Why does my gp want to put me on the mirena coil?

[thelegohooverer]

I’ve been to my gp and awaiting blood work results. I went to discuss peri as I have a lot of symptoms but as I still have periods albeit a shorter cycle, she says it’s not peri, but “hormonal” and recommended mirena.

It ended up being a very short discussion as she wants bloods done first.

I’m extremely reluctant to put anything in my body that I have to convince someone to take out if I don’t like it. (Bad experiences with doctors in the past)

First I don’t understand what the coil is going to do for me? (I don’t understand much to be fair) but surely if a drop in oestrogen production is causing these symptoms then wouldn’t progesterone have the opposite effect?

And if it is a good idea, what are my alternatives?

I’d like to be prepared when I’m next with the gp. So would really appreciate any thoughts on this

It makes no sense at all [confuse]

The Mirena can be used as the progesterone part of HRT but it's not used on its own as a substitute for estrogen.

Sorry but she doesn't sound as if she knows anything about hrt or peri or menopause. Unless there are other reasons for her advice.

If you are over 45 you don't need blood tests anyway to diagnose peri- that's in the 2015 Nice guidance.

HRT is prescribed on symptoms for women over 45.

See a different dr?

If I understood her correctly she was suggesting the coil now, with a view to it being convenient to add on the oestrogen part of hrt in a few years time.

I may well have misunderstood.

Might you prefer a low dose combined pill instead?

She hasn’t explained her rather odd recommendation to you at all well, which is a good enough reason to get a second opinion.

As others have said, your doctor sounds confused or like she hasn't explained herself properly.
Mirena + estrogen is a common form of HRT. I've recently started on it and it's working well for me. Like you, I was really hesitant because I know the coil doesn't work for all women and I was worried I wouldn't be able to get it removed quickly if I didn't get on with it. Luckily, it's all been fine. Better than fine actually.
I wondered if your doctor suggested the mirena because she thought your only symptom was heavy periods?

Put simply they get paid to put the coil into women - they get a fee.

Just say no I don’t want contraception never mind the coil which I have told you I don’t want - for a variety of reasons. Can you do bloods and hrt please

Mirena performs as the progesterone part of HRT. It's licensed as such.
Then one will need oestrogen additionally.

I wondered if your doctor suggested the mirena because she thought your only symptom was heavy periods?

But the OP doesn't have these, just shorter cycles.

Also, she should not be doing blood tests if you are 45+. Wasting NHS £££!

Nice says don't do this.

If it looks like a duck, sounds like a duck, walks like a duck (it's peri :) )

Some extra details….

I’m 44 so just under the threshold by a few months.
I’m in Ireland and paying for both the gp appointments and the blood tests myself. My periods have always been light.
I don’t need contraception per se because dh has had a vasectomy.

I understand the idea of pairing the coil and oestrogen for hrt but she seemed to be suggesting getting the coil in first and then looking at oestrogen in months or possibly years? I’m worried that’s going to make everything worse than it already us and I’m almost on my knees.

She’s been a pretty good gp up to this.

My symptoms have been brain fog, waking with anxiety, worsening pms with a couple of days of black depression, loss of libido, shortening cycles, utter exhaustion except for three days after my period, weight gain, mood swings, digestive issues, new food intolerances, insomnia.

But I’m still having periods.

If you have Facebook there is an amazing group called The Irish Menopause. Loads of fantastic advice and which doctors aren't complete idiots when it come to menopause. It still shocks me that GP's aren't taught something that 50% of the world's population will go through at some point.

Thanks @Ohjustboreoff I’ll check that out

@JinglingHellsBells

It makes no sense at all [confuse]

The Mirena can be used as the progesterone part of HRT but it's not used on its own as a substitute for estrogen.

Sorry but she doesn't sound as if she knows anything about hrt or peri or menopause. Unless there are other reasons for her advice.

If you are over 45 you don't need blood tests anyway to diagnose peri- that's in the 2015 Nice guidance.

HRT is prescribed on symptoms for women over 45.

See a different dr?

Exactly what I was going to say. (Nurse working in women's health)

Well that was a complete waste of time. Bloods came back normal so there’s nothing wrong with me. I asked why then I was feeling …. and listed off all my symptoms.
She asked if I was stressed (obviously) or depressed (getting there with conversation) and recommended I listen to a podcast.

You couldn’t make this stuff up.

What were they actually testing for? There's no test per se for perimenopause.

While GPs were bungling my assessment for perimenopause earlier this year I did get a combined pill, kind of HRT lite I suppose, which helped a wee bit with the symptoms you describe.

If you are going to pay for it all anyway, you can see a specialist online and do a FaceTime appointment. Your gp doesn’t seem to know how to treat the menopause at all. Complete ignorance of something that affects half the population. Can’t imagine how many women they have messed up by now!