Print

Please login or register.
1 Hour 1 Day 1 Week 1 Month Forever
Login with username, password and session length

[Bedscabbie]

Started bleeding back in August - 4yrs into meno. Various tests have ruled out most things but I continue to bleed for 4-5 days every 2-3 wks. I was presented with 3 options - do nothing, hysterectomy or mirena - put in a couple of days ago. Still haven't got the pain under control despite maxing out on heavy painkillers & it feels like uterus is in permanent spasm. Wanting mirena to be the solution but don't know how long I can cope with this. Had 4 mirenas previously for contraception & heavy bleeding but gp wouldn't replace any more as I was too old. Anybody else had similar issues? Or can suggest strategies?

[Bedscabbie]

Also have sphincter of oddi dysfunction type 2 & have had gall bladder & bile duct surgery & now having pancreatic problems - anyone else have all this to put up with?

[peri]

I didn't realize there was an age limit on having a mirena Bedscabbie, I'm 52 and I've got one x

[Cazikins]

You may be too old to have the mirena for contraception but it is ok as the progesterone part of HRT.

Please see below the info, which is taken from the Treatment option section at the top of the page

"Mirena is a levonorgestrel (type of progestogen) releasing system which sits inside the womb, gradually releasing the progestogen into the womb. It is licensed in the UK and Ireland as a contraceptive agent, for treatment of heavy periods and, from August 2004, also for the progestogen component of HRT. It can be used in both the perimenopause and postmenopause and it is particularly useful for:

Persistent progestogenic side effects from systemic HRT despite changes in type and route of progestogen.
When contraception is required along with HRT in the perimenopause.
When withdrawal bleeds on sequential HRT are heavy, after investigation if indicated. (see WHEN TO BE REFERRED )
With Mirena in place, systemic estrogen alone can be taken as the Mirena provides adequate protection of the womb lining and the estrogen dose and route can be tailored to meet the individual's needs.

Progestogenic absorption throughout the body is minimal so reducing progestogenic side effects. The effect of Mirena on the womb lining can significantly reduce bleeding and when used as part of an HRT regimen, in time, 30 to 60% of women have no bleeding at all. Although Mirena used for contraception is licensed for 5 years, the license for use for the progestogen part of HRT is currently 4 years."

[Hurdity]

Hi Bedscabbie

 

That is a lot of bleeding for being that long into menopause! If you have reached menopause and been 12 months without a bleed then any bleeding after that should be investigated - but you have been 4 years. Did you have a scan/hysteroscopy at all to check whether anything was wrong, before having the Mirena fitted? You haven't said how old you are but Mirena is usually given for heavy bleeding during the fertile years and peri-menopause, not after menopause - but as Cazikins says it can be used as the progestogen part of HRT along with oestrogen once you've reached menopause.

Hurdity x

[Bedscabbie]

I'm 55 &'had ultrasound & hysteroscopy before being presented with 3 options : do nothing & put up with bleeding (dr wouldn't recommend this), mirena or hysterectomy (which I would like to avoid).
I had been asking my gp about another mirena but she couldn't/wouldn't do it herself as I'm too old for her to do it for contraception which it is licensed for & so I was referred to gynae under 2 week rule.
Hysteroscopy & biopsy were excruciatingly painful but at least it ruled out problems, but of course the bleeding continued every 2-3 weeks with what feels like right sided ovarian pain.
So I had mirena on Wednesday - what a bloody mess! (Literally) & it feels like uterus is still in spasm. Taking mefenamic acid & naproxen (not together) along side my regular meds. Just hoping things settle down soon as I really think it is the best solution for me.

[peri]

So do I Bedscabbie and I hope it works for you, keep us posted x

[Hurdity]

Thanks for the info Bedscabbie - and sorry to hear about your ongoing pain.

As you had Mirenas before for heavy bleeding and contraception - I am interested to know how you dated your menopause if you had a Mirena. Are you counting 4 years from when your periods stopped with the Mirena in? If so then you will most likely not have been at menopause then - apologies if you know this already and have dated it from complete absence of periods without Mirena. How long had you been without a Mirena following the GP saying they wouldn't give you another, and had the other one been in for some time? Although the average age of meno is around 51 and 80% of women have reached meno by 54 - there is still the 20 % who don't so if you have only recently stopped the Mirena then maybe you are not yet at menopause? There are a few late menopausers on here! Have you had blood tests to see if you have any ovarian function? I'm probably going off on an unnecessary scenario here - but these things just occurred to me.

Do you have any menopausal symptoms like flushes and sweats or mood changes?

Hurdity x

[Bedscabbie]

I was diagnosed by blood tests as otherwise we'd be none the wiser! Blood tests done in 2012 (aged51) were inconclusive but repeated again in 2013 showed I was definitely menopausal. I had first pmb in 2014 & was referred to gynae for investigation & all was clear. Then pmb started again in August 2016 & continued every 2-3 weeks since. At one stage I counted up bleeding on 23 out of 56 days.

[Bedscabbie]

The flushing & sweating last year was so bad that I had to change my top at work halfway through the morning! Which apparently could be down to hormones, infection or pancreas. So then I was started on Livial - but I bled continually on that so switched to Evorel patch in April. Finally I started feeling like my old self again. Ok then for 5 months when bleeding started again - this time with what felt like right sided ovarian pain. So referall back to local hospital.

[Hurdity]

OK - the first thing is you cannot diagnose that someone is post-menopause from blood tests alone - FSH is very variable and can go into the post-menopausal range even while in peri-menopause:

"Home kits can be used to check for a raised FSH in a urine test, and you can have a blood test to measure the level, however the level depends on the phase of the cycle and can vary by a factor of 10-30 or more during the menstrual cycle. If having a blood level measured, the blood sample should be taken on the 3rd to 5th day of a period. A normal level does not exclude early menopausal transition and a raised level does not exclude continuing ovarian function. One raised level should therefore not be relied upon as a reason to stop using contraception since egg release can still occur late in the menopausal transition."

http://www.menopausematters.co.uk/diagnose.php

Women on here have been diagnosed as post-menopausal on the basis of FSH levels - even after only skipping one period! One woman was told she would be unlikely ever to have another period ( having just missed one) which was traumatic for her - in fact she was just at the beginning of peri-menopause!

So when you had the bleeds in 2014 and 2016 - did you have a Mirena in? If so then you were most likely not post-menopausal when you were told you were in 2013. I am amazed that there seems to be such inconsistency and lack of knowledge about this - after all the information is readily available. The only way you can tell if you are post-menopausal is to have 12 months without bleeding and without being on any form of HRT/Mirena. Alternatively to assume it is likely once you have reached a certain age/stage after periods first became irregular.

If you did have a Mirena in 2014 and had a bleed - then this could just have been what would have been a particularly heavy period if you did not have the Mirena - which often happens during peri-menopause (very heavy bleeding) - ie not PMB after all!!! Sounds like you might have been given a lot of unnecessary worry - although i can see that sudden bleeding with a Mirena when you hadn't done so before could be concerning - but women going through natural menopause do not get investigated for sudden bleeds - only if 12 months has passed without one. With a Mirena, the cessation of periods is not the natural state if you see what I mean?

In your position - I would either go for another Mirena - they have to refer you if you want this for HRT, and then use a patch oestrogen as you have been doing - eg Estradot (smaller than Evorel), or try one of the sequential HRT types which should cause a predictable bleed every 4 weeks - such as Evorel sequi or better still Femseven sequi which is better tolerated.

I hope this is helpful and not confusing - but women who have had Mirenas are in a different position re menopause than those who don't regarding knowing where they are in menopause!

Hurdity x

[Bedscabbie]

Think my previous mirena was removed in 2013?
Still lots of cramping spamming pain despite maxing my painkillers but desperate for it to settle down otherwise Drs will want to take the easy solution & simply remove it.
Otherwise not keen on having another mirena after the trauma of this one - a nicked blood vessel and blood everywhere was not much fun.