Don't know what to do...

[Ferrousfumerate1]

I started the mirena/estrogel combo in January after a year without periods.

To cut a very boring story short, I've bled regularly since the coil's been in. Had a few weeks where it was clear, then it would return. I've persisted, though, to see if it would settle down. I've also had a scan and everything is fine.

A month ago, I also started experiencing really crap hair shedding; I've had it before, a few years ago, when my ferritin levels dropped considerably. I've seen a dermatologist, and he's pretty sure it's the same thing again - my ferritin levels are very low, probably due to the continuous bleeding of sorts, and I'm on a high iron/Vit D/lysine routine.

I still decided to stick with it as around the time I saw the dermatologist - 3 weeks ago or so - I decided to up the estrogel and my bleeding stopped. I thought, yah! I've stopped the trigger for TE and the mirena has settled. And, I felt pretty good.

These past few days, however, I've had bleeding. A rusty brown discharge that requires a tampax.

So now what? I unfortunately got prescribed Oestrodose instead of estrogel which i've been taking since Saturday and I wondered if that caused the bleeding? Today I've started estrogel again.

But what do I do? Stay with the mirena? Find another progesterone? I feel good in myself (won't if I go bald, though). And I have no idea what progesterone to try (the sleepiness equated with utrogesterone really worries me. I get up 5.30 most mornings to write/exercise and it's 'my time' of day).

The use of continuous HRT can cause spotting or bleeding for up to 6 months (or maybe slightly longer.) So that's to be expected.

How much oestrogel are you using now? The lining of the womb responds directly to the amount absorbed so if you have increased the gel, it's not that unlikely that the Mirena may be struggling to control this.

By the way there is NO difference between Oestrogel and Oestrodose. The ingredients are identical (read the box if you have both around!) I've used it for 10 years. I've had both depending on which pharmacy I use and actually compared one pump of each at the same time and there is no difference. [There seems to be this 'myth' going around forums at the moment that they are different- they aren't.]

Have you tried Utrogestan? If not, give it a whirl. Please don't make a decision based on hearsay. Again, it's a case of people with 'problems' posting on forums. I've used Utrogestan for a few years. I am on long cycle HRT under a consultant. I use 12 days every 6 weeks or so. I feel fine on it though slightly lethargic after a week, but then I think I've only got a few more days to go...

I honestly don't find it makes me sleepy- couldn't do my job if it did!

The formulation of Oestrodose and Oestrogel is identical- if you compare the ingredients listed on the leaflets. There is no difference. Quality control in pharma would not allow it to be different but on the same script. The product is made by Besins. (Both sorts.) It is repackaged in the UK as Oestrodose by a UK pharma company but the product is made in France.

I know there are posters on other forums (MM) who swear they are different, but I have both cartons in the house at the moment and have specifically squirted out one pump of each to compare. I cannot see, smell or feel any difference at all. Please bear in mind that some posters who insist there is a difference have all kinds of other health issues - some of them report severe depression and similar- and they may attribute any slight changes in response to HRT to the difference between gels, when it's more likely to be a perceived difference according to their own moods at the time. I think after 10 years' use of both I'd notice a difference, and I don't.

Thanks Polly. Perhaps people have different sensitivities? It is a parallel import...the consistency is def different. We sampled both today. Estrogel is much more gel like.

I need to speak to my sister who's a pharmacist. Maybe the carrier is different.

It's interesting that after a month of no-bleed, it started up again the day I started on oestrodose. It could be a coincidence, of course.

I don't think they are different.
They are both made by the SAME company in Belgium (sorry said France - that's where the licence is held.).
The carrier is the same. Can you see the leaflets showing this? The listed ingredients are identical.

The only difference which I think may confuse people is that the pump action of Oestrodose is slightly different - it's a slightly different carton. When you depress the plunger you can hear the spring mechanism operating as the pump releases the gel. It does this more slowly than pump in Oestrogel. This means it comes out as a slightly 'less round' blob and appears softer in consistency to the eye as it covers a slightly larger area.

Even if the carrier were different, the amount of estradiol has to be the same and the difference in consistency if any at all is minute because both pumps contain the same amount of gel - 80gms.

You wouldn't get any difference in bleeding from one day's use of either.