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[flossie fiddler]

Was on HRT for 6 years from 2013 to 2019, Initially Evorel Sequi, which was fine. But then started getting irregular bleeding after a couple of years. Switched to Evorel Conti but still bleeding. Had 2 scans in 2016. Second one showed a IU polyp, which was removed. Conti still caused bleeds so went on Evorel Sequi and that was that until I stopped HRT at the end of 2019 due to supply issues. Was a hot mess during pandemic but no bleeds. Went back on HRT  Aug 2022. Evorel Conti again caused bleeds every 3 weeks, so in Jan 2023 switched to Evorel 50 with Utrogestan 100 nightly with no breaks. Still getting bleeds, regular cycle of 21 days, and in addition, Utrogestan knocks me out, makes me feel groggy, and gets stuck on the internal scar tissue I have due to ACDF spinal surgery, which then causes heartburn.

Saw my GP today, whose specialised is gynae. She's referring me for scans, but has discussed options if scans don't show anything, as they never have before (crossing fingers). She said I shouldn't really be bleeding post meno. Discussed going back on Evorel Conti, but know it causes bleeds, or also trying FemSeven Conti, but her recommendation was Mirena coil plus oestrogen patches. She said it's the absolute best thing to thin the womb lining and hopefully stop the post meno bleeding.

Having done research, it looks like that might be the best option for me. I asked whether the fact I haven't given birth might hinder insertion, but she said it should be fine if I stay relaxed, and if I'm having sex, and have no problems when I have smears, then insertion of Mirena shouldn't give me any problems.

There's a clinic in October when she could do it, and she thinks my scan appointment will be very quick, so has sent me away to do research and take it from there. Providing my scans are OK, I think I'm going to go for it.

Experiences and comments welcome. I had a little trawl around the forums, but thought a new thread would keep all the info together for my own reference.

Thanks for reading.

[Hurdity]

Hi flossie fiddler - I remember you yes but can't remember your story. Hello! Sorry to hear about your ongoing symptoms and bleeding.

Yes important first to identify what might be causing the bleeding to rule out any abnormal reason, but if all OK on that score then you have to decide your options.

The Mirena coil is definitely the most recommended option as your gynae says, and if you are fine with synthetic progestogens - which sounds like you are, then hopefully you would be fine with the Mirena. The other alternative is to accept the bleeds and take the progestogen cyclically (which could be Utrogestan, or Provera) - which is what I and some others do eg sheila99. This is due to side effects from progesterone - the groggy feeling you mention which for me occurs even when taking it vaginally, due to systemic absorption. Bleeding into your 60s and 70s though is not for the faint-hearted but unfortunately there is no other option if you don't want a Mirena and don't want to take progesterone continuously

Hopefully others will be along with their Mirena experiences....

Hurdity x

[flossie fiddler]

Thanks, Hurdity. I’m absolutely fine with synthetic - I was on to for 6 years previously, and it was part of the contraceptive pill I was on for 24 years. The switch to Utrogestan was because of the bleeding, in the hope that a different type might help, which it hasn’t.

Hopefully there’s nothing untoward but even if there is, best to get things sorted.

Fingers crossed, and hopefully I can have the Mirena. I’m not fazed by a sequential routine, but if I can cope with the IUD, I think that’s what I’d prefer, having done a bit of research.

[Yam900]

I was dogged by post menopausal bleeding after I started hrt. I gave up for a while but felt blasted awful so I tried a new approach.
I used to use/ take both my sandrena gel last thing at night I still use my sandrena gel last thing at night but started taking the utrogestan earlier on in the evening whilst I'm still eating and drinking. I'm not sure if I'm digesting it better but no bleeds since.

[flossie fiddler]

Yam900 That’s interesting, thanks. I’m really strict with the not eating, because I know that taking it with food can increase absorption so maybe that’s what’s happening with you.

I could try that, but as I’m getting progesterone side effects like fatigue, headaches, heartburn, low level cramps and low mood, the last thing I need is increased absorption. It’s such a balancing act, isn’t it?

I have my ultrasound scans on 25th Sept, so will take things from there. I think if there’s nothing untoward, I will try the Mirena.