Mirena working overtime, HRT?

[FlindersKeepers]

Hi everyone, I’m new on this board so first off, hello.

I’m 45, in Germany and my insurance allows me to go straight to a gynaecologist.
Last week I went in for a check-up with a new doctor as I'd been having disturbed sleep and night sweats. I’m on my second Mirena (2009-2014, 2014 to now), has a history of PCOS and had fibroids removed by laser surgery in 2014.

My Dr did an ultrasound which was mostly OK (tiny cysts on one ovary) and also did a full hormone blood screen, thinking that all was probably ok.
The results came back and my new gyno called a specialist at the local teaching hospital. According to him, the Mirena is working too well and has shut down my ovaries, so I'm in a temporary menopause. Great.

He's given me oestrogen gel (Gynokadin) and progestin (utrogestan) capsules, both are lower doses but still it is HRT with the mirena still in place. He says to take/use them daily for 6 weeks then come back for another set of bloods.

I'd been having virtually no periods, but my old gyno told me that was due to the mirena. I’m finding it difficult to lose weight (despite heavy exercise and a good diet) and my hair has thinned, both of which I thought were to do with stress (heavy workload, doing a part-time MSc, ill partner... yes I know). The brain fog, ditto.
To be honest, I’m considering having the Mirena removed as the likelihood of pregnancy is low (ill partner, PCOS, age).

Has anyone else ever experienced this? I’m struggling to get my head around it, so any ideas would be gratefully received. Thanks.

I should also add that I do indeed have an underactive thyroid (not Hashimoto's) which is well controlled by L-Thyroxin - this was checked at the same time.

Sorry you are having all of this.

I am puzzled why you have been given Utrogestan when you still have the Mirena in place. You don't need both!

The Mirena plus gel is one classic regime with HRT. We only need Utrogestan (micronised progesterone) to stop the lining overgrowing, when using estrogen. So with the Mirena you don't need it.

The trouble is, you will get a double dose of progestogens and this can negate all the benefits of estrogen, can make you feel fatter or bloated and grumpy!

You also don't need Utrogestan daily ever with HRT Obviously for women who don't have a Mirena either) - it can be used cyclically for a few days every month which gives a withdrawal bleed .

If you have been happy with the Mirena and not had side effects, just add gel. I'm sorry but I've used HRT for 10 years with a Harley St consultant and discussed all the options and your gynae is wrong.

Heck. Thanks Polly! It just didn't seem right, I'll try and get the lab results off him and look into finding someone else. I feel bloody awful today, if I was feeling a bit crap on Mirena, I really don't want to feel double crap with taking the capsules on top

Well, things have taken an interesting turn.
I started to see an endocrinologist who thought that I probably was in peri and the combination with PCOS needed a lot more study.
So I've had a DEXA scan for my bones (excellent, all that cheese and weight training paid off), I'll get retested for insulin resistance, my mammogram is scheduled and she sent me off for another ultrasound (I am heavily insured).

Where a huge mass was found, a suspected pedunculated fibroid.
I'd had ones inside the uterus removed 8 years ago, so it seemed likely, so I got an appointment with my old surgeon.
He did the laparoscopy today.

Well, it wasn't fibroids. It was the ovary. Like a rock he said. He doesn't think it is cancer, but thinks it is this Guardian article on teratomas, test results within 2 days.
Both ovaries are now out, womb still in. Woah.
The mirena also removed. Ha.

Obviously I am not sure what happens next! I do wonder if all these years doctors have been seeing a PCOS ovary on my scans that never was though.

I wish you well- what a horrible shock. Hope it's all okay long term.