Progesterone - IUD vs pill

[VanCleefArpels]

My Mirena coil needs replacing and Dr dealing with my menopause suggested replacing it even though I don’t need it for contraception as it’s a good way to add the progesterone to the oestrogen gel I use daily, and I’ve always got on well with the Mirena. All good stuff. Except for the fact my GP surgery has peremptorily ceased IUD services (Covid ?!?!?) and my local sexual health services are only funded for under 50’s 🙄. Therefore I need to go to a gynae which may take ages. In the meantime Dr has prescribed a progesterone pill.

I’m now wondering what the pros/cons are of the pill and whether I need to bother to get the IUD replaced at all? Dr told me all this in an email 🙄 so thought I’d come to the MN hive mind instead of actually trying to talk to her….

Hi I am awaiting a mirena too.

Has your doctor prescribed the mini pill? Or norethisterone progesterone?

My GP said it's just 'handy' if someone has the Mirena coil as then they don't have to consider that aspect & can just focus on oestrogen.

Personally I would not get the coil just for menopause / peri treatment. (But I've never had the coil & cant imagine it)

I'm on Utrogestan for progesterone. I'm not 100 % sure of how many to take as dosage is based on a 28 day cycle, mine is less. GP unclear too

Oh I'm in Ireland just to say. Those issues of waiting etc aren't relevant as you'd have to pay to have coil fitted regardless, here.

Hi Earringsandlipstick.
I live in mainland UK. Most treatments are free. However you do need to pay for prescriptions here.
My Gynecologist recommended the mirena. Telling me that it was the best treatment available.
I am shocked that you have been told something different!
The only other option I was given was norethisterone, this tablet made me very unwell.
I was enquiring if op, had been offered the mini pill?
I am currently suffering awaiting another appointment Gynecologist!

Telling me that it was the best treatment available.

Well, they are wrong if they said that. Are you sure? Perhaps they said the 'best treatment available for you' which is very different.

If a woman is already using Mirena, for contraceptive reasons, it makes things easier.

If however they are not (like me), it's not good advice to suggest they have one fitted for treatment of peri symptoms.

The only other option I was given was norethisterone, this tablet made me very unwell.

This is also totally inaccurate.

Norethisterone is a synthetic progesterone & not as effective. The recommendation is body identical progesterone, mice

Sorry I posted too soon ...

The recommendation is body identical progesterone, micronised progesterone, Utrogestan. This is what I take. It's not licensed for this use in Ireland so information cab be scant, but is highly effective.

GPs & consultants specialising in this area will prescribe this.

It would probably be worth you doing some reading around this.

It would probably be worth you doing some reading around this.

Sorry that sounds patronising. Not meant that way. Just meaning to double check you've got the right information from your consultant.

Most treatments are free. However you do need to pay for prescriptions here.

My point here was in Ireland you wouldn't have to wait for the options OP describes. That's because GP visits are not free unless you've a medical card, and coil fitting incurs a specific higher charge.

A typical cost is initial consult €70, fitting €180, coil purchase €145

I am currently suffering awaiting another appointment Gynecologist!

I just saw this. I'm sorry to hear that & hope you get good advice. Just to say I know that most gynae consultants (my DBro is one!) aren't particularly knowledgeable about the area.

I wonder would the information provided by Dr Louise Newsom be helpful? In Ireland, the best bets are either an informed GP, women's health centre or specially trained endocrinologist with an interest in the area of peri / menopause.

www.menopausedoctor.co.uk/

@YummieMummyof3

This might be if interest in particular
d2931px9t312xa.cloudfront.net/menopausedoctor/files/information/559/Progesterone%20Intolerance%20v21-02.pdf

The mirena is the delivery system of progesterone that gives the lowest dose that is still safe with fewest side effects. Utrogestan is next best as a capsule but some women do get quite a lot of symptoms from the progesterone element. This is why mirenas are suggested as well as the fact that for women who still have the potential of pregnancy they provide fantastic contraception.

That's true re the coil and of course if you need a contraceptive that's another point in its favour.

However I never had it & didn't want it, and was certainly not going to get as part of treatment for menopausal symptoms.

The reactions tend to be with the synthetic versions of progesterone not Utrogestan.

I suspect op. Like myself doesn't need the mirena for contraception. It's for gyne reasons. I have been back to my Gp after the debilitating side effects of northiserone and have been given transemetic acid. I hope I have spelled it correctly. I did query if it was a long term solution and I was told other patients have been taking it for years!
I was wondering if the mini pill would be a solution while waiting for the mirena? Or am I too old at 47

Why not ask about Utrogestan Yummy? It sounds to be that your doctor isn't well informed.

The side effects are mostly with synthetic progesterone which is what you've been on.

Now to try and get an appointment with my GP. Wish me luck

Concerned about OP

How are you getting along VanCleefArpels?

OP here!

I’ve had Mirena for over 20 years (well,several!) and love it dearly - no periods at all for decades is priceless! My issue now is getting a new one fitted for non contraceptive purposes as the current has come to the end of its useful life

I’ve been prescribed Utrogestan and having read the leaflet I’m now concerned as it refers to days in the cycle etc when I’ve not had a cycle for 20 years! I’ve got a call booked in with my GP next week to actually talk it through - but I’m now thinking I will be best off paying privately to get a new Mirena to avoid having a bleed etc with the pills

Hi Ladies.

I have been reading information regarding Ultrogestan. Does it need to be taken at the same time of day every night? Does it cause drowsiness?
I am a shift worker. I couldn't take medication at the same time evey day. I would need a 6 hour window.

On the leaflet it says take at bedtime and take the estrogen at the same time

Honestly OP I would stick with the mirena of you can, ask any gyne and they will tell you that mirena and patch or gel is the gold standard for HRT. The progesterone is a tiny dose as it goes directly where it's needed and avoids liver and bloodstream.

I had my mirena replaced a couple of weeks ago (used for HRT) at a sexual health complex contraception clinic because my threads had disappeared but the doc who did mine said he did loads of straightforward replacements for HRT with GP referral , so might be worth asking your GP to refer or even ring round a few as it seems a bit hit and miss with the 50 yrs cut off.

Thanks @rosie39forever - it’s the good old postcode lottery obviously, I can get it done on nhs via gynaecologist but the wait times are too long so I’m going to do it privately

Gynae as opposed to sexual health clinic I should have said

@VanCleefArpels
Yes gyne is definitely best, I was lucky to get Consultant gyne at the clinic I attended and even though he had to locate the lost threads it was really quick and painless unlike when the GP does it and they have to scrape me off the ceiling😆

An update of anyone is interested….

I spoke to GP today who explained that Mirena is still providing some contraceptive protection (such as is required 🤦🏻‍♀️😜) just by virtue of being there and so can happily sit there til I’m 55 as long as I take the progesterone in another format alongside the estrogen gel. So I’m going to carry on taking the pills for a while and see how I go, on the basis that having an invasive and painful procedure is not top of my fun list especially during a pandemic.

I was interested to learn that they treat anyone as having the possibility of pregnancy til age 55 unless of course ovaries are removed or some such. Which makes a mockery of the sexual health services cut off of 50 of course. But who expects left hand and right hand to speak to each other in the health service?!