from what I've read but it does make sense as maybe it's only the progesterone that's artificially elevated and they'll still be able to see my estrogen level.

The doctor also said that the nurse who examined me for STIs would have told me if I had VA so it's unlikely but I can have a test at my surgery next week.

I have read somewhere (sorry can't remember where now) that it is the gap between progesterone and estrogen that can cause VA so if I do have that I'm not sure about taking another hormone to counteract the one I'm already taking for heavy periods that I'm no longer getting - however on the flip side that might be a bit of a short term solution that I could regret as I've also read that the Mirena Coil can be a better option, combined with estrogen, to help with the menopause as opposed to HRT taken orally.

Anyway I'm going to try stopping the Replens and see if my symptoms worsen again.

Hope you are all okay

[Maryjane]

All I will say is that VA can't necessarily be seen , as told to me by now retired Dr Annie Evans ....the damage starts happening in the epithial layers quietly causing damage before seen on the surface .

What test are they going to do for VA ?

[Sarah H]

Hi Maryjane
Thank you for replying. I saw a male doctor who said I should re-book to see a female doctor (which I was pleased with as I've seen an article describing an examination for VA which involved more than a smear test would). I think calling it a test was wrong - it's an examination I think.