Mirena and progesterone intolerance

[Lioney]

I have been on HRT about 7 years.
Attend an NHS menopause clinic.
Currently 100 Estradot.
200 Utrogestan for 14 days.
Tostran every other day.
Estring and Ovestin.

Very progesterone intolerant. Stsrted off with Femoston and ended up suicidal.
I had no idea what was wrong with me.
Then realised evert time I tried a progesterone product such as Depo Provera, Provera, the mini pill i became seriously depressed.

Then i was prescribed Utrogestan.
I have always struggled with Utrogestan but managed it by using it cyclically.
Used it in 3 monthly cycles too.

I have Vaginal Atrophy and using Utrogestan vaginally makes those symptoms unmanageable even with an Estring and Ovestin.

Now developing complications and have a thickened lining of the womb. 8.7mm

Currently waiting on a hysteroscopy and biopsy.

I feel like I need to do something else or come off HRT but I'm 49. Postmenopausal since 43 and the menopause symptoms were awful. I need to function!

I'm really worried about having a severe reaction to a Mirena.
That I won't be able to get it removed.
But I can't go on as I am with the Utrogestan.

Any advice and suggestions appreciated.

Hi there
You are not alone re: being progesterone intolerant; there are many many women in the same boat and it's awful.

All I can suggest is, to give the Mirena a go, on the understanding that if it doesn't suit you, it comes out. That's what I did. I experienced persistent post meno bleeding on HRT and eventually got a mirena fitted. I was given the nurses phone number on leaving and she said, if at any time I want it out, to give her a call.

The mirena delivers a much smaller progesterone dose than utrogestan and directly to the womb area. It's also great at keeping the lining thin.

All the best, as I know you are struggling with all this from reading your other post. 🌸

Bump

I'm in the same boat OP, and I haven't got a solution, I'm afraid.

I've tried:
Mirena (depressed + angry + cramping + constant spotting + insomnia)
Evorel Sequi (depressed + skin allergy reaction to progesterone patches)
Utrogestan orally (severely depressed + insomnia)
Utrogestan vaginally (depressed + angry + burning sensation + insomnia)

Consultant advised Lutigest, which is currently out of production so I can't get hold of it. So my GP has prescribed a double dose of the mini pill to try for 12 days starting this weekend. I'm pretty sure it's not going to end well, but we shall see.

TBH I'm rapidly reaching the end of my tether. Unless by some miracle the mini pill works, then I'm going to look at having a complete hysterectomy/oophorectomy so I never have to worry about periods/progesterone again and can reclaim my life.

@Spirael
I really feel for you.

I lasted 2 months on the mini Pill a few years ago by just the standard daily dose.

I'm currently on day 8 off 200 my Utrogestan and started to have suicidal thoughts today.

I think my HRT journey needs to end.

Its no longer safe.
If I feeling this on the Mirena I won't be able to get help.

Push for a hysterectomy i would. Many are progesterone intolerant it seems. It's a key reason why women come off HRT.

Its not something I want to explore.

Fair enough

I stuck with Femoston Conti because the dose of progestogen is lower and consistent which I hoped I would get used to, but it isn't doing its job bleeding wise, so I am wondering if it is the end of my hrt journey too. ☹️

I was hoping vaginal utrogeston would be the answer.

Mirena seems to start off as a higher dose that diminishes over time, but it will depend on your own systemic absorption as to whether it is acceptable.

I've started to reduce my HRT very slowly.

Starting sertraline tomorrow so hoping that will help too.

I'm in a similar position OP, waiting for a biopsy, desperately depressed on 100 mg Utrogestan, 200 made me very weepy so I had to go back to 100. I'm ready to make a private appointment to find out what my next step should be.
I wouldn't refuse antidepressants but in the past (treatment-resistant depression in my 20s and 30s until it lifted around 35) they've rarely been very effective.

I was on prozac about 20 yrs ago and it made all the difference.

I just need to do something else.

I've have attended 5 different menopause clinics. 3 NHS and 2 private.

They all recommended the Mirena.

@Lioney im in exactly the same position as you except I've only tried oral and vaginal Utro and I've now got a coil.

I couldn't tolerate the pill even tried three different types. Suicidal thoughts on all.

I had a coil fitted a month ago. GP said v happy to take it out if I felt bad.

I have had far fewer suicidal thoughts. I am a bit snappy with the family though. The main side effects are total and utter exhaustion ( utrogestan made me feel like a zombie so I'm not surprised at this) and never ending headaches.

The bleeding is easing off now.

Have had a blood test and going to get some testosterone tomorrow. Also going to discuss some low blood results which seem to suggest that I'm vitamin deficient which might explain the exhaustion.

All in all I'm going to hang onto it for now. Def not feeling as bad.

Also I have terrible prolapses front and back and the vaginal utro made them super sore too. Though the ovestin helps a bit.

Ive asked the GP if I can have a hysterectomy & oophorectomy (not sure if it would make the prolapses worse). Appreciate you might not fancy that though!

@Moredarkchocolateplease

Thanks. A hysterectomy would be an absolute last resort I'm still in my 40s and the risk of prolapse etc.

I'm going to try sertraline along side HRT to see if it is more bearable.

Wishing you all the best.

Good luck

If I was you, I would not try the mirena. I was 'persuaded' to have it after the birth of my 2nd child despite having a documented progesterone intolerance. I'm not exaggerating when i say it nearly killed me. I begged them to take it out, they told me to let it settle, but I literally went from feeling fine to not being able to get out of bed in a number of weeks (I also got covered in a horrible skin rash that went away when it was taken out).

it took me months and months to recover, probably a year or so to feel like myself again

I've not touched a hormone since then

I'm 50 now and just managing with diet, exercise and vitamins. It's not ideal but I can't go down that path again!

@Lioney
Hi
Hope you’re feeling better and the sertraline is kicking in.
Can I ask, you seem to be the last person on any thread to mention Tostran - are you still able to get it?
My GP has finally prescribed me testosterone as part of my HRT and it’s Tostran. I’ve been trekking round pharmacies for the last 24 hours, only to be told it’s out of stock.
Thanks

Thank you for this thread. I didn't realise progesterone intolerance was so common. I don't feel so alone. I can't wait to go through menopause to escape the symptoms. I have discussed hysterectomy with my doctor but don't feel the risks are worth it for me.

@Wid I haven't been able to get Tostran since about April.

I will run out soon... not really sure what I will do probably just wean myself off it.

Hope you find some soon.

@CoffeeIsTheAnswer1
My periods stopped almost 9 years ago. Symptoms are as bad now as back then.

I just need to get through the next few months and try to get off the HRT.

Hi Lioney x

I am also progesterone intolerant...tried Evorel Sequi. Was determined to give it three months as advised. Was dreading swapping to combined patch in month three, for all the usual reasons but especially mental health-the day after I put it on, I was soccinf uncontrollably.

I was very resistant to Mirena and in fact, four days after I had it put in, my anxiety whooshed up.

I've gone up from Evorel 50 to 150 (not all at once) but I am MUCH better physically and mentally than I was: the aches and pains have gone and my energy is improving. I think this is partly due to testosterone every other day as well.

In addition to this, I also take Citalopram 40mg.

Sounds like a lot but has honestly saved my career and my sanity!

I think the key is with progesterone intolerance with the coil, is to balance it out with the oestrogen.

It's not perfect but I am doing so much better when I honestly thought I'd never get there...

Keep going xx

*sobbing

Maybe a different type of progesterone intolerance then? Doctor has told me menopause should take care of it.

I had truly terrible menopause symptoms, off work, unable to function. Couldn't tolerate progesterone at all, the impact on my mood was horrendous. Had a mirena fitted during a procedure to remove uterine polyps. Best decision I ever made. I have a high dose of oestrogen in patches and the mirena and it's life changing. I seem to remember the first few months of the mirena took a bit of adjusting to, can't remember exact side effects I had but nothing on the disaster that was other forms of progesterone. I'd go for it, you can always remove it. If you can afford it look into a private gynae who will take it out post procedure if you're worried the nhs would drag their feet about it. Or just discuss your concerns with gp and know your options re removal on nhs, how fast it could be done if you can't tolerate it. It could allow you to feel confident to try it. I sympathise, menopause was horrendous for me, which is why I'd urge you to give the mirena ago.

A different type of progesterone intolerance? So far I haven't tolerated any progesterone well.

How would menopause take care of it?

@TravellingIncognito

I was considering the Mirena as my absolute last resort.

I was due to have a hysteroscopy and biopsy so was going to ask for it to be fitted then.

Unfortunately I had a really bad experience with the hospital. My anxiety and mental health is now so bad that I'm unable to go ahead with the procedure.
I'm on sertraline 100, betablockers and even resorted to diazepam to attend a hospital appointment last week.

It took 3 months to get a fast track appointment for a hysteroscopy and biopsy. I can't imagine how long it would take to get an appointment to remove a coil.

My GP doesn't fit/remove coils.

Unfortunately I have ended up suicidal due to progesterone in the past. My mental health is currently the worst its ever been.

The risk now is if I make the wrong choice, with such poor medical care, it could be detrimental.

Mine is autoimmune. It doesn't require exogenous progesterone to occur.