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Menopause

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Medroxyprogesterone or Mirena coil?

11 replies

bellabride · 31/08/2021 20:35

I have an appointment with my GP this week to change the progesterone component of my HRT, as Utrogestan isn't controlling frequent bleeding.
I was increased to 200mg every day, 6 months ago; I'm also on Evorel 75 patches ( 6 months too).
GP has previously mentioned the possibility of changing to either medroxyprogesterone or a Mirena coil.
Anyone have any experience or advice that might help me be better informed before my appointment.
The bleeding is really getting me down, and goes on for up to 3 weeks at a time, with only a week or so bleed-free before it starts again.

OP posts:
JinglingHellsBells · 01/09/2021 09:01

I could offer some insights, but it's without knowing what stage of meno you are at etc @bellabride

Evorel and progesterone daily is for women post meno (no period for 12 months) and although some bleeding is normal for a few months on a continuous regime, it's usually just spotting or very light bleeding.

Are you actually post menopause (were you when you started this combination?)

If not, you ought to be using a sequential regime of 12 days Utrogestan each month with a predictable bleed afterwards. (You can still do this type post-meno. I've done it that way for years, for various reasons, with my consultant's guidance.)

If you change to MPA, that's Provera instead of Utrogestan.

Statistically, if you want that facts, MPA is linked to higher cases of breast cancer (still very low, but higher than Utrogestan.)

The progesterone in the Mirena is still a synthetic one, but may be slightly safer.

Have you tried using Utrogestan vaginally ? That can help absorption. If you are using it daily, it may not work (needs to be inserted after sex) but it might be an option.

It's used that way in Europe and in the UK as a fertility drug, but not actually licensed as HRT by that route. But again, meno consultants prescribe it that way.

Roselilly36 · 01/09/2021 09:06

I have a Mirena, now on my 3rd, I was flooding really badly before. Very rarely have a period now. Agony having them inserted for me though, I won’t lie. I know not that the same for every woman though.

JinglingHellsBells · 01/09/2021 10:43

@bellabride If you are post menopause, why is your dr not going straight for a combined, continuous patch which would have both estrogen and progestin in it? Why the separate form of progestin, if you can't get on with Utrogestan?

bellabride · 01/09/2021 11:13

I’m 57 so post menopausal. My dr is Newson dr. They don’t seem to prescribe combined patch but I’ll ask about it. She’s phoning me today.

OP posts:
bellabride · 01/09/2021 11:13

It would be most straightforward option I think.

OP posts:
JinglingHellsBells · 01/09/2021 12:20

I'm puzzled why she would offer MPA (synthetic) and not combined patches (also synthetic.)

Do you need to be on a 75mcg patch? That's the same as 3 pumps of gel (according to her info here) and maybe it's too much for the amount of Utrogestan - has she suggested using it vaginally?

HRT brands and strengths

bellabride · 01/09/2021 12:28

I reduced patch already from 100 to 75 and symptoms are not really completely resolved now. Insomnia and night sweats came back. I only reduced to try to control the bleeding. Not keen on the practical side of using utrogestan vaginally.

OP posts:
AlbertBridge · 01/09/2021 12:32

I'm having bleeds like that and they scanned me and I'm teeming with fibroids. Yay.

oneglassandpuzzled · 01/09/2021 12:34

I switched from Utrogestan to a mirena for similar reasons eight months ago. The mirena has worked well for me. I fell good.

bellabride · 01/09/2021 13:01

I had hysteroscopy and biopsy and all fine.

OP posts:
TheRealMummyPig · 13/09/2021 12:04

@bellabride
Hi OP, can I ask what Dr Newson recommended when you had your appointment?

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