Active discussions

Meet the Other Phone. A phone that grows with your child.

Meet the Other Phone.
A phone that grows with your child.

Buy now

Please or to access all these features

Talk
Menopause

Mumsnet doesn't verify the qualifications of users. If you have medical concerns, please consult a healthcare professional.

Original poster

HRT Do I get a new Mirena or switch to combined patch age 57

33 replies

Sunsnowsun · 19/06/2023 20:28

I am 57 and am on Everol 75 with a Mirena.

My Mirena is now 4 years old and is expired in terms of HRT.

My GP suggested a new Mirena or moving to a combination patch.
Anyone had to make the same decision and if so how did you find it, were there any benefits or negatives ?
to complicate this my GP does not fit Mirena, so would need to go to a family planning clinic, not sure if they would fit it.

any thoughts ???

OP posts:
imperialqueen · 20/06/2023 00:04

I saw a gynaecologist a couple of weeks ago who told me the mirena coil was fine for the progesterone element of hrt for 5 years. My coil has been in 5 years this September and she said althought the hormone does reduce the closer you get to 5 years, there is still enough hormone left in the coil for the full 5 years to cover the hrt.

Obviously she maybe wrong and your gp is right.

Original poster
Sunsnowsun · 20/06/2023 21:38

@imperialqueen thanks for your reply, that echoes what I have read, I think the issue is that it is only licensed for use with HRT for 4 years. I’ve got on really well with the Mirena so I think I am leaning towards getting it replaced, but may try a combined patch and have the replacement as a back up.

OP posts:
LongTermLurker · 20/06/2023 21:41

That's interesting. I was told 5 years, even though it's now licensed as a contraceptive for 6 years.

WhereAreWeNow · 22/06/2023 12:30

I thought it was 5 years too

Blossom4538 · 23/06/2023 21:39

So sorry to hijack the thread, but please may I ask how you get on with this combination please and side effects when you first went onto HRT and Mirena Coil?

I have had GP suggest either both combo HRT or est HRT and coil….

I’m early 40s. Thanks!

Joliv123 · 23/06/2023 21:48

I get along well with Mirena coil and the estrogel , I’ve used Mirena for contraception for years no problem , it’s been in 4 years so I called and spoke to the nurse , my doctors don’t change them there, so was told to ring the sexual health clinic , there are 2 in my area , first one said I had to ring the other centre as they won’t do this for me as 50 years is their cut off, so I rang the other they said the same , I then watched the Davina programme and thought how unfair is this postcode lottery ! I have asked for a call with the senior nurse at the clinic I really hope I can carry on with Mirena as it works for me , I’m 53 .

MissisBee · 23/06/2023 22:00

Although the licence is for 4 years, FSRH have updated their guidance and it can be used for 5 years for HRT. So takes the time pressure off you for now. If you can find somewhere to fit and can tolerate it, I'd get it replaced. Most sexual health services aren't commissioned for HRT use; where I work is. Most of the mirenas I fit now are for HRT. I do find though, over 50, some cervixes do reach a point where they say no thank you to a new one! Using vaginal oestrogen for a good few weeks pre-fit reduces the chance of that though.

WhereAreWeNow · 23/06/2023 22:15

@MissisBee thats interesting about needing vaginal estrogen. I'm worried about this postcode lottery. The sexual health clinic only fitted mine for contraception. They wouldn't have done it for HRT. I'm not sure what I'll do when it needs replacing. I'll be 50 and I'm not sure they'll believe it's for contraception. Do you have any idea how to find clinics that will fit it for HRT?

Joliv123 · 23/06/2023 22:32

I told them I wanted it for contraception and still wouldn’t agree when I first called the clinic the nurse at my doctors said not to mention HRT as they definitely won’t fit it for HRT , I really hope I can continue as I feel really well with the combo of gel and Mirena , I think it’s so unfair a friend of mine had her Mirena changed her doctors fit them at the surgery but she lives in a different area to me , she’s 57

imperialqueen · 24/06/2023 11:31

This is really awful. How can one country have such different rules. I had to go to the sexual health clinic, to get my mirena out, I am 52, the nurse had the issue that missibee mentions. A gynocolosit within the clinic prescribed me hrt in the hope this helps and another appointment for September to give it another go. Sunsnow.. hope you get something sorted soon,

WhereAreWeNow · 24/06/2023 11:32

I don't understand why if the Mirena is a recognised and recommended part of HRT treatment, it's so hard to get one! I would have thought it's in the NHS's interests to make it easy for women to get them fitted, whether for HRT, heavy periods, and/or contraception. They're effective and must save the NHS money long term.

SusannaOh · 25/06/2023 02:37

There isn't a 75 combined patch, which complicates things further. If you want to just use patches.
I was using a combination of patches - a 50 combined patch plus a 25 estrogen only . But the GP has said that's not enough progesterone. So I'm now trialling Utrogestan and hating it. Really fed up I was OK with the patches.

purpleopolis · 25/06/2023 08:28

I had a Mirena coil for HRT fitted two weeks ago by a private gynaecologist . It is licensed for 5 years for HRT and I have a card to get it removed in 5 year's time. Your GP I'm afraid, is wrong. I'm afraid to say a lot of GPs don't seem to be fully up to date on HRT.

Blossom4538 · 25/06/2023 09:35

@purpleopolis how have you been getting on? Any side effects?

purpleopolis · 25/06/2023 10:03

@Blossom4538 - it's my third one, but my first on HRT. I had the previous two for mainly heavy periods. I had this one as I have been experiencing post meno bleeding, two years into HRT, which I had investigated too at hospital and nothing untoward found, so I opted for a mirena again as I got on with it so well previously. I was on utrogestan, but it just wasn't doing enough it seems for the progesterone element.

I do have bleeding, but I think it's still my lining shedding from before. The gynae said that should eventually settle. I recommend them, but I do think the success of them is heavily dependant on the skill of the person who puts them in. I've got a tilted womb, which is very high up and my GP and Nurse at my surgery couldn't even do a smear for me this year as they couldn't find my cervix ( I had to go to hospital) which is why I had to get a gynaecologist to fit mine.

Blossom4538 · 25/06/2023 10:35

Oh, ok! Yep, I sometimes have issues with ease of smears so we’ll see.
How did you find going onto HRT? Initial side effects, positives/negatives?

thanks!

purpleopolis · 25/06/2023 14:26

@Blossom4538 - i might not be the best person to ask Confusedi will say it can be difficult to get it right...l have been on it for 2 years and to be honest, it hasn't been easy and I'm still struggling to get it right. I've never felt great, have had post menopausal bleeding on and off and I've been all all the different patches and upped the strength to 100 mcg, but I'm a poor absorber and have just discovered that for the past 18 months, my Estrogen level has remained that of a post-menopausal woman.Confused I'd been thinking that this is how it was. Funnily enough, no hot flushes though, but that's about it, everything else I seem to get. My bleeding is probably due to not enough oestrogen as I've now discovered from a Meno specialist. I'm now trying Lenzetto spray in a last ditch effort to get some much needed oestrogen. Negatives: GPs and gynaecologists seem to think one size fits all and cannot deal with anything outside the box, which can leave women stranded. From my experience and also from what I've read, GPs still don't know enough about HRT so they cannot help those that struggle, as is what has been happening to me. My GP told me they didn't have a clue - they even suggested I go private for help. You can get referred to meno clinics on the NHS but the waiting list is a year.

So the positives are if you are a 'good absorber' and get it right quickly, I think it can change your life for the better, but if you have anything out of the 'norm' you may face frustrations. I've already had to pay out a small fortune to get help and I'm still having to, as I was getting nowhere fast otherwise and there really isn't much point on me being on HRT if nothing changes.

I'm sorry I can't be more positive! Hopefully I'm on the up, but good luck with what you decide to do.

Original poster
Sunsnowsun · 29/06/2023 13:51

Quick update, I saw my GP this week and was advised the Mirena is now licensed for 5 years for HRT, so don’t need to do anything until next year.

At the moment my GP does not fit Mirena and they send patients to the local clinics, but they as others have said won’t fit Mirena if for HRT. I have flagged this with the nurse and GP at my practice and am hoping that by next year they have a strategy.

OP posts:
BridportSpectacular · 29/06/2023 15:01

I ended up having to get a gynae appointment to fit mine. They have a well woman clinic where they do them - it gets booked up though. I was glad I was at the hospital getting it done as I fainted and had to stay in for the afternoon.

They've advised me to book in for the clinic when I need it changed/replaced. Not sure I will get it replaced, ...but that's 4 years away yet - I'm 54.

But anyway that was the way round it - the nurse at my surgery originally referred me to the gynae. The contraception clinic don't get the funding to do it where I am.

I'm tolerating it well, the gynae also proscribed testosterone which was a bonus, and oestrogel. But I don't fancy getting another one fitted.

howdoipullmyselftogether · 29/06/2023 15:35

Interested to read about everyone's experiences with this.

I had my first one at 45 for heavy periods mainly, was due to have it replaced just as covid hit and ended up having it in for 6 years before replacement at 51 - which they said was ok - and I started to get some break-through light spotting sporadically towards the end of that 6th year, so it definitely had reduced efficacy.

If I'm honest, I had the replacement because I have no idea what is happening with my cycles now of course and it seemed daft to mess with something that was working for me and gives me the HRT effect in part at least and really I've been in a mess with peri symptoms/anxiety/ underactive thyroid so didn't want to risk losing it, if that makes any sense. I'm now 53 and wonder (from time to time) what will happen at the end of this one and also if I should be having any other HRT.

The replacement at 51 was considerably sorer than my original one (I kept re-reading the guidance on how bad the pain needed to be to get medical help as it was really pretty sore!) - I wonder if that's an indicator that at 56 I shouldn't contemplate another, from the comments above about the cervix being less likely to accept it as it ages?

purpleopolis · 29/06/2023 18:23

@Sunsnowsun Are you absolutely certain that they won't fit a mirena for you for HRT? All HRT is available in the NHS and you are using a Mirena coil for HRT. The clinic in my area fits them. The only reason I went private for mine, was that I had to wait two weeks, and for me, I needed to get one asap die to other stuff I had going on at that time. I think perhaps give them a ring?

purpleopolis · 29/06/2023 18:27

....sorry about types, but hopefully you get my gist....plus I had a gynaecologist fit mine as I know people have trouble finding my cervix 🙄 a lot less hassle for me to go straight to a gynaecologist, but I'm pretty sure your clinic should fit them. You should not have to suffer and wait.

WhereAreWeNow · 29/06/2023 23:19

@purpleopolis it's the same where I live. GPs can't do it so they refer to sexual health clinic but the NHS trust only funds the sexual health clinic to fit Mirena coils for contraception so thru won't do it for HRT. It's a bit of a catch 22.

purpleopolis · 30/06/2023 09:06

@WhereAreWeNow - That is terrible 😳 I don't understand why some do and some don't? I suppose I was 'lucky' in that I had to pay to get one put in privately ( god help me in five year's time when it has to come out and be replaced) - I thought that this HRT shennanigans had been sorted out for all women now in the U.K, regardless of whether it's a mirena coil or not. They cost pennies to the NHS.

purpleopolis · 30/06/2023 09:10

@WhereAreWeNow - I suppose there is a way around it. Tell them that it's wanted for contraception....women at over 60 have been known to give birth after all.