Mirena and Utrogestan

[Pollymollydolly]

Has anyone else been prescribed Utrogestan in combination with the mirena?

I have a mirena, originally fitted as the progesterone part of my hrt. I use estradot 100 patches and testogel a pea sized amount every day. I was still experiencing panic attacks and insomnia so have now been prescribed Utrogestan 100 for continuous use, 1 a night.

I have to say it’s been amazing, no more panic attacks. It’s like my anxiety has been switched off.

I’m happy with my hrt regime, but I’m also interested to know if anyone else is using Utrogestan with the mirena - everything I read online seems to be about using one or the other, not both.

It's a bit odd, as Utrogestan is not an anti-anxiety drug.
It can be sedating but many women find that a negative rather than something to enjoy. The only reason to use both would be if the Mirena was for contraception.

Personally, I'd not be happy using two lots of progesterone.

Is this being prescribed privately as you are also on testosterone?

I’m not in the uk.

It’s not being prescribed as anti-anxiety - rather that my low levels were contributing to the anxiety/panic attacks.

I’m happy to use the two types of progesterone, I obviously need it as it has sorted the anxiety issues. I still have sleep issues but tbh I’m pretty much a lifelong insomniac - I’d love if the Utrogestan induced drowsinesss but it has no such effect on me! I haven’t had any side effects at all, other than the lack of panic attacks.

I have total faith in my doctor, she is a menopause specialist and very up to date on treatment options. Using Utrogestan alongside the mirena is not common but it is not contraindicated. As it’s uncommon I just wondered if anyone else on here was on the same hrt regime as me.

Interesting what you have to say. I was only having a review yesterday and was told Utrogestan can help with anxiety. The specialist decided to up my dose of Oestrogel to 3 pumps first. I have the Mirena fitted. I am also on Androfeme and she increased the dose of this also. If this doesn't work for my anxiety she said she would introduce Utrogestan.

@Theblacksheepandme It’s amazing the difference the Utrogestan has made, it is literally like my anxiety has been switched off. I know my panic attacks were menopause related as I’d never had one until I hit peri.

I hope the adjustments your specialist has made helps your anxiety, but if not then imo Utrogestan is definitely worth a try.

I was considering a Mirena for contraception, didn’t realise I’d still need Utrogestan.

Hmm, back to the drawing board I go.

I also find the utrogestan keeps my anxiety at bay, ive noticed as i gave myself a few days off to see if i'd have a withdrawal bleed & my anxiety crept back in something awful.

How did you know when to start your progesterone capsules without a period ? I don’t bleed at all with mirena coil- I can start capsules as mirena is 5yrs old so not valid for HRT protection but good for another 3 yrs for contraception

My understanding is you only need uterogestan as well - if your mirena is more than 5 yrs old - between 5-8yrs mirena is only guaranteed for contraception-0-5 yrs it can be contraception and HRT progesterone protection

@RestingMurderousFace if you have the Mirina you don’t need utrog unless you have had it for years

It would seem the mirena for about 5 years has enough protective use with oestrogen, but up to 8 it is still good for contraception not protective for HRT purposes.

I am 10 years PM. I am on estrogen patches and originally Utrogestan, but I'd read how patchy uptake can be; so I had a Mirena fitted. My GP noted it was now in for 6 years so time to go back on Utrogesten, or get a removal/refit (which I didn't fancy as the fit wasn't pleasant). So the coil is still in but I'm now taking progesterone again.

I wasn't aware progesterone did anything other than keep your uterine lining thin.

No idea where the anxiety alleviation came from for the OP, but whatever helps.

Why do some women have side effects?
Utrogestan is metabolised in the body to allopregnanlone, which plays an important role in neurological resilience. It exerts a neuroprotective, antidepressant and anxiolytic effect, via GABA receptors in the brain. For some women this produces a calming effect, for others they experience side effects, which can be severe.

i’ve just copied and pasted this from a menopause clinic site (Rowena Health) which explains why Utrogestan has a calming effect for some women.

I have a mirena (as part of my peri/menopause HRT) and then was prescribed 100 utrogeston at 1 a night as was still bleeding. I am also on patches. So far so good (am 50 and had the mirena fitted in 2022). Interested to hear about the testosterone @Pollymollydolly

Yes! I take extra progesterone with the mirena coil @Pollymollydolly I had the mirena coil fitted Jan 2020 for the progesterone element of HRT (I'm on Evorel 75 patches for the estrogen) and I started getting break through bleeding in 2021 so following a scan to make sure all was ok (which it was) Meno Nurse said to take an additional progesterone tablet every day (it's not the same as utrogestan though) and this stopped the break through bleeding.

@Beanandpeas and @Christine0708 some of us do need extra progesterone within 5 years of the coil being fitted - be that for anxiety (as the OP's experience) but also for break through bleeding (my experience). We are all different so HRT is not necessarily a 'one size fits all' solution. Have to say @Pollymollydolly when I went on the additional progesterone, life was a lot calmer, less anxiety ridden for me too.

@ClementsR2024 I’m getting on very well with the testosterone, I haven’t had any issues apart from a hairy patch on my thigh where I put it on 😂 I was prescribed it for decreased libido and it has normalised this, I also just generally feel better.

@Projectme pleased to hear you noticed a calming effect too with the progesterone. I agree, HRT is such an individual thing it really needs to be adjusted accordingly. Unfortunately I think a lot of GPs take a ‘one size fits all’ approach so it’s not surprising some women don’t get on with HRT.

I’ve actually stopped taking the extra progesterone now,I took it for a good while and it really helped. I had been having awful panic attacks - purely menopause driven - which were really affecting my life. Thankfully they have completely stopped and I reduced the progesterone before stopping completely and haven’t had a recurrence of the panic attacks.

I’m another woman whose experience of Utrogestan has been calming and mellowing of panic and anxiety. After having crap experiences with the mini pill (progesterone only) in my twenties, I was frankly scared and reluctant when it became time to take the Utrogestan part of the cycle (oppositional progesterone to prevent uterine thickening) alongside Oestrogel when I first started HRT earlier in the year.

In fact, it was so brilliant in calming and balancing me that I’m debating taking it continuously instead of cycling it.

Just wanted to add my voice to OP’s that the neurological beneficial effects are definitely a Thing for some of us.

Same as above. I had an awful time on the mini pill (but felt great on the day combined)

My menopause doctor said Utrogestan can really calm anxiety.

I was hoping it would help my sleep. I still wake very frequently but I’m now not having the 3am panic and busy mind. My mind feels calm so I get back to sleep quicker.

Oh I take it continually too and it’s nice not to have the ups and downs..

Im guessing she’s upped your progesterone also as you are at the limit with your oestrogen on 100 and still having symptoms. And a higher dose of oestrogen will need sufficient progesterone (maybe she’s worried there’s not enough in the coil).

I’m sure I’ve read some women are on 200 Utrogestan. It is really important you have enough progesterone if you are on the highest level of oestrogen to protect the womb lining.