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[Optimist]

Hi all could I have some help please?
Thinking of trialling the Mirena-meno clinic DR says that's my only remaining choice after no success on femoston 1/5 conti! Terrible side effects from month 3-4 with what I can only think is the progesterone build up. Increased urine freq & volume, chronic constipation, insomnia like never before! Etc the list goes on... I tried several HRTs now and have had 2nd meno clinic appt but DR didn't agree with progesterone build up just “you're having a really bad menopause!!”.
I was put back onto everol 50 but conti this time but after 2weeks and awful symptoms continuing went back to 2 weeks of oestrogen only and OMG the difference after 5 days, slept like a baby, massive decrease in urine and no constipation!! Unfortunately have had to have the conti again and 1 week in all symptoms back.
So what I would like to ask is has anybody else been not good on progesterone but has had success with Mirena and everol oestrogen (75mg patch DR advised)??
Experiences gratefully received thanks ladies xxx

[Dancinggirl]

I did get some side effects at first after the Mirena was fitted - felt quite sedated and tired - but once it settled, the Mirena with Oestrogel (one-two pumps per day) was my best non bleed HRT experience. I must add that I had a premature menopause so had 25 years of HRT and tried just about everything. In my experience all HRTs bring some side effects. DG x

[Lucy]

Hi Optimist.  I have a mirena coil and am on evorel 25.  The mirena has been a total lifesaver.  It completely changed my life as my periods were about three weeks long and very heavy and I thought I was going to have to have a hysterectomy.  The mirena stopped the periods.  Now I am in peri menopause and am on Evorel 25 patches. (A very low dose) This stopped the hot flushes and I got better sleep.  I am still suffering from horrendous anxiety but that's a problem I've had for half my life and is only exacerbated by the meno.  In my view the mirena and evorel are a great combination.  Let me know if you have any questions and good luck. 

[Mary G]

Optimist, if you are going to have a Mirena coil and you are progesterone intolerant, I would urge you to use it with Oestrogel rather than patches because you might need a high dose of oestrogen to counter the progesterone which is easier to achieve with gel and it is also more dose flexible too.  I would start with 2 pumps of gel but be prepared to increase to 3.  My experience of the Mirena was that although most of it is confined to the womb, enough of it gets into your overall system to cause side effects.

It might be worth asking if you can have a Jaydess coil instead because it has a lower progesterone dose.  I have just read that it can be used for HRT purposes off licence.

I think progesterone intolerant women do suffer with a cumulative effect and the side effects seem to last longer with higher/longer doses of it.  This is definitely the case for me.

[Hurdity]

Hi Optimist - the thing is with continuous progestogen - it doesn't even need to be - a build-up or not - it's just that it's continuous and if you are sensitive to a particular type - there is no respite! There is no way I would want to take progresterone all the time because I would feel the same as I do when I have it for the 12-14 days every 8 weeks - foggy-headed and headachey, more tired than usual - but ALL THE TIME!!

If you are thinking of the Mirena - then why not try Femseven sequi patches for 2 or 3 months first, as these contain the same progestogen - and then build up to Femseven conti? If you can tolerate these but maybe need a higher dose of oestrogen then the Mirena is your answer. As Mary G says there is the Jaydess and we have discussed this before - some consultants are prepared to sanction this - but needs to be changed more frequently than Mirena.

Although I don't have the Mirena I do use patches (Estradot) - have only ever used these and they suit me very well, never had any problems

Hurdity x

[Optimist]

Thanks ladies, I've been told that although it's non systemic it does get into your bloodstream with side effects.
I've never heard of the jaydess coil, will look it up thank you.
I have also been reading about the oestrogel and have found prof Studd website which has lots of information and he seems to deal in progesterone intolerance with treatments to minimise side effects so if all else fails it would be an expensive trip but hopefully worth it.
Hurdity, hi, I've trialled femseven and alongside low mood the damn patches would not stick! However one thing I have learnt in my journey so far is that in the early days I didn't give the hrt long enough for side effects to settle. Think I was too anxious at the start looking for a quick fix!
I'm just at the point now where I feel I've gone full circle and still no better. The femoston early on made me feel great, mood hair, nails,all great no aches and pains, slept well loads of energy but 3-4 months in and I felt awful again.
The Meno specialist didn't even suggest trying the sequi version of that which I'm wondering if it would be an option even though I'd have a monthly bleed maybe.
Back on everol 50 but conti this time and I'm either not absorbing properly or the dose isn't high enough as I feel tired, aching all over, hot flushes at night again and not sleeping well again. Thinking of putting on extra half oestrogen patch short term again!
Think I may need to trial the Mirena before I give up at least then I can have a higher dose of oestrogen! Or pay to go see prof Studd.
Think you're on utrogesten Hurdity?
Thanks ladies for your stories-really helpful. I'll update as I go along xx

[Dancinggirl]

Optimist - sounds as though you should try the Femoston 1.10 sequential first - this could suit you very well. 
If you do go for the Mirena - yes, there is the hit of progesterone at first but it does deliver more locally and less systemically I believe, so I found there were fewer side effect overall after the first 3 months or so.  I think you do have to stick out at least 3 months with any HRt regime.  DG x

[Jacquiemalley]

I had a Mirena fitted in Feb last year, much better for me as I couldn't tolerate progesterone in evorel patches and could make femseven stick 😀 Now have evorel 75 patch and Mirena and fingers crossed all good 😀😀

Good luck with your quest

[Optimist]

Thanks all. Mrsjam that sounds so positive and good to hear although you couldn't tolerate progestin well you're managing with 75 everol. That's what the menopause clinic Dr has said should be my next trial too and wondering if with the higher oestrogen dose I will tolerate the progesterone better. So I have options that I need to think about. Femoston 1/10 sequi (mood much better than most I've tried) or Gel/patch & Mirena. Think specialist has been going for the conti over sequi to suppress any remaining cycle to avoid bleeds/mood swings. When I asked her re conti while still peri she said she'd written a paper on it and that no women should have to have periods at this stage. However she also didn't acknowledge any of the worsening side effects I was getting was down to progesterone. Still so many DRs who think differently about the menopause and how it should be treated! No wonder all the confusion 😊
Many thanks ladies for your help xx

[Brainless]

I'm also struggling with progesterone and looking at all the alternatives. Please will you keep us posted

[Optimist]

Certainly will brainless (love the name-exactly how I felt today!!) x

[Brainless]

Thanks optimist. Brainless is my permanent state these days