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[awake and nervous]

Hi all

My menopause journey continues and I’m looking for a bit reassurance about having a coil fitted for the first time at the age of 61 as an alternative way of delivering progesterone.

A bit of background - sorry it’s so lengthy!

I have been post meno for around 5 years. I’ve been on oral HRT for 10 years to control debilitating flushes: sequential for the first 4-5 years, then continuous after bleeds stopped on sequential. I’ve gradually reduced the dose over time and latterly was on Femoston-conti 0.5 mg/2.5 mg. No issues at all on this regime over the past 10 years.

However, at last prescription renewal in June of this year, a different GP at the practice suggested I try bio-identical HRT and I started Estraderm MX50 patches and Utrogestan 100.

Unfortunately I didn’t tolerate it at all well and within a week was suffering full on side effects - breast tenderness, fluid retention, lethargy, short temper, and feeling down and a bit ‘out of it’. Due to supply issues, the Utrogestan ran out while I was on holiday, so I had 5 days without HRT. Once home again I had an unexpected bleed - my first in over 5 years! This was just like a period, ie with cramps, and  tailed off after 5-6 days. After a phone consult, I took a break of three weeks, then started on Evorel Conti 50 patches. I felt better on the Evorel, but after 3 weeks I had another unexpected bleed for 4-5 days. Then 11 days later another bleed for 2-3 days.

I had another phone consult and finally a face to face appointment with yet another GP. She thought the bleeds were most likely reaction to the change in HRT, but given my age and the length of time I’ve been on HRT, she made an appointment for me to have an ultrasound and advised me to stop HRT for the time being.

The ultrasound revealed my endometrium was 4mm with thickening to 6mm around the cervix. At the follow up phone consult, GP referred me to Gynae at the hospital, to see if further investigation was required. She also asked how I was getting on without HRT. I told her I’d had no further bleeds since stopping and felt better in myself, but that my flushes had returned and while (currently) not as frequent as they were 10 years ago, they are pretty intense when they happen! For this reason, I am keen to get back on continuous HRT if at all possible.

At my Gynae appointment the consultant recommended an endometrial biopsy (I think during a hysteroscopy?) to make sure there is nothing else going on. At the same time, he recommended I have a coil fitted as he believed this would be the best way to deliver progesterone where it is needed and to prevent further bleeds in the future. Estrogen component would probably be gel.

I have asked for general anaesthetic as I have never had children and also have vaginal atrophy. Procedure should be early next year.

So…

Has anyone ever had a coil fitted for the first time so late in life?

If so, how did you get on?

Thanks for reading.

[Ceebee]

I have no experience with a coil but was there a reason why you didn't go back to Femoston Conti if there were no issues with it for so long? (I am in my late 60s and on Evorel Conti.)

[awake and nervous]

I have no experience with a coil but was there a reason why you didn't go back to Femoston Conti if there were no issues with it for so long? (I am in my late 60s and on Evorel Conti.)

@Ceebee
My GP was trying me on bioidentical HRT because it’s meant to be a more ‘natural’ solution (reduced risk factors) and I’d been on synthetic HRT for over 10 years. My understanding is that the thickening of my endometrium was likely in part due to the HRT I’d been on, and that the thickening is not ideal because of greater risk of tumours forming, etc. To be honest, the excellent support I had from my regular GP kind of fell apart after lockdown. I haven’t actually managed to have an appointment with him since 2019. He knew my history and we were on the same page with where I was going on the HRT journey. Since May this year, I’ve had phone consultations with 3 different GPs at the practice (none of them my old regular GP) each very understanding but with a slightly different take on my situation. And my only face to face consultation was with the third one who, while lovely and very professional, was obviously busy and doing things very much by the book.
 

[Dazedandconfused]

Hi awake and nervous, I'm 60 and had a Mirena fitted just over a month ago, so far, so good 

Before it was fitted I had had a rather sudden and dramatic bleeding episode which was investigated with a TV scan, two week pathway etc.  My lining was a bit thick so I had a biopsy.  All was clear but gynae thought I probably wasn't absorbing Utrogestan very well so suggested the coil. 

I had a long chat to menopause nurse at my surgery as I'd never had a coil before.  She answered all my questions, allayed my concerns and fitted the coil a few days later.  It wasn't a pleasant experience but I wouldn't say it was particularly painful, just uncomfortable. 

So far, and I don't want to tempt fate here, it's been great.  I've had no more bleeding, only some very slight spotting, which is almost non-existent.  Apart from the first couple of days of minor cramps, I wouldn't even know it's there.  The only downside is that I stopped HRT while the investigations were being done, which amounted to about a month from start to finish.  I'm going through the tender boobs at the moment from restarting but other than that, all good.  It's early days but I'm keeping everything crossed that it's going to work for me.

[Tinkerbell]

Not first time but I had my second Mirena fitted when I was 59. I plan to get one after that when it needs replacing in 3.5 years time. I had both when post meno.

[Suziemc]

Not quite the same situation but I had coil fitted two months before my 60th birthday. I've also had two kids but thought I'd share my experience in case it helps.
I'm 10 years post meno, started HRT late (when 58) and experienced post menopausal bleeding 10mths in. TVS showed slightly thickened endometrium so hysteroscopy and biopsy arranged and Mirena suggested to prevent further thickening (I'd been taking Utrogestan)

 I'd had a coil back in the 80s and didn't get on with it at  the time so it was removed after a few months.  The gynaecologist and nurse both reassured me that not the same as back then so I decided to go for it. As Dazedandconfused said, not exactly a pleasant experience but just uncomfortable, not dissimilar to having a smear, with the odd pinching!  But some of that was the biopsy being taken.

Afterwards I had absolutely no pain or cramping. I did have spotting for about four months. It wasn't constant and got less and less over time. Now I wouldn't know it's there and would definitely make the same decision if I had to make it again.

Oh and my estrogen is Oestrogel which suits me fine 🙂

[awake and nervous]

Hi Dazedandconfused

Thanks for this. So glad to hear such a positive outcome for you. Hope my experience will be the same :-)
Like you, I guess I’ll have to be prepared to ‘start again’ once on the new regime as I’ve now been offf HRT for 3 months. But I can handle that if the long term outcome is going to be better for me!

Hi awake and nervous, I'm 60 and had a Mirena fitted just over a month ago, so far, so good 

Before it was fitted I had had a rather sudden and dramatic bleeding episode which was investigated with a TV scan, two week pathway etc.  My lining was a bit thick so I had a biopsy.  All was clear but gynae thought I probably wasn't absorbing Utrogestan very well so suggested the coil. 

I had a long chat to menopause nurse at my surgery as I'd never had a coil before.  She answered all my questions, allayed my concerns and fitted the coil a few days later.  It wasn't a pleasant experience but I wouldn't say it was particularly painful, just uncomfortable. 

So far, and I don't want to tempt fate here, it's been great.  I've had no more bleeding, only some very slight spotting, which is almost non-existent.  Apart from the first couple of days of minor cramps, I wouldn't even know it's there.  The only downside is that I stopped HRT while the investigations were being done, which amounted to about a month from start to finish.  I'm going through the tender boobs at the moment from restarting but other than that, all good.  It's early days but I'm keeping everything crossed that it's going to work for me.

[awake and nervous]

Hi Tinkerbell

Thanks - and good to know you’re doing well with the coil.

I’ve been told the coil can stay in for 5 years, then it will be removed. The consultant did say I wouldn’t get another one after that so just hope that by then the hot flushes have gone!

Not first time but I had my second Mirena fitted when I was 59. I plan to get one after that when it needs replacing in 3.5 years time. I had both when post meno.

[awake and nervous]

Hi Suziemc

And thanks for sharing your experience. I had read that the coil is much better than it was and that most, though not all, women do well on it. But it’s good to hear it from other women :-)

I think it will likely be Oestrogel for me too.

I have heard that women like me, who haven’t had children, can find the experience of having the coil fitted extremely painful. So I’m glad I’ll be knocked out for it!

Not quite the same situation but I had coil fitted two months before my 60th birthday. I've also had two kids but thought I'd share my experience in case it helps.
I'm 10 years post meno, started HRT late (when 58) and experienced post menopausal bleeding 10mths in. TVS showed slightly thickened endometrium so hysteroscopy and biopsy arranged and Mirena suggested to prevent further thickening (I'd been taking Utrogestan)

 I'd had a coil back in the 80s and didn't get on with it at  the time so it was removed after a few months.  The gynaecologist and nurse both reassured me that not the same as back then so I decided to go for it. As Dazedandconfused said, not exactly a pleasant experience but just uncomfortable, not dissimilar to having a smear, with the odd pinching!  But some of that was the biopsy being taken.

Afterwards I had absolutely no pain or cramping. I did have spotting for about four months. It wasn't constant and got less and less over time. Now I wouldn't know it's there and would definitely make the same decision if I had to make it again.

Oh and my estrogen is Oestrogel which suits me fine 🙂