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[Orba]

Hi  everyone,
So, a few months ago I had a recurrent UTI and after many antibiotics it went. I saw a urologist who ruled out bladder cancer and recommended daily antibiotics if it starts again. I mentioned to him I was also getting period type pains / pelvic pain  but he said this was a Gynae issue.
My GP referred me to Gynae and I eventually saw someone last week after a 4 month wait. I had a normal ultrasound.
The consultant did the usual internal exam then   said I had a mild cystocele but he felt my period type pains were being caused by the mirena I was using for the progesterone element of my HRT . I have had the coil in place for 2 years and it is still in situ.
I asked him why it would suddenly start causing pain after 2 years  and he said the womb needs a rest and maybe I'm using too much HRT !!!
I use 2 pumps of oestradiol daily.
I'm bemused to say the least . Can this happen ? Has anyone else developed problems with Mirena after it's been in a while ?
He suggested having it removed and using patches but the reason I had the combination I did was because the patches caused bad cramps and bleeding.
My NHS appointment lasted with the consultant lasted about 10 mins  and I felt rushed , I m not sure about this diagnosis as if the coil hasn't moved. Then why is there pain ?   Thoughts appreciated x

[joziel]

Well it's one of those weird situations where you won't know unless you try. If it's removed and the pain goes, then you know it was that...

You can always get another one put in again if the pain doesn't go.

There are other ways to deal with the bleeding. Not combined patches, but higher doses of utrogestan and perhaps adding in a POP like desogestrel as well.

[Orba]

Well it's one of those weird situations where you won't know unless you try. If it's removed and the pain goes, then you know it was that...

You can always get another one put in again if the pain doesn't go.

There are other ways to deal with the bleeding. Not combined patches, but higher doses of utrogestan and perhaps adding in a POP like desogestrel as well.

Yes , I did think that but I found the insertion painful so would have to be prepared to go thru it again but as you say only one way to find out . . .
Thanks for input

[Mary G]

I used to get the odd cramping feeling but I did used to get a lot of infections.  Every year my smear test would flag up an infection of some kind but that stopped when I had the coil removed. 

I also suffered with a lot of vaginal itching and burning but that could have been caused by low oestrogen.

If you get on well with it overall, I would stick with it or you could consider a lower dose coil like the Kyleena or the Jaydess which might be more tolerable.

[joziel]

The lower dose coils aren't approved for HRT progestin use though. Although they might well work, for many women. You'd need to do some scans for a while to check. I think they are smaller though, so they might cause less discomfort.

The Mirena needs to be replaced after 5 years anyway, so you're only saving 3 years if you stick it out now anyway....

[Mary G]

You can have a lower dose progesterone coil fitted off licence as long as you have regular scans - it's better and safer to have regular scans anyway.

For someone who is progesterone intolerant or experiencing problems with the Mirena it's definitely worth considering.  This is some information from Chelsea and Westminster menopause clinic:

https://www.chelwest.nhs.uk/your-visit/patient-leaflets/medicine-services/levonorgestrel-intrauterine-system-with-hormone-replacement-therapy