Conflicting advice. Do I need a new Mirena?

[Tightlippedmama]

I’m 54. I’ve been using HRT patches for a couple of months. Last period was 9 months ago. The one before that, 10 months before the last one.

I’ve had Mirenas for over 20 years. The current one went in coming up to four years ago.

The HRT patches do not have any progesterone in them.

One doctor tells me the Mirena can come out forever in December, a year after my last bleed.

Another doctor has told me the progesterone in my current Mirena has ‘run out’ and I’m to get myself down to clinic and have another one put in.

I am confused.

Mirena for the progesterone component of HRT is licensed for four years, although I have read that may be changing to five.

And the GP who told you it should come and forever needs to retrain, you can use unopposed Estrogen if you still have a uterus.

Ask for a gynaecologist referral, they'll know the latest research

Can’t use!
Thinking about it he possibly means for contraception purposes, as one year post meno and over 50 you don’t need BC.

The guidelines from FSRH now advise Mirena can be used for HRT for up to 5 years now not 4. So you can keep it a further year.

Fertility is assumed to be finished by the age of 55 so if you only needed it for contraception you could have it removed at 55.

But, as you are using it as a progesterone component of HRT you will need to either have it replaced at the 5 year mark, or swap to a combined preparation patch (oestrogen and prog) and have it removed, or stop your HRT if no longer needed and have it removed at 55.

You shouldn't need a gynaecology referral - you need to talk to a GP with an interest in women's health and who is a coil fitter. Gynae actually don't deal with a lot of HRT.

Hope that helps.

I'm 45 and had a mirena fitted a few months ago. Three different GPs have all told me that, although normally the mirena needs changing every 5 years, mine can stay in for 7, until I'm 52 and the menopause is behind me.

I hadn't realised the mirena contained HRT or rather I suppose that it's contraceptive is HRT?

Anyway the nurse in our Gp practice told me my mirena could be left in for ten years through perimenopause and menopause which would take me to 55 years.
The Gp who fitted the coil confirmed that it could remain in place that long but that the contraceptive part of it would run out after 5 years so if menopause wasn't over it wouldn't be an effective contraceptive. She did mention something about if I had gone through menopause but felt I needed the hormones to replace it but it went over my head that it would be for HRT reasons.

I'm 46, and when I had my last mirena fitted my GP said that as I was 45 I could keep it in for 10 years

I hadn't realised the mirena contained HRT or rather I suppose that it's contraceptive is HRT?

women using HRT use 2 hormones if they have a uterus.

One of those is a progestogen. The Mirena releases progestogen into the uterus to counteract the effects of estrogen (as HRT.)

You can either use a Mirena or patch/ pill forms of progestogen with HRT.

I hadn't realised the mirena contained HRT or rather I suppose that it's contraceptive is HRT?

I think there is some confusion here on the thread over Mirena use for contraception or heavy periods, and Mirena use for HRT. :)

Same device, different uses.

Thanks queen that makes sense now.

Thanks for some good advice.

I’ve had Mirenas for heavy periods AND contraception.

I moved here since my last Mirena was fitted. No one at my current GP surgery fits coils or, for that matter specialises in women’s health. I know this because I asked!

What I do not want to happen is to start having monthly bleeds again, if I start taking progesterone via patch rather than via Mirena. It is the Menopause!

If I continue HRT and the Mirena finally comes out, can I have the additional progesterone without bleeds?