Mirena coil - wwyd?

[Judystilldreamsofhorses]

Hello, can anyone help, please? I had a consultation re HRT a few weeks ago. The doctor recommended Mirena plus oestrogen but I ended up with patches (Evorel Sequi) because I was a bit scared of the idea of a coil! We agreed to review in three months. The patches are completely useless and keep falling off if I have a bath, so today I rang to book in for a coil at the sexual health centre, per the GP’s instruction.

All fine, until I mentioned it was part of HRT, then not fine. The receptionist had a big rant about how you cannot self-refer (which is what the doctor told me to do) and the GP needed to write to them. Apparently coils can only be fitted as part of HRT by one special person, and there is a huge waiting list. (Not if you want it as contraception. I said - truthfully - it would also be contraception but she was having none of it!)

Anyway, rang the surgery, the receptionist there was lovely and said she would talk to the doctor about doing the referral. Now I wonder if I should just ring again in a few days and say I want it as contraception, not mention HRT? It’s the same thing, right? Or am I missing something? My surgery doesn’t have someone who fits them so that is not an option. I didn’t give any personal information on the phone to the SH clinic.

Sorry you had such an unhelpful receptionist at the clinic. Yes, it's exactly the same Mirena IUD which is fitted whether for contraception or HRT. I'd just call back and say you want it for contraception. Had a similar (though much more pleasant) situation locally where I'd been recommended by a private HRT specialist, AND my GP, AND the practice nurse, to get my old Mirena replaced as part of HRT, so absolutely no doubt that was what I wanted to do. It's not at all controversial; Mirena is generally recommended as the lowest-dose way to get the progesterone element of HRT while also providing contraception.

Similarly to your area, if I wanted Mirena for contraception it could be done in the GP clinic ASAP, whereas if I said it was for HRT then it had to be done in the community gynae clinic, which had a long wait. Had a chat with my GP about it. I said "Oh well I want it for contraception mainly...". Would all have been booked in OK but I opted for the gynae clinic in the end because I knew that removal of my old Mirena would be complicated as the threads had disappeared, I have fibroids, and it had been there for about 10 years.... the gynae clinic are specialists in difficult cases so I thought I'd be better off with them. All went well - removal of the old one took a while but the doc was extremely gentle, used a numbing gel which worked really well for me. Insertion of the new IUD was quite straightforward. I remember my first one was OK too - for me, it was pretty much like a smear test. Obviously this isn't everyone's experience, but I think amongst my friends quite a few found it easier than we expected - the experiences of the women who had a tough time can lead people to think that is 'normal'.

Thank you for replying. I felt like the clinic receptionist was really angry! It is the exact same place that I would go to, just that it is this one single person who does the HRT Mirena. I think I will ring again on Friday and hope I get a different receptionist.

I’ve never given birth so was a bit apprehensive (still am) but these patches floating about the bath are definitely not the one. It’s good to know that not everyone has a terrible experience having it fitted.

Same here OP. GP told me to self refer to the clinic as they don't fit coils at my GP surgery. The clinic asked me loads of questions about my sex life (which I found really embarrassing and intrusive - it was the way she asked). At some point in the conversation I realised that they would only fit it for contraceptive purposes so I didn't mention the HRT aspect.
It's worked brilliantly for me. Insertion was painful but it was over quick enough. Cramps like period pain for a week. Spotting on and off for a few months. And then nothing. No more pain, no more PMT, no more bleeding. It's a miracle!
I would just call the clinic back and say you want it for contraception. Good luck!

I really wish I hadn’t phoned the surgery. If I book in now and say it’s for contraceptive purposes, they’ll click when they get the GP referral through. What an idiot I am. I said to the lady on the phone that the school holidays would be ideal (I teach) and she said she wasn’t sure it would be by then, so the wait is obviously massive.

Don't beat yourself up about it @Judystilldreamsofhorses . Are there any other sexual health clinics within reach? If you're in a city there may well be several. Could you just go to another one?

I think this is a funding thing. There is ample funding for contraceptive coils - mine has run out and I was initially just trying to get it removed, but no availability. I then said I would have a new one inserted and appointment was issued for about 3 weeks later. At the appointment I had the choice from the full panel of contraceptive options. It’s still in there because it’s stuck with the strings removed so I am awaiting hysteroscopy (6 months delay).

I could have written this post word for word, OP. I am in exactly the same position and even a teacher too! Had mirena for years, needs replacing and on waiting list for it to be done at GP surgery. They sent link by text to their clinic, but appointments were all during school, so I stupidly didn't book one. Then in my appointment about starting HRT, GP said need coil replacing before I can start. Didn't hear any more for 2 weeks so I phoned them. No way they can make the appointment and I have to wait to be texted again. Or ring the local sexual health clinic. So I did. Conversation went exactly as yours. She asked why I was wanting it and I stupidly said HRT. She then got annoyed and went on at me about referrals and specialist clinic etc. I trued to explain that it was originally put in for heavy periods and contraception but she said that didn't matter, they wouldn't do it because I needed a referral. I have now decided that the next ti.e I get a text link to clinic at GPS I will just book it and tell school thst I need time off for medical treatment.

Sorry that I have no advice just wanted to sympathise with you!

Yep I had a bad experience too. I wanted mine removing, it was 5 years old so of no use.
The doctor gave me the clinics number ( doctors no longer fit or remove them) and told me to say it was for ' contraceptive reasons,' well I was fuming when I came off the phone with the clinic.
In brief: the receptionist told me that all telephone consultations were full. Could I just book an appointment to have it removed? No.
Ok so what then?
I had to ring early morning, at a time when I am travelling to work and hopefully, if I was lucky, someone would call me back to speak to me. But I'm working and can't answer my phone, I'm customer facing, could I arrange a call back during my lunch hour? No, it's random, during office hours and they will ask very personal questions.
Any way I asked if they could ring me in a month's time when I had a couple of days off. No we don't do call backs on those days!
Honestly wtf!
Eventually, I arranged for a call back when I was on annual leave on a day they actually did do call backs. The nurse was rude and Ill informed. I simply wanted my coil removing. Bloody hell, she knew better. Insisted I should have another one fitted, asked me lots of extremely personal questions. I said is this really necessary?
I'm not happy telling you when I last had sex and with whom, I'm not happy telling you my dh has had a vescectomy, I'm not happy with you questioning why I do not want another coil fitted.
She then proceeded to tell me the advice 2 doctors had given me was incorrect.
I questioned her on this and said so you are telling me the advice given by 2 doctors is wrong. She kept repeating herself until in the end admitted she was wrong!
I was very worried about my appointment to the point where I was physically ill on the day. All caused by anxiety thanks to the frankly disgusting treatment I had received.
The doctor I saw ( female) was brilliant and unlike other times the removal was painless. She's also spoke to me about HRT which I am taking and was very positive.
I did receive an online survey to complete about the experience I had had prior to seeing the doctor. I did not hold back. Told them exactly what I thought and scored them the lowest scores in all areas.

She also said that if I phoned up again saying it was for contraception, then as soon as I mentioned my age at the triage appointment they will refuse anyway because it must be for HRT . I'm 48.

Oh man, so many of us in the same boat! I am 49 so I guess they would rumble me if I rang back, so I will just have to wait for the GP referral.

That makes total sense about it being a money thing too. I hadn’t thought about finding for contraceptives -, high - versus funding for menopause - crap.

Don’t have the Mirena if you don’t want it. I refused one after a horrendous experience having one put in.

I’m currently on 1mg sequential tablets and get the progesterone element from the mini pill. No Mirena, no pain, no waiting, no patches or messy gel! Just two tablets every morning.

@Freeekedout i am on the mini pill and was told it wasn’t licences to be the progesterone element?

Just be very careful about saying you want the coil for contraception because they may insert a different type than the mirena and only the mirena is licensed for HRT.

Thanks @ButtOutBobsMum I was clear it was the Mirena I wanted, and am going to wait for the GP's referral anyway.

No, shouldn't be a problem due to age. You are advised to keep using contraception until 2 years post LMP if under 50 or 1 Yr post LMP if over 50. Eg www.nhs.uk/conditions/contraception/menopause-contraceptive-pill/#:~:text=All%20women%20can%20stop%20using,or%20other%20method%20of%20contraception.

On a different note I'm 54 and have a more a which is due to be removed this year but I'm wondering if it really has to be - could I just leave it in basically forever?!

@lurchermummy you do need to have it removed but apart from the obvious intrusive nature of the examination and procedure it is almost always a very quick procedure with at most a brief pulling and pain as the mirena or coil comes through the cervix.

@yikesanotherbooboo thanks - and it wasn't too bad having it put in. What would actually be the consequences of leaving it in though? Why does it actually matter (just wondering?) - thanks

@DivorcedAndDelighted I’ve no idea re periods as the mini pill has stopped them. I went on it a few years back because my cycle had started to get shorter which was a (literal) pain. At the time the nurse suggested a Mirena and now I think that would have been a smart option!

My stupid patch came off in the bath again tonight and I have now officially given them up as a bad job. I shower every morning which is fine, but I really enjoy a bubble bath with my Kindle a few evenings a week. Hopefully the referral will come through sooner rather than later.

Can you put the patch somewhere you can keep out of the bath? Like top of your shoulder or something? At least till you get the iud?

Sorry, just seen it’s supposed to be below the waist.

That would be ideal! I have tried waterproof wound covers, which are useless, and also removing it before getting in, but it loses its stick then when it’s off your skin. The best option is a silicon blister plaster over it but they get soggy and stick to your clothes.

@lurchermummy , if you leave a foreign body in there is a chance of infection in time or of it becoming embedded and possibly causing problems.much better to remove after 5-7 years when it will probably be easy to do so.

Yes. I was advised by a GP who had a special interest in contraception & fitted many Mirenas that this was fine as long as you were not relying on it for contraception. Hence I kept mine in for about 10 years then got it replaced when I wanted a new one for HRT. Removal was a bit tricky but this was largely because the threads disappeared after about 1 year, possibly because it got caught on a fibroid.
I was a little concerned and read up on the subject - don't recall finding any expert advice against it, but I may have missed it.

Just updating to say I rang the GP to chase this up earlier, and was told the referral was done on 18 May. So I called the clinic and after being VERY pushy I am booked for Mirena on 5 July. I also have a call with the doctor at my surgery to figure out the oestrogen part next week.