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[Hothothot]

Hello everyone,

Is there anyone out there using a mirena coil as part of their hrt who didn't get on with a mirena when they were younger?

I am currently using 100mcg Estradot patches, and Utrogestone, (had to go to a really high dose of oestrogen to control the hot flushes - 24 a day on average, hourly) but I'm not enjoying the Utrogestone much. Taking it orally gives me the most almighty headaches, and using it vaginally for half of the month I find inconvenient and messy. Plus I have a full week of withdrawal bleeding, so that's 3 weeks of the month with gubbins to deal with. 

I had a mirena fitted when I was in my mid thirties for contraception, but bled every day for 6 months, and my adult onset acne got a lot worse. I gave up after 6 months and had it removed. I have asked my GP whether with less of my own progesterone I might have more success with it, and she said it was entirely possible. Has anyone experienced anything similar? I would love to get some advice from anyone who has experienced a similar situation before going ahead with having one fitted.

I'm nearly 51, still peri, but I think getting close to menopause, with a history of endometriosis.

Any responses would be most welcome, and thank you all in advance!

Hothothot

[Abba Fan]

Hi Hothothot,
I had the Mirena in my 30's too and also had terrible acne with it, huge pustules on my neck. I'm post meno and have been using Mirena for the last 9 months and this time I haven't had any acne, I was unable to get along with utrogestan so the Mirena saved me from having to have a hysterectomy.

[peri]

Hi Hothothot

I've just had the mirena removed after 6 months.  My main reasons for doing so were a constant flat mood and lack of libido (I didn't have any spots).  I felt so much better after having it removed it just wasn't right for me, but I am glad I tried. 

I take utrogestan too but only do it for 7 days (vaginally).  It's not perfect and I do struggle with progesterone withdrawal (really awful for a couple of days a month), but I think it's the best option available at this time.  Sorry I couldn't be more positive x

[Dancinggirl]

The Mirena with gel was my best HRT option. Well worth trying. DGx

[Hothothot]

Hello Abba Fan, peri and Dancinggirl,

Thank you so much for taking the time to respond to my question. 

peri - I also had no libido when I had the mirena in my 30's (I would much rather have had a cup of tea!), but since I don't seem to have much of one now I'm not so concerned about that aspect of it. I am slightly concerned about the low mood though, because I have definitely become slightly moody and grumpy since starting the hrt.

Abba Fan and Dancinggirl, I'm really glad to hear it has worked for some people. I have friends and family who swear by mirena - my dearest friend was too saved from a hysterectomy by mirena, and my eldest daughter, who also has endometriosis, has found that despite some drawbacks, it has been of overall benefit.

I think I'll just have to give it a go and see. My GP did say it wouldn't be a problem removing it quickly if I had problems with it again.

Thanks again for your helpful comments, and fingers crossed!

Hothothot x

[peri]

Hothothot as long as you're not progesterone intolerant you'll be fine.  Also, the person who fitted mine told me they cannot refuse to remove it should you request it x

[Mary G]

Hothothot, you are taking a lot of progesterone so that could be part of your problem because your oestrogen levels are being constantly undermined.  You could try doing what peri and I do (although I am in the process of changing to a new regime) and that is 100mg Utrogestan vaginally for 7 days each month.  It might be worth giving it one last shot before having the Mirena fitted.

I probably would have been OK with the Mirena if I had used Oestrogel instead of patches which I found to be ineffectual to say the least.  The Mirena/Oestrogel combination works well for many women who are not progesterone intolerant. 

[Hothothot]

Hello Mary G and peri,

peri - thanks for that - it's good to know.

Mary G - thanks for taking the time to reply to my question - does your GP oversee your dosage, or do you see a gynae?  My GP has never prescribed this kind of combination before, so will only go with the dosages listed for Utrogestone - I took the initiative myself to try it vaginally after reading the various threads here - the 200mg orally made me feel dreadful! I don't think my body particularly likes any form of progesterone (including my own), but I wouldn't go as far as to say intolerant. I was actually very reluctant to try hrt at all initially, because I never got on with the pill and assumed I'd have the same problems. My hot flushes became so unbearable though that I would have ended up depressed without it.

 I was originally using oestrogel whilst trying to get the dosage right, but ended up needing 4 pumps a day, so having to divide the dose, and it became a real faff. I've had two weeks on the Estrodot 100mcg patches, and they seem to suit me well.

Would 100mg Utrogestone vaginally for 7 days be enough to prevent womb lining build up given my relatively high oestrogen dose?

Thanks again for your help. x

[Mary G]

Hothothot, I initially went to Professor Studd who prescribed this dose of Utrogestan but I also visit a gynaecologist regularly for check ups and uterine scans to check the lining measurement. 

For the record, Professor Studd does not stick to the NHS guidelines for progesterone doses but he does not make regular uterine scans a condition of using the 100mg 7 day Utrogestan dose.  I have yet to hear about any woman on the low dose Utrogestan who has run into serious problems and if it was at all risky, there is no way someone of Professor Studd's credentials would prescribe that dose.  The NHS don't offer routine uterine scans so they overprescribe the progesterone part of HRT to cover themselves which is not a problem if you can take it but it's a deal breaker if you have problems with it. 

You don't have to be progesterone intolerant to have problems with it, you can just experience low mood or it can simply undermine the oestrogen which means you get poor results and lack of symptom control from your HRT regime. 

If I were you, I would try the 100mg Utrogestan for 7 days and then after a few months, have a scan to make sure you are getting adequate clearing/thinning.  You will probably find that the low dose is enough but it is worth checking to make sure. 

I hope that helps!

[Hothothot]

That's all really useful information Mary G - thank you so much.