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[BobbingAlong]

Hi there, I had a Mirena put in about 16 months ago and at the same time I started to use oestrogel.

It took a good few months to settle.  I was prepared for this though, as although some friends (generally younger) had gone straight to no periods, I did have one friend (my age...50 yrs old), who said she had had spotting for 7 months or so. 

Also, over the first year I did experiment with the dose of the oestrogel and I imagine this may have had an impact. I started on 2 pumps and after 3 months thought my breasts were going to explode!  So then tried 1 pump for a few months, then even tried ½ a pump which seemed ok for a few months until gradually anxiety and “warm” flushes at night returned. 

4 months ago I added half a pump of tostran to the mix which did absolute wonders for the muscle fatigue and exhaustion I'd started getting after my usual weekly gym sessions.  Around this time I also settled back to 1 pump of oestrogel.   This is the dose I've been on for about  4 months now.

When I started this regimen, my periods were still mostly regular, with a much shorter cycle. My cycle had gradually dropped from a 35 day cycle down to around 24 days over the last decade. I've been able to track my cycle still whilst on the Mirena as I still get quite marked (but improved) PMT symptoms and breast pain etc leading up to period and then a very, very light period with almost un-noticeable cramping . Or you could just call it heavier, pinker spotting than the brown I get most of rest of month. Over the last year I've had a small run of 21 day cycles and then one month I had 2 periods in the month....at least I think they were.  I don't think I'm skipping any yet?

I tend to only get about 3 days a month (towards the end of the follicular phase) when I don't spot. I know I cannot ask “is this normal?” for Mirena use in Peri as there is no normal??!!!  But I just wondered if there were any other ladies in Peri on the Mirena who also had spotting most of the time?  Should I be worried?

[Dancinggirl]

I'm afraid only around 30-60% of women are bleed free with the Mirena and if you are peri meno and still producing quite a bit of oestrogen anyway, then you are more likely to get some bleeding. It would be worth having the Mirena checked to see if it is still in place and possibly have a scan to see why you are bleeding so much. DG x

[elsie001]

I've had my mirena coil for 3.5 years.  Got it fitted when I was peri - took a good few months for the bleeding to stop but was expecting that as heavy periods were my main reason for choosing the coil.  I was given oestrogel but found that it gave me symptoms of high oestrogen - sore boobs, spotting etc so stopped. In fact, in the run up to full-blown meno (bloods done in January confirmed it), I was suffering with naturally high levels of oestrogen despite having the coil.  Think it was my body's last gasp at trying to ovulate (I'm 52).

Might be worth asking your GP to have your hormone levels checked as you might not need the added oestrogen yet? Results can be a bit unreliable during peri so they might want to repeat the test after 3 months or so.

For me, the mirena coil has been a life saver. I was at my wits end with flooding and insomnia and it was seriously impacting on my life.

[Dancinggirl]

Good post elsie001 - sounds very logical to me.  I believe one should only introduce a very low dose of oestrogen at first anyway, as the hormones through peri meno are fluctuating and too much oestrogen can give more problems.

Bobbingalong - from what you have told us, you are in a very early stage of peri meno so probably don't need much oestrogen - in fact your oestrogen requirements will probably remain uncertain for some time - sadly we can't expect to feel good every day.   Your symptoms will fluctuate I'm afraid until your own oestrogen levels drop more as you go into post meno.   The peri stage is challenging because of the fluctuations. DG x

[BobbingAlong]

Thank you so much for your replies DancingGirl & Elsie001.

I can feel the strings, so it should be in the right place I guess.  Managing the fluctuations does seem to be the challenge in Peri and I have fiddled about with the oestrogen dose up and down to try get the perfect balance which just doesn't exist does it???!!! Or at least the balance is right for some of the days and then your body does a massive surge then a massive drop. 

Elsie, thank you for sharing your experiences of oestrogen being too high and that you got spotting as one of the symptoms , along with the breast pain of course.  I was on Tibolone for a couple of years (not usually prescribed pre meno/possibly mistakenly prescribed but is a long story in an earlier post ) and my breasts LOVED it. It was the most comfortable they have ever been.  But I can't have that and so must find a way to live with lumpier boobs side effect. And to be honest, the coil side of things as you say, it is a blessing to not have flooding periods and I now take no Ibuprofen at all.  From around early 40's my period pain was very bad and would wake me at night etc, flooding too and I was taking a ridiculously high amount of ibuprofen to cope.  So, I will be sticking with the Mirena one way or the other I think as it ticks a lot of boxes for me and spotting is not the end of the world.....as long as it is “normal” and not indicator of something going wrong.

So, yes, DG & Elsie, I think I may need to consider that the oestrogen may be a little high and try dropping down to half a pump again or even nothing. Although, I may hang on for another month as I have had a run of 13 days so far without really lumpy sore breasts (just a little lumpy) and I've had greatly reduced anxiety and ibs type symptoms too compared to when I was on ½ pump.

[BobbingAlong]

Also since starting this post I went on another major googling session and finally found some reports of women who spotted most of the time. Previously when I had googled, all I found was women who had spotted but then it had resolved after 3 to 6 to 12 months. I understood that some 30-60% of women still had some bleeding/spotting but I interpreted this(mistakenly?) as they still had a period once a month, not spotting most of month as well as a period.

[BobbingAlong]

UPDATE.
just wanted to update this as I searched the boards endlessly using key words "mirena" "spotting", "still bleeding" etc when I was wondering what was happening with my mirena coil. And often wondered what happened with some folk in the end.... Wether things resolved or they had it removed etc...
So.....
It took a long time, but shortly after this original post the almost constant spotting finally stopped. It was around 17\18 months. I've continued to have mild spotting when it is my period, but that's minimal and even that has got lighter and lighter. I'm now at 27 months with mirena and very glad I stuck it out as  it's sorted out the painful periods and intense ibs symptoms I'd get when the period cramps would seem to affect my whole bowel too. I'm on 2 pumps of oestrogel now.... it doesn't smooth out all my symptoms as my peri hormones are fluctuating (as they do!) and cycles getting very irregular now, but STILL not skipping yet. However, I've never got on with progesterone in any oral contraceptive etc, so I'm sticking with the coil and so glad the spotting stopped in the end. Xxxx

[Hurdity]

Thanks for the update BobblingAlong and glad your spotting stopped.

There is a difference in terms of bleeding whether the woman is peri or post menopause and the reason for starting with the Mirena. If used during early peri or even before this, for heavy bleeding - then it is usual for periods to continue for some time albeit with less bleeding - so that would be expected (bleeding or spotting). As you get further towards menopause then gradually the bleeding may stop and then if you add oestrogen as part of HRT it can start again. If it is started very late peri or post-meno for the progestogen part of HRT then bleeding or spotting may happen for the first few months but this should resolve fairly soon eg latest around 9 months I read but should be invesitgated if it doesn't? Also will depend on oestrogen dose.

Glad all is well

Hurdity x

[BobbingAlong]

Thanks hurdity
Yes, I was kind of prepared for the possibility of a few months of months of continuous spotting in between monthly bleeds as it had happened to a friend for 7 months or so who'd also been in early peri.
But 16 months was not what I'd expected. Prob a combination of factors as you said and I did keep playing around with Oestrogel dose, so that may have contributed too.
Anyhow, got there in the end!
Although a little voice in back of my mind just wondered "but will it all go pear shaped again when this Mirena expires and I have to replace it"  Blimey! One thing at a time eh? Said voice told to shut up! 😜 Xxxx