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[ann58]

I have been using a mirena coil as the progesterone part of hrt and had an oestrogen patch. I stopped the patch a couple of weeks ago and had the coil removed last Monday.
I am 7 years post meno and 61. I haven't stopped bleeding since the coil was removed. Does this sound normal?

[KiltedCupid]

ann58 - do you mean Monday of this week? If so, I really wouldn't worry. Even if it was Monday of last week, I wouldn't worry. The Mirena is a very efficient, in situ prog, and you just withdrawn in, there will be bleeding. You asked me on another thread how long post meno I was when I had mine removed. I've had 2 and about 3 years post meno when the first one was removed. I don't remember heavy bleeding with that but the 2nd one I had heavy bleeding for at least a week. The only difference between the 2 is that the first one was put in straight after being on Elleste conti so I was switching from a conti regime with no bleeds but the 2nd one was going from and Oestrogel Utro sequi regime where I was less than strict with the Utro so it may have been a result of that. It could be that your coil was running out of steam before you had it removed and possibly not as efficient as when first fitted and you've therefor built up a bit of lining which is now coming away.

How long have you been bleeding?

[ann58]

My coil was changed in May so I had only had it for about 6 months (Previous one for almost 5 years)
Yes Monday just gone. I had a slight bleed straight after then nothing on Tuesday and started bleeding more on Wednesday.  It isn't a heavy bleed just medium.

[KiltedCupid]

ann58 - the straight after removal bleed is normal and the fact it took a couple of days for the other bleed to start would indicate it's prog withdrawal. I really wouldn't worry just now, if you're still bleeding a week or so after removal, call your gp for reassurance but post removal bleeding is normal.

[ann58]

Thank you for your reply, you have helped to reassure me 

[Hurdity]

Hi ann58

Yes I asked you some questions on your other thread!

Just to recap what I said on that thread - you would not expect to have any progesterone withdrawal bleeding unless there had been some lining build-up while taking HRT, and this would only be likely to happen on higher doses of oestrogen or possibly also if you have another condition eg possibly fibroids or a polyp, I would have thought. As you are 7 years post-menopausal and the Mirena was recent (and also I think you were only on a low/medium dose of oestrogen?) then maybe worth visiting your doc just to check out in any case? In other words if it is progesterone withdrawal bleeding you would ideally want to check that your lining has thinned out properly after the bleed - as it means it has built up while on this HRT?

The other suggestion was that the bleeding was due to trauma ie the physical act of taking it out which I presume is a little invasive? If you are on low/medium dose of oestrogen then maybe you have some VA ie thinning of tissues which might be fragile and could have been temporarily injured during the process leading to bleeding? A doc would be able to tell you?

Sorry can't remember your oestrogen dose? Interestingly you can also get bleeding/spotting after Mirena insertion with low oestrogen doses due to overthinning of the uterus. However you would have expected this some weeks or months after insertion and if the lining was already thin, but not only after removal if you see what I mean?

Anyway I hope these explanations and suggestions are helpful - just really saying there could be several reasons for the bleeding, but very unlikely to be worrying!

Hurdity x

[KiltedCupid]

Thank you for your reply, you have helped to reassure me 

No problem ann58 - how are you today?

[ann58]

Hurdity Thank you for your reply. I had totally forgot I had asked the same question on the other thread. I'm blaming that on the stroke as I have had trouble remembering things since
I had a mirena for almost 6 years in total. I was on 50mcg oestrogen but reduced it over the last month and removed it completely the same day as the coil.
I do have a fibroid which was only 2cm at my last ultrasound in 2017 but at a recent mri it was showing 5cm. My gp has referred me for another ultrasound and I called to ask about the bleeding. she said it's normal to bleed for up to 2 weeks after removal.

[KiltedCupid]

ann58 - really pleased to hear your gp reassured you and organised a scan. You've got a good one there. Hope things are now settling after the removal.

[ann58]

It's one week today and still bleeding. Hope it stops by next week. I could do without this on top of everything else.

[KiltedCupid]

Yes, I'm sure you've had enough of it. At least your doc is on board and will keep you monitored. It might have something to do with the fibroid but they'll know more at your scan so all will make sense then. Hope you're taking things easy in the meantime.

[Hurdity]

Hurdity Thank you for your reply. I had totally forgot I had asked the same question on the other thread. I'm blaming that on the stroke as I have had trouble remembering things since
I had a mirena for almost 6 years in total. I was on 50mcg oestrogen but reduced it over the last month and removed it completely the same day as the coil.
I do have a fibroid which was only 2cm at my last ultrasound in 2017 but at a recent mri it was showing 5cm. My gp has referred me for another ultrasound and I called to ask about the bleeding. she said it's normal to bleed for up to 2 weeks after removal.

No problem re forgetting - quite understandable!

If you've had the same Mirena in for 6 years then this could account for the bleeding after removal - because the progestogen may be running low so not quite sufficient to protect your uterus and therefore it has thickened slightly due to the medium dose oestrogen patch. In this case it would be a progesterone withdrawal bleed. The Mirena should be changed after 4 years for HRT ( some gynaes allow 5 years) for endometrial protection.

Anyone reading this who has a Mirena and HRT must make sure they get it changed regularly as required. It seems some docs are a bit lax about this.....

In addition if your fibroid has grown from 2 cm to 5 cm while using the HRT this tends to indicate that the progestogen was "running out" and the oestrogen causing the fibroid to grow and this could make the bleeding worse.

So - it's good that your doc has ordered another scan - to check on the thickness of your lining and presumably the fibroid too?

Let's hope it eases soon - will your scan be soon - I hope so? Let us know how it goes!

Hurdity x

[ann58]

Hurdity This was my second mirena coil and it was only in for one year so I would have thought the progesterone would have still been quite strong.
It is 2 weeks since I had it removed and still some bleeding but very slight now.
I am still waiting for an appointment for ultrasound scan.

[Dollydream]

Hi Ann

I had a mirena removed which was being used alongside oestrogel as an HRT regime - I have stopped HRT now.  It was removed at a hysteroscopy investigation and the bleeding lasted almost 2 weeks after.  I thought that the bleeding may have been caused by the hysteroscopy, but this was the 2nd hysteroscopy procedure that I'd had and I didn't bleed much with the first, so I can only put it down to the mirena removal.  Let us know how you get on with your scan.

Dolly x

[ann58]

Thank you Dolly. So far no bleeding today. Still waiting for scan appointment.