Print

Please login or register.
1 Hour 1 Day 1 Week 1 Month Forever
Login with username, password and session length

[misslelith]

Hi.  I have been on Evorel 50 and Evorel Conti patches for about 2 and a half years with no problems because I started with hot flushes although they were quite minimal.  I am also on my third Mirena coil.  I had the coil fitted because of severe bleeding throughout my 40s/early 50s and it really was successful - I'm 57 now.  The coil should have been taken out last October and I am due back at the hospital for this removing when I receive an appointment. I  started spotting about a month ago and last month had extremely tender breasts for about 3 weeks. GP has told me to now just use the the Evorel Conti patch on its own as this should settle the breakthrough bleed. She did advise that if this does not stop I would need further investigations. I have no idea when I went into the menopause because I have been on the Mirena coil for so long and just feel I am all over the place.  Does anyone know if this is a common thing? Last month I was very anxious and depressed and had time off work and not sure if all this is related. Does anyone have any advice or has gone through a similar experience? I'm just a bit confused about about all the different hormones. Thanks in advance if anyone can offer any advice.

[Hurdity]

Hi misslelith

It sounds like you have been taking a lot of progesterone. Do you mean you have been on Evorel sequi ( which is two weeks of evorel 50 - the oestrogen - followed by 2 weeks of evorel conti - the oestrogen and progestogen combined) as well as having the mirena (consisting of progestogen)? When was the last mirena fitted? That amount of prog would send many of us completely up the wall! I can't explain your symptoms except if you have been taking the sequi as above then your body will register the rise and fall in the progestogen when you are on the conti patch. Perhaps if the Mirena is near the end of its life you are noticing this more and also bleeding because of the Evorel sequi which is designed to give a monthly withdrawal bleed?

It's up to you what you decide to take as HRT - you could either go onto Evorel conti assuming you are now post-menopausal, or you could have another Mirena fitted (this will stop the womb lining from getting too thick which it would do if you had just oestrogen) and then just add the Evorel 50 oestrogen patch which would then keep you on an even keel and control the bleeding. If you felt the oestrogen dose was too low you could ask for a higher patch and bleeding should be controlled as it would be a new coil.

Hurdity  x

[misslelith]

Hi Hurdity
Thank you for your reply . The coil was due to come out last October as it ran out then . I have also been using the patches as you say - two weeks on one patch and two weeks on the other . So the Gp thinks I am having a bit of spotting because the coil has stopped working . She said to just go onto the everol conti from now on and get the coil removed which is well by it's sell by date by now ! She didn't mention having another one fitted . Would too much progesterone have an effect on mood, skin, etc ? I will ask the gynaecologist when I get it taken out as the GP can't do it.

[Hurdity]

The coil doesn't actually "run out" of progestogen for a long time after the licensing time for HRT has passed - which is 4 years. I think I read somewhere that there is still progestogen ( or can be) after 10 years. Also it is licensed for contraception for 5 years. Therefore if it has only been in for 4.5 years it will almost certainly still be chucking out some progestogen. You will therefore almost certainly be having too much if you are taking Evorel conti as well or Evorel sequi ( when you are tkaing the conti patches).

One reason for the spotting could actually be due to excess progestogen - which can cause overthinning and ulceration, and spotting. It does depend where you are now in menopause, ie whether you are still ovulating at all in the background and producing some oestrogen as well as from the patch.

Yes too much progestogen could have an effect on all of that - not sure about skin but defo mood! However I would have thought you might have noticed the effects before now ie when you started the Evorel sequi ( or conti ) 2 years ago on top of the Mirena.

Also you have two different synthetic progestogens in your body - levonorgestrel from the Mirena and norethisterone fromn the Evorel so who knows how they are interacting with all your various receptors and hormones?!

If you were happy with the Mirena this would be the better option rather than the patches because as I said you won;t have to worry about progesterone for another 4 years. This should be your choice and either option should protect your uterus. You might prefer just to have a single patch and then not worry - buit you could still do the same with the mirena in - just have oestrogen only patches. I can't understand why you weren't given just Eovrel 50 rather than sequi/conti - but maybe even with the Mirena in your bleeds were heavy? However if all is healthy in your womb you shouldn't have heavy bleeds now....so either Mirena + oestrogen, or combi patch, should be fine.

Hurdity x