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[Emo10]

Yeah, if 2 pumps made it worse my guess was that I might need something else to manage my symptoms. I did start with the mirena and hrt at the same time so didn't give the mirena a chance on it's own.

It might sound odd but I am pretty certain there were months I didn't ovulate (based on my symptom monitoring). It almost felt like that oestrogen reignited my ovaries because for a while it really evened me out but then suddenly got too much.

[CrispyChick]

Ladies

As I understand it, taking bioidentical prog, like utrogestan whilst on the mirena will be fruitless as both the progesterone and progestin will compete for the same receptor sites. 

[joziel]

But doesn't that depend on whether the levonorgestrel in the Mirena gets into the system much or stays local in the uterus?

[CrispyChick]

Probably. But I think it likely does get into the system.

[joziel]

Emo, are you on the Mirena for heavy bleeding or unpredictable/uncontrolled bleeding? Or just because it appealed to you for other reasons?

It would be difficult to recommend you coming off if you went on for bleeding because it does control bleeding really well and because utrogestan often doesn't, if women are prone to having bleeding issues on HRT.

But if you went on it just because you liked the convenience or something, you could try switching to utrogestan. If you want to try the utrgoestan-only thing, get the book by Lara Briden called Hormone Repair Manual. And know that your GP may resist this with "computer says no" because it's not a way they really use it, by itself, in the UK. So you might need to at least accept a script for estrogen and then just get the progesterone...

[Emo10]

Joziel, my Mirena was to control my heavy, long and increasingly frequent periods. It has done that and I'm now at frequent spotting but very light which is the lesser of two evils.

I still might consider swapping my progesterone depending on what happens symptom wise moving forward. I can still tell my symptoms are cyclical and worse in the second half so will keep monitoring that.

[joziel]

You can try asking to add in utrogestan as well with your Mirena. It won't do any harm for you to also take utrogestan. If the reasoning explained by CrispyChick is right, then it might not help you - but it's not going to make things any worse.

You would just need to convince a GP to prescribe you utrogestan when you already have a Mirena...