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

[Sunsnowsun]

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 ???

I think it's just to do with how different trusts commission services @purpleopolis but I don't really understand either. I did say it was for contraception last time (even though it wasn't really). Not sure how long I can get away with saying that!

I had my call yesterday with the nurse from the sexual health clinic, they won’t fit the coil as I’m over 50 , I did say well you can still get pregnant over 50 , she said she couldn’t comment on that but to go back to my doctor and get a referral for the gynaecology department at the hospital , but that she thought there was a year long waiting list

@Joliv123 and @WhereAreWeNow
I am truly shocked that medical 'professionals' are still uneducated about HRT. You are certainly able to have a mirena coil after 50, what utter rubbish. my own GP is in the dark about HRT still and I have to tell them what I want and need as they do not have a clue.

These people should educate themselves and become familiar with the British Menopause Society's guide for Clinicians, here is a link. It refers to HRT and it's equivalents and refers to Mirena coils. This ignorance has to stop as it's harming women.

thebms.org.uk/wp-content/uploads/2023/04/15-BMS-TfC-HRT-preparations-and-equivalent-alternatives-APR2023-A.pdf

She asked if I was still having periods I replied that since my daughter was born 21 years ago and I have had the coil ever since I have never had a period she told me it must have thrown me into early menopause , I couldn’t believe what I was hearing , this one has been in just over 4 years and over the last couple of months I have had period pains etc but no bleeding , so I said I believed I could still potentially be fertile , she advised the doctors do a blood test , the information and health care seems so different depending on where you live and how educated the professional is that’s supporting you , next step for s to contact the doctors again and try to get to see the gynaecologist

@Joliv123 - I just can't believe she was still asking you if you had periods when you've had a Mirena coil for all this time and that the coil had thrown you into menopause...I am speechless. I was hoping that since HRT had become in such demand theses days, the government were ensuring that all health professionals were educated in HRT, but this is beyond HRT and to do with women's overall productive health knowledge. So sad. Yes, it does seem to differ across the UK too, for some strange reason, again, not right. I hope you get there in the end.

I know it’s bizarre , upshot is the nurse I have just spoken to at my doctors said ring back next week , the other nurse has had the HRT training, and the nurse I spoke to hadn’t so I’ll try again next week, it’s not urgent , it is ok for 5 years but apparently there is a waiting list of more than a year to see our gynaecologist, so I do need to get on the list and also get some advise

@Joliv123 - I wish you luck.

If you can push to it (as I was desperate) , or anyone else reading this thread, I did see a private gynaecologist at my local private hospital. The initial consultation was £200 and I had some good advice on HRT plus a new prescription and follow ups are usually around £150.

I ended up paying just under £400 in all, for the mirena coil ( which included the cost of a follow up and insertion of the coil, plus the coil cost itself). Not ideal, but I really had no choice. I had post meno bleeding, heavily, every month and utrogestan wasn't dealing with it.
I had to go private for it, as my surgery nurse and GP cannot find my cervix when they tried to do a smear earlier this year, so I ended up being referred to hospital for the first time in my life. My smear was then five months late due to hospital waiting list. I'd always had them on time previously.
I've only been at this surgery for a couple of years since moving house and the previous nurse always found it ( tilted womb and high up). I knew I'd need a referral for it or I'd have trouble getting one otherwise. I dread having next smear in five years 😬

There's always something scuppering us it seems.

i also can confirm the Mirena is issues for licence, for 5 years for HRT. I am 57 too and had such issues with the progesterone element of HRT ( I bled) that I was fitted recently fitted with a Mirena bu a private gynaecologist ( also works for NHS) it was easier than waiting for NHS or going to family planning.
I don’t know if you are aware, but a combined patch only goes up to 50 mg Estradiol ( estrogen) so won’t be the equivalent of the Evorel that you had. You could carry on with your Evorel and use Utrogestan as the progesterone element instead, but that is what I had problems with, lots don’t though.