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[Sally S]

Hi there,

I can't find an answer to my query on the safety of using Mirena coil versus taking Utrogestan as part of HRT, with regards to any potential breast cancer increased risk.  Can anyone shed any light on this, please!?  I wondered whether it is thought that taking Utrogestan which is a body identical progesterone is safer - even though more is absorbed by the body as opposed to having a Mirena coil fitted, which is synthetic/not body identical but less is absorbed by the body?  This would be used with body identical oestrogen gel or patch.   Sorry, it sounds technical but not sure my GP knows the facts and figures.  Thank you for any advice. x

[Loulou1960]

Hi..Understand your concerns...after lots of research on research papers,,I decided to have the utrogestan for part of my cycle.7-10days vaginally..As a retired nurse with lots of experience  I personally didn't want the mirena coil due to continuous progesterone,but obviously it's an individual choice.

[SueLW]

Hi..Understand your concerns...after lots of research on research papers,,I decided to have the utrogestan for part of my cycle.7-10days vaginally..As a retired nurse with lots of experience  I personally didn't want the mirena coil due to continuous progesterone,but obviously it's an individual choice.

Did you find any evidence to bear on the 2 types of progesterone pertaining to breast cancer risk?

[Dancinggirl]

The Mirena is transdermal so is probably a good choice generally and is favoured by many gynaes because it give fewer problems all round.   Utrogestan is described as ‘breast friendly' but can give more side effects unless used vaginally.  I personally didn't get on with Utrogestan - felt sedated, got erratic bleeding and cramps.  I had the Mirena in post meno for 4 years (with Oestrogel) and it was the least hassle overall.

In terms of breast cancer risk I doubt there is much difference between the two. If I were you I'd try Utrogestan first, see how you get on and if it doesn't work out then try the Mirena.

Unless you are over 60 the breast cancer risk for any HRT is very tiny and I believe there is strong doubt now as to whether HRT increases the BC risk at all as many studies have been quite flawed. DG x

[Hurdity]

Here is a fairly recent paper on progesterone (Utrogestan) and breast cancer risk:

https://www.tandfonline.com/doi/pdf/10.1080/13697137.2017.1421925?needAccess=true

One here on synthetic progestins vs progesterone:

https://systematicreviewsjournal.biomedcentral.com/articles/10.1186/s13643-016-0294-5

and this one here which compares the relative risk of breast cancer from Progesterone, dydrogesterone and synthetics (I don't think it distinguishes between the different types?):

https://www.ncbi.nlm.nih.gov/pubmed/17333341

There is a growing body of evidence showing that progesterone itself (used vaginally) may well be associated with the least risks and no increased risk when used short term for only five years.

The amount of absorption of progestogen by the Mirena at least over some of its life is approx comparable to a Femseven patch - and as Loulou1960 says, with a Mirena it is being absorbed all the time.

Like her I chose to maintain a (longer) cycle, and use micronised progesterone (Utrogestan) vaginally - to minimise exposure to progesterone. Nil-by-mouth gal me!

Hurdity x

[Sally S]

Just the information I was after, thank you, Loulou, Dancinggirl and Hurdity.  I am in Peri-menopause, I'm 44 so from info I've read on here, I'd be taking the Utrogestan for just part of the month not continually. I thought I may try this first as my Dr surgery told me I'd be on a waiting list for Mirena for a lot of months.  Does the Utrogestron absorb/dissolve into your body immediately if it's inserted internally rather than taken orally?  Hurdity - are you a former GP or Scientist? You and Dancinggirl are so knowledgeable.  This site is invaluable with all you informed and helpful ladies!

[Hurdity]

Sally S there are many of us on here who have between us either lots of personal experience or knowledge of different treatments and HRT regimes - some of us have just been around for a longer time and in our 60's so have had time to read a lot about it. Being a scientist can help with understanding some of the more tricky technical papers or seeing through the stats but it's not necessary - many of us just enjoy reading about it all and then helping others with what we know to give something back!

Hurdity x