Success using Mirena as part of HRT if you cannot tolerate the contraceptive pill

[Dogsgottabone]

Hi all,

I am back to the GP next week to discuss HRT which the GP suggested after discussing my symptoms last time I saw them.

My blood test (am under 45) showed iron deficiency, almost certainly due to my now much longer heavier periods.

I expect the GP will suggest mirena for the bleeding and to act as the progesterone part of HRT.

However due to not tolerating hormonal contraception I am really concerned about not being able to remove the mirena if it affects me mentally and emotionally.

Does anyone have any positive stories about being unable to tolerate hormonal contraception but being able to tolerate the coil and it working for them in this regard?

I want to walk in to my appointment with a plan and I'm almost there but this is the stumbling block.

I was where you are. Horrendous PMS and bleeding. Had the Mirena and I'm now on my 3rd with oestrogen added as part of HRT recently.

It does however take around 6 weeks to settle after the Mirena is put in.

I had to give up on the pill in my 20s because of side effects.
Had my first mirena at 40 and had two more after that. Absolutely no issand life changing benefits

@PritiPatelsMaker thanks for replying.

I did try it twice in my 30s, the first time I never stopped bleeding (therefore no sex, so it did its job as a contraceptive!) and the second time the pain was awful, I could absolutely feel it, so I only lasted a fortnight with it in.

When you say it took a few weeks to settle what do you mean? Pain or bleeding or hormonal side effects?

@PritiPatelsMaker thanks for replying.

I did try it twice in my 30s, the first time I never stopped bleeding (therefore no sex, so it did its job as a contraceptive!) and the second time the pain was awful, I could absolutely feel it, so I only lasted a fortnight with it in.

When you say it took a few weeks to settle what do you mean? Pain or bleeding or hormonal side effects?

@SilverSalver thanks that's what I need to hear I think! I'm just so worried about what happens if I need it out fast if the hormones don't agree with me. I can't ruin anymore of my life feeling the way i did the last time I tried a pill.

I had spotting and was a bit emotional for a few weeks but the discomfort stopped after about 24 hours. Spotting for 6 weeks was still 100% better than my life with the Mirena though.

I never noticed any impact from the hormones, whereas on the pill I had constant migraine and other things.
It settled instantly and I had a regular period which consisted of one day spotting.
Insertion was painful, but I have an inverted uterus. Take paracetamol half an hour before. It's so worth it for years of relief.

Thanks both.

Has anyone else felt the most awful emotional lows on the pill and then been fine on mirena?

I’ve just started HRT, and my progesterone is taken vaginally.

I took the mini pill for 10 weeks and felt horrific. I had some scary, dark thoughts. Because I’d this, I’m really not keen to try the coil (or any sort of progesterone at all!).

Fortunately that hasn’t affected my mood at all, but has stopped bleeding (not sure what will happen when I finish my two weeks …) and improved my skin.

Has anyone else felt the most awful emotional lows on the pill and then been fine on mirena

Mine was more stunning headaches but no, it wasn't great emotionally either.

I’m probably post menopausal now but had Mirena fitted so could stop oral hrt that was causing horrible mood swings. The fitting itself wasn’t painful but I did faint and fit was very glad the gynae fitted it in hospital….as I was on the ward for several hours after. But apparently that v v unusual!

I had spotting for a couple of months but the mood swings have settled and I feel more like me. It’s a small steady dose of progesterone that seems to suit me better…and oestrogen gel.

don’t know what happens in 5 years time. I think I’ll just have to hope the menopause symptoms have settled….

I have never found a pill that works but currently on my 2nd mirena. Haven’t really had any issues that couldn’t just be put down to a normal cycle - pms migraine, sometimes very bad pms mental health, but I don’t think it’s down to the mirena, I had similar issues when I had a copper coil. If anything everything is less severe with the mirena.

Thank you so much everyone who replied

@Vegemite001thats really interesting, I didn't realise that vaginal progesterone could help with bleeding. And of course the benefit is that if my mental health nose dives (crying for the best part of the day like on the pill) I can stop using it via a phone call with GP.

Perhaps that's the way to go. I am hammering the iron tablets and don't eat anything that doesn't contain iron or vitamin c, but I am concerned about stopping the very heavy bleeding.

I am going to look into that today. What names do your estrogen and progesterone have?

Though reading my thread back of course the mirena is vaginal progesterone! 🤦🏼‍♀️

When you say not tolerating the pill, do you know which bit? The Mirena is progesterone only, but once you add in HRT you would be back on estrogen too.

I’m not at that stage yet but I have a mirena and a bit of a bumpy history with the pill. I have had the mini pill at various times of my life and have sometimes tolerated it and sometimes not (it was especially bad in my early 20s).

this is my second mirena and I had a bit of a nightmare getting it replaced (it was stuck out of reach), so had to go on the mini pill for 10 months whilst waiting. From memory of my first, the mirena took a few weeks to settle and when considering friends’ experiences there were some who just couldn’t stick with it, but if you do stick with it it’s very good indeed. This time I had really sore boobs for a couple of weeks after but they did settle.

I chose it over other things like the implant and injection as it’s a much lower dose of hormone in exactly the right place. It hasn’t really caused me a problem in that regard.

when discussing the pros and cons with the (fairly expert) gynae consultant who changed my mirena (see awkwardness above), his take was that mirena is the best, safest, and most effective hrt available. His specialism is endo and he’s one of the leading minimally invasive gynae surgeons in the U.K. - I suspect on his advice I will be having at least two more mirenas, possibly a third.

@Dogsgottabone Ah, sorry, I wasn't clear. I don't take the Utrogestan pessaries (vaginal progesterone) for bleeding, it's for the progesterone part of my HRT.

One of my peri symptoms is heavy and unpredictable periods, so I'm hoping, long term, it helps with that. I'm on my first month of HRT, and the utrogestan seems to have stopped/delayed/affected my periods - so it def affects things. Just don't yet know quite how!

I was fine on the pill for many years, but after my second child was persuaded by my consultant at my 6 week check to have an implant in my arm - I can’t remember what it was called - and this led to me becoming almost murderous! I have never felt so awful. I had gone to the consultant because I had a serious PPH after giving birth and ended up in ICU for a week. I did actually want to be sterilised but her persuaded me the new wonder implant would ensure I didn’t get pregnant for at least 2 years.
I had monthly checks and every time I asked for its removal and to be sterilised, but he kept telling me it would ‘settle down’.
on my 6 monthly check up I saw his female colleague. Again, I told her how it was making me feel, that my marriage was about to break down, I had PND and wanted to throw myself off a bridge on a regular basis. By the next week, I was booked in for sterilisation and the implant was removed. Within a couple of days I felt like my old self. It turned out that the implant I had was being trialled by this consultant and was since removed from service doe to so many women having the same side effects as me.

in my 40s I started with horrendous heavy periods. I saw another female gynaecologist and she suggested the mirena. I was extremely nervous because of my previous experience of hormonal contraception but it has been amazing! Periods stopped within about 6 months, sailed through menopause with only a few hot flushes and sleepless nights but nothing debilitating.

No you totally were clear, that was my understanding of what you were saying.

I need to both stem the bleeding (ditto long unpredictable periods) and provide a progesterone HRT element so I think that sounds like it might be the right step for me!

What are the names of your HRT types? I want to be able to specify the right thing when I go in next week.

If you don't mind sharing 😊

No worries x

I take Utrogestan vaginal. It's actually prescribed off license by my private menopause GP - it's usually used as part of IVF treatment. She wanted to put me on to oral utrogestan - apparently it's a different version of progesterone that is much better tolerated, but since I was so anxious about any sort of progesterone, she said it would have the fewest affects. www.utrogestan-vaginal.co.uk/home/

I also take (I think!) Estrodot 50. So, basically a sticker on my butt that gets changed twice a week.

So far, no miraculous cures. PMS is non existent (yay!!! Having never had it really, these last few years I was very rage-y). Migranes are worse :( Acne also worse, but not as bad as it has been. I'm absolutely sleeping better, though.

Hope that helps!

@Soontobe60 thats absolutely horrendous you poor thing. What is it with these bloody doctors? I know it isn't all of them but how dare they not agree to stop a course of treatment that is making someone ill??

Thank you so much for replying. I wonder did they offer you a commitment to remove the coil if you wanted them to do so immediately?

@Vegemite001 absolutely brilliant thank you!

I am hoping to stop the bleeding a bit, stop my breasts feeling like they are going to explode, rehydrate my eyes, stabilise my dizziness and reinstate some brain cells as I can't remember words all the time and it's getting embarrassing at work.

Oh and stop waking up with a sweaty chest and help my appalling urinary incontinence when I walk the dog!

Marina coil help - I have been on the marina for three months with no problems at all and two weeks ago started Oestrogel. I have just started my first period in three months. Has anyone else experienced this?