What to do?

[user50and]

Please can someone help me try and get my head around things, I do have a GP appointment in the morning to try and get it sorted.

I'm 50, still get regular periods. I started HRT on 06/10/21, Estraderm 50 patches and Utrogestan 100mg x 2 for 12 days a month. On the advice of my GP I changed to 100mg vaginally in December as I was feeling anxious, overwhelmed and a bit detached/wired.

I decided on 07/01/22 to have a Mirena fitted as the Utrogestan was a bit messy, my periods would stop and I'd save money. Or so I thought. I've put on half a stone so far, my mood has been very low and dark, to the point I've considered harming myself, I've become totally demotivated, don't care what I look like, could easily not get out of bed all day, spotted for 7 weeks, have dull period like pains 80% of the time and just feel generally crap about myself. I moved to 75 patches on the 2nd March which have made no difference at all.

I'm seriously at a loss. Do I get the Mirena taken out and go to back to Utrogestan? do I give up altogether? do I persevere for a little longer? the only positives Ive experienced are sleep and no sweating at night..

it's rough when you are still having periods at 50. maybe abalation to end those could be considered?
how much of the mood do you think is hormonal and how much is life itself (increased work commitments, teens, finances etc.)
weight gain have you taken liberties with portion sizes and reduced physical activities?
HRT has some long term benefits (bone and vag attrophy) but not all women take it.
sleep can be dealt with using melatonin or ashwangara
night sweats can be helped with certain night wear and bedding. i used an ice pack on a few occasions but only had night sweats 3-4 times.

fall are you on HRT?

You're right, I probably haven't been doing as much activity since Jan. I started a new job and WFH almost 100% so the only steps I'm doing during the day are to the kitchen and back! I do a couple of HIIT classes a week as well.

I've just noticed a sudden downward turn in my mood since I had the coil fitted. My mood wasn't 100% before hence starting HRT but for example in December I was ok, happy and motivated, now I'm completely the opposite 😞

Nothing has really changed in terms of teen moods and finances, we have a couple of holidays booked which I should be really looking forward to, but I'm not. God what a joy I am! 😆

I don't know if this is much help but here goes....

years ago I was offered the Mirena as part of HRT but declined it. This was partly as the progestogen in it is the same as in one type of birth control Pill which gave me acne.

(I need to say that this is private menopause treatment as it might make a slight difference to you.) My consultant suggested if I did try it, give it 3 months and if I wasn't happy, he'd take it out.

Utrogestan has become 'flavour of the month' very recently, as it has a better safety record it seems re. breast cancer .

However, it doesn't suit everyone. I was advised I'd either love it or hate it.

I find it okay although agree that the vaginal use is a bit messy and I can't say I enjoy that part. However, as I'm a long term user of HRT ( almost 14 years) I'm going for what appears to be the safest.

Before Utrogestan, I did use Norethisterone - it's a synthetic progestogen- for several years. I got on ok with it although was a bit more PMS-ish each cycle than I am with Utrogestan.

So, all I'm saying is it's not a choice of the Mirena OR Utrogestan. You might be ok on patches where the progestogen is Norethisterone.

I think I'd give your coil another 2-3 weeks then ditch it if i felt the same!

Thanks jingling that's really helpful. I did have another thought. Would dumping the patches in favour of gel be better? I have some Estradiol gel here, maybe I'll absorb that better than the patches?

@user50and, i'm too old. i was a true bitch to my husband and children but life was challenging (nurse/shiftwork/3 kids a year apart/dh who worked long hours) staff would chat about the benefits of antidepressants but honestly i never thought a pill would fix the stuff around me that was going on.
i was lucky in that my hot flashes were incredibly mild, only had a few episodes of night sweats and periods slowed down to a few times a year after 42.
i use melatonin and ashwanghara (sp) when needed (a few times a week).
lots of exercise though...45 minutes a day dedicated to it.

Fall... I'm interested in trying melatonin and ashwagandha too as HRT still hasn't sorted my anxiety and terrible sleep. What do you take if you don't mind me asking?
I'm the same as you OP in that I'm thinking of asking for alternatives. I'm on utrogestan and Gel but it's not having the desired effect ATM.

@user50and

Thanks jingling that's really helpful. I did have another thought. Would dumping the patches in favour of gel be better? I have some Estradiol gel here, maybe I'll absorb that better than the patches?

It's worth a try. There is evidently a bit of a supply issue with gel at the moment, although Besins are saying it is short term, so you may be forced back onto patches at some point.

All I'm saying is there are more options other than Mirena and utrogestan.

If you are up for tablet form, then Femoston is a body identical estrogen and the progestogen is very similar to Utrogestan and has the same safety profile as it.

That's worth considering. They don't suggest tablets for older women but for you, it's definitely an option.

jingling I still have periods though? isn't Femoston for women who haven't had a period for at least 6 months?

@user50and No, it's not.

Here is a very helpful list on Menopause Matters, written by meno consultant.

HRT for perimenopause

Just checked 2x5mg of melatonin
Or 1 400mg capsule of ashwagandha
Both help slightly, neither are that sedating but once asleep you stay in a deeper sleep longer.

Im really struggling with staying asleep. Fall asleep easy 9 or 10 o clock but awakw 2 am and cant get back to sleep. Can i get anything without prescription?

Thanks jingling I'd definitely be up for a tablet form. Save faffing around with patches, gels AND tablets. I've been reading up on Femoston and it sounds ideal? I'm just curious as to why women WOULDN'T take a tablet instead? is it because of the possible risks associated with the tablets do you think?