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[MsUlysses]

Please help.

My merina coil has expired, and they can't get it out to replace it. Cervix clamped shut apparently, 3 tries and no luck but a lot of bleeding.

I was doing well on the estrogen only patch with the coil, so was then started on oral progesterone for endometrial protection. I got sore, very itchy breasts. I talked to the gynaecologist and she says to reduce the patch, I did, menopause symptoms started to return. Talked to the GP, she's says take the progesterone vaginally. Not been doing it long enough to see the benefits.

So, I'm 49 and no idea when I last had a period and now I've no contraception cover. Not ideal.

I'm waiting for an NHS appointment to replace the coil under anesthetic but who knows how long that will take. I can get a private appointment but not for 6 weeks or so and at a considerable cost (£1500).

I'm a bit at my wits end. Tearful and sore. Any help, thoughts or suggestions welcome.

Combined patch any better than oral progesterone for side effects? What to do about contraception? Should I use sequential hrt? Should I get the coil replacement asap?

Thank you.

[Dotty]

How long have you had this coil ?

[MsUlysses]

It expired, after 5 years, last November.

[Dotty]

The Mirena has now been extended up to 8 years for contraception, but it’s still 4 years for endometrial protection.

[Mary G]

First of all, I really wouldn't worry about it.

I had my first Mirena coil in place from 1998 to 2005 (7 years) and it was perfectly OK.  I was 44, nearly post menopause, using a 50mcg patch and the gynaecologist who did my transvaginal scan said it was absolutely fine and the womb lining was very thin.

Mirena coils don't run out of steam immediately and you don't need to panic bang on 5 years.  I kept mine in for 7 years and to be honest, I felt better when it was churning out a lower dose.  A lot of women now opt for the lower dose Kyleena coil because they find it more tolerable - they have regular scans to make sure.

I've attached the doses of both the Mirena and the Kyleena coils and you will see the reducing dose on a year by year basis:

https://www.drugs.com/dosage/mirena.html#:~:text=Dosing%20Over%20Time,mcg%2Fday%20after%208%20years.

https://www.drugs.com/dosage/kyleena.html

I would do nothing, wait for the appointment and I definitely wouldn't stop/reduce HRT or take extra progesterone.  You don't need to worry about contraception either.

[Tinkerbell]

Dotty - I got a text recently from my GP surgery saying that the Mirena could now stay in for 5 years for HRT purposes.

[Dotty]

Hi Tinkerbell.. have a look at this info from the BMS.



https://thebms.org.uk/2024/01/mirena-extended-licence-for-contraception/#:~:text=Mirena%20is%20a%2052mg%20Levonorgestrel,endometrial%20protection%20(4%20years).

Although Dr Louise Newson does say 5 years.

[MsUlysses]

The Mirena has now been extended up to 8 years for contraception, but it’s still 4 years for endometrial protection.

The GP has put me on the progesterone for endometrial protection but it's just messing with everything.

[MsUlysses]

First of all, I really wouldn't worry about it.

I had my first Mirena coil in place from 1998 to 2005 (7 years) and it was perfectly OK.  I was 44, nearly post menopause, using a 50mcg patch and the gynaecologist who did my transvaginal scan said it was absolutely fine and the womb lining was very thin.

Mirena coils don't run out of steam immediately and you don't need to panic bang on 5 years.  I kept mine in for 7 years and to be honest, I felt better when it was churning out a lower dose.  A lot of women now opt for the lower dose Kyleena coil because they find it more tolerable - they have regular scans to make sure.

I've attached the doses of both the Mirena and the Kyleena coils and you will see the reducing dose on a year by year basis:

https://www.drugs.com/dosage/mirena.html#:~:text=Dosing%20Over%20Time,mcg%2Fday%20after%208%20years.

https://www.drugs.com/dosage/kyleena.html

I would do nothing, wait for the appointment and I definitely wouldn't stop/reduce HRT or take extra progesterone.  You don't need to worry about contraception either.

Thanks Mary, that's useful advice. I think I'll just come off the progesterone and wait for the NHS appointment. If contraception is ok for a while yet, and there's some residual endometrial protection I can live with it for the year it might take to be seen. So sick of feeling sick.

[MsUlysses]

The NHS are now saying 6 years, or ten if you were over 45 when it was inserted for contraception. https://sh24.org.uk/help-centre/update-coil-guidelines

[Mary G]

First of all, I really wouldn't worry about it.

I had my first Mirena coil in place from 1998 to 2005 (7 years) and it was perfectly OK.  I was 44, nearly post menopause, using a 50mcg patch and the gynaecologist who did my transvaginal scan said it was absolutely fine and the womb lining was very thin.

Mirena coils don't run out of steam immediately and you don't need to panic bang on 5 years.  I kept mine in for 7 years and to be honest, I felt better when it was churning out a lower dose.  A lot of women now opt for the lower dose Kyleena coil because they find it more tolerable - they have regular scans to make sure.

I've attached the doses of both the Mirena and the Kyleena coils and you will see the reducing dose on a year by year basis:

https://www.drugs.com/dosage/mirena.html#:~:text=Dosing%20Over%20Time,mcg%2Fday%20after%208%20years.

https://www.drugs.com/dosage/kyleena.html

I would do nothing, wait for the appointment and I definitely wouldn't stop/reduce HRT or take extra progesterone.  You don't need to worry about contraception either.

Thanks Mary, that's useful advice. I think I'll just come off the progesterone and wait for the NHS appointment. If contraception is ok for a while yet, and there's some residual endometrial protection I can live with it for the year it might take to be seen. So sick of feeling sick.

I think that's a good decision.  Hopefully you won't have to wait more than a year.