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[LucyLoo]

Hi there, I'm 42, peri menopausal and a Prof Studd patient (seeing Michael Savvas). I take 4 pumps estrogel every morning, small blob of testim and 100mg utrogestan for 7 days per calendar month. I'm going to try 10 days of utrogestan this month (on advice of Dr Savvas as I've been OKish on 7 days). Started regime last December for severe PMS (low mood, anxiety and exhaustion) and osteopenia.  I feel much better on the regime.

I am having a uterine scan today to see how my fibroids are looking as my last period was very heavy and lasted 2 weeks. I think the Mirena coil could be a good solution for my heavy periods but I am worried about progesterone side effects. I can't tolerate the contraceptive pill (feel terrible as the progesterone builds up) and believe progesterone is the cause. However I've been surprised that I haven't reacted too badly to 100mg utrogestan vaginally. I usually start getting PMS symptoms and exhaustion around day 6 or 7 (struggling a bit today and it's day 6).

My question is – has anyone who is progesterone intolerant got on OK with the mirena because their estrogel / patch has “overridden” the progesterone side effects? Physically I think the mirena could be great and I'd love to have no more periods. But I'm scared about the potential for exhaustion, sugar craving, depression etc (my usual progesterone side effects) and the fact I can't get it out myself. I don't think the lower dose jaydess coil is an option for me as Dr Savvas has already said it'd have to be the mirena because this is licensed for use with HRT. I also think as I'm on a high dose of estrogel I probably do need the mirena to counter balance this. If anyone has any thoughts / experiences I'd be really grateful.

[Rosti]

Hi Lucyloo.

I struggled with utrogestan with tolerance issues.  By about day 6 I could hardly get out of bed.  I tried utrogestan continuously and that didn't work spectacularly.

I have been prescribed the Jaydess coil together with estradot patches and a tiny smidge of testosterone although I am not needing as much because levonorgestrel is a testosterone derived progestogen.

I have had the Jaydess since April and it has been great. In the words of the Meno clinic an 'excellent' response.  It is not guaranteed as a no bleed option and I did have a little spotting for about 5 days but otherwise really positive.

The risk is mitigated by a minimum of 2 scans a year.

I had the same concerns about not being able to remove it and raised this at the time when they said it would not be a problem but that I should give it a fair go.

Anyway... Seems to work for me and I hope you get a suitable solution.

Xxx

[LucyLoo]

Hi Rosti,

Thanks so much for sharing your positive experience! Do you mind me asking which meno clinic you are at as it's great to hear they condone us of the Jaydess coil with HRT? I'd rather have the Jaydess given it's a lower dose of progesterone. Do you mind me asking what your estradot patch dose is too? I know we're all different but it'd be good to understand so I can go armed to my next appointment with more info! Thanks so much xxx

[Perinowpost]

Hi Lucyloo

There are lots of ladies who love the mirena but I'm not one of them.  I'm prog intolerant like you and I had it removed after 6 months.  Symptoms included low mood, weight gain and loss of libido.  All those symptoms disappeared within 48 hours of having it removed.  I'm on a evorel 50 and utrogestan, I've tried all types of hrt and found this one the best regime (for me).  Like you though I do struggle with the utrogestan from about day 5.

Good news on the Jaydess Rosti, I asked for that and was told I couldn't have it.  I'd be interested to know where you go too x

[Rosti]

Hi

I am with Nick Panay's team in London.  They have been very good. 

I am using estradot 50mcg currently and it seems that my body doesn't like too much of either oestrogen or progesterone.  Excesses of either tend to cause problems so it has been about finding the balance.  I am still peri so I do tend to get fluctuations but we're working on that now too.

I really do think it's about balance based upon the progesterone loading as well as hot flush management at least that's been the most successful strategy for me so far!

[Mary G]

LucyLoo, if you take a very high dose of Oestrogel then yes, you could counter the effects of the coil but it you are severely progesterone intolerant like me, then I would really push for the Jaydess coil because the lower dose of progesterone could make all the difference.

Why not ask to have a Jaydess off licence and accept full responsibility by having regular uterine scans?  This is definitely what I would do.  Another member (can't remember who) was offered a Jaydess off licence so it is possible and well worth pushing for.

I had a Mirena for contraception and was OK with it until my oestrogen levels dropped.  I tried it with patches which were ineffectual and didn't give me anything like enough oestrogen but didn't ever try it with Oestrogel which I think would have worked much better because it is more dose flexible and I think it is much easier to achieve the high levels of oestrogen that you will need with a Mirena coil. 

Perinowpost, I too struggle with Utrogestan but my tipping point is day 3 - I take a very low dose and have regular scans.  Apparently the NHS are trialling a 5 day Utrogestan regime for severely progesterone intolerant women.  I don't have any further details of this trial but a former member's gynaecologist mentioned it to her during her last appointment and she is doing it with regular scans.

[Perinowpost]

Mary G yes you and I have spoken about this before.  I have been using only 7 days for the last year but when I went for a private scan my womb lining was 6mm so I've had to go back up to 10/12 days x

[Perinowpost]

Rosti I agree with you, my body doesn't like high doses of O or P.  I'd love to go to Nick Panay but I'm in Yorkshire so it's a bit of a trek x

[Mary G]

Perinowpost, just out of interest, where were you in your cycle when you had your scan?  I have had 6mm in the past but it was at the latter part of the cycle so it was considered OK.  Immediately post bleed is usually about 2mm. 

[Perinowpost]

It was 2 weeks after my withdrawal bleed Mary G, do you think this was ok? The sonographor said she would like it to be 4mm.  Sorry to take your post on a different tangent Lucyloo but prog intolerance is a real issue that many of us are struggling with.  I've said it many times before but it's about time we had some alternatives x

[LucyLoo]

Hi ladies, thanks so much for your replies, they are so helpful. Perinowpost, I'm so glad you're talking about prog intolerance, I really struggle too. I spent yesterday exhausted and the evening feeling desperately low and in tears and I know it's the progesterone. I took day 7 of utro last night and can't wait to start feeling better, hopefully in a few days (I'm just taking it for 7 days per calendar month). I had a scan yesterday and will go to the Drs in a week or two to see what my lining reading is. I am going to speak to Dr Savvas at my next appt about getting the Jaydess. Thank you for letting us know you're under Nick Panay's team Rosti. I originally got referred to his team at the Chelsea and Westminster but the gynae I saw prescribed me the BCP continuously and I felt dreadful. I should have known it wouldn't work as I've never got on with it in the past. I tried Yasmin BCP as it's supposed to be good for PMS but for me I felt suicidal after a week. I ended up paying to go privately in desperation, even though my money is very tight. I have an online friend (via PMS forum) who also got the Jaydess via Nick Panay's team and is getting on really well. She's in her early 30's and uses it with 100mcg oestrogen patches for severe PMS. I'll let you know if I have any luck with Dr Savvas. My next appointment is in September but I might bring it forward and do it via the phone if I can x   

[Perinowpost]

Lucyloo Yes please keep us informed.  I usually feel worse for a few days with prog withdrawal and then gradually pick up and feel fine until the next time.  Thinking of you and good luck xx

[Mary G]

Good luck Lucyloo, I really hope you can swing the Jaydess.

Perinowpost, 6mm at that part of your cycle is absolutely fine, you do not need to increase your progesterone based on that lining measurement.   The sonographer is wrong, didn't she know that you are on cyclical HRT and therefore shed your lining each cycle?   Did she even ask you?  If you were on continuous combined HRT or post menopause and not on HRT then she would be right, it should be under 5mm but this is not the case with you.   It's obvious that the lining will build up with a cyclical HRT regime otherwise where does all the blood come from?  I despair.

I hope that helps.