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[Holsy]

Good Morning all

Is anyone taking evorel conti with the mirena coil? I've had the coil fitted for 15 years due to be changed this year, or so I thought. I first had it fitted due to extremely heavy periods because of fibroids. I started on evorel 50 in 2019 aged 49, which took a while to settle down after having so many menopause symptoms.
Over the last couple of months my hot flushes, anxiety and lack of sleep started to edge back in, so wondered if it was because the coil perhaps was coming to the end of it's life and needed to be replaced. There were also some other issues going on in my life which could also have been contributing. But I arranged for the coil to be replaced anyway. The doctor said that the coil is now licenced for 8 years and not 5 and should keep it in but try evorel conti instead. I queried the double amount of progesterone but she said it wasn't an issue. I'm really not sure. Everything was fine with the coil and evorel 50.
Is anyone else taking this combination? Wonder if I should just push to get the coil replaced, which she did say she would do if I wasn't happy on the conti.
All advice appreciated.

[Dotty]

Hi if symptoms have come back it’s likely that you need more oestrogen not more progesterone. You could increase to a 75 patch.

The Mirena has been extended to 8 years for contraception but not for endometrial protection .

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

[sheila99]

I agree with Dotty, it's more likely you need more oestrogen. Evorel conti only comes in 50mcg but if you have a mirena you could use a 75 oestrogen only patch with it.

[Holsy]

Thanks Dotty & Sheila99
I did query needing more oestrogen instead but she said progesterone. It's really frustrating..... as at all hrt reviews, I've been told I need to stay on as low a dose as possible and they're reluctant to increase it.
So am I reading that report correctly, that I should have the coil replaced as I'm using it with oestrogen? 

[Holsy]

Or would it be better to just have the coil removed and hope that the fibroids are not going to cause any further issues?

I keep reading conflicting advice on the nhs, menopause pages etc

[GraceM]

If you stayed on evorel and the coil is 5 years old, you would have to take an alternative progesterone as the coil is not effective for hrt purposes once its in 5 years (some say it needs changing after 4 years now for hrt purposes).  I would have chosen utrogestan tablets as at least its a body identical progesterone, whereas the coil and the progestin in the evorel conti are both synthetic. Alternatively get the coil changed, and then you can take the evorel patch as you were, with the option to increase the dose. 

[Holsy]

Thanks GraceM
I have just spoken to my pharmacist who was really helpful and explained the different levels of progesterone in the coil and the evorel conti. So I have arranged another doctors appointment to have the coil replaced, which I should have done in the first place rather than be talked out of it.

I will take a look at utrogestan tablets as my appointment is not for a while. Although I do need the coil for my fibroids, I think, I could do with a scan to check if they are still an issue, but the doctor won't send me for a scan unless they're causing me an issue.

Just reluctant to change things as it took me so long to get to a point of feeling normalish again after trying various hrt treatments.