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.

I’m feeling that I may be intolerant to utrogestan. I’ve noticed a link in timing to my low mood and suicidal thoughts. I’m day 4 into my 12 day dose and I’m literally now scared to take it . I feel like I don’t want it in my body , I’m also scared to not take incase it messes with my head further. I’m running out of energy - as are my kids and husband . I feel really frightened and alone . My gp isn’t very supportive and the referral that I pushed for to the menopause clinic has been rejected. Apparently my mental health symptoms aren’t cyclical - which is rubbish . After trailing back over 15 years of my gp appointment notes I mentioned hormones and a possible link to my mood on 9 separate occasions . I actually feel devastated. Sorry - long message just. Im just not sure where to go or what to do .

I took my progesterone patch off when I was a few days into the third month of trying it. Like you, I'd been dreading it and I just couldn't carry on with it because of the impact on my MH...

I can tolerate the Mirena. But only with Evorel 150 (oestrogen only).

I was petrified to try it, and it wasn't easy on the lower doses of oestrogen. But I'm absolutely fine, in fact great, with Mirena + Evorel 150 + citalopram 40.

This combination overrides the menstrual cycle, stops all the fluctuations and the symptoms that they cause....

These might be useful for you:

studd.co.uk/dep_women.php

www.pms.org.uk/app/uploads/2018/06/guidelinesfinal60210.pdf

xx

I don't have a cycle as I'm postmenopausal and never had PMT.

No-but you are progesterone intolerant, which is what both Studd and Panay suggest is the cause of most pmt....

If you want to use HRT and still have a uterus, you will need some sort of progesterone opposition, so what I was saying was that, for me, and for many people with progesterone intolerance, whether that is their own progesterone or not, Mirena + oestrogen (in a high enough dose) can be a good solution.

Others who want/need HRT but cannot tolerate any progesterone at all, will need a hysterectomy so they can use oestrogen only HRT...

You could try it until you have your hysterectomy 🤷‍♀️

It's not as simple as just having a hysterectomy. I discussed this with my doctor and was warned about all the risks and complications that come with it. If your symptoms are severe enough, it might be worth it, but it's not without it's own risks.

Absolutely!

As you've tried everything else, perhaps Mirena and oestrogen patches/gel/tablets might be worth trying before hysterectomy, which, as you say, is a very serious operation and might not relieve the symptoms in case.

Best of luck x

I can tolerate utrogestan but the synthetic progestins are a no no for me, I was offered a mirena countless times and always refused. The thought of getting suicidal and not being able to instantly remove the root cause was just too much. Not a risk I was prepared to take.

What other options are there apart from putting up with it or getting a hysterectomy?

I guess it probably a case of managing the individual symptoms-antidepressants for mood and hot flashes etc.

I've heard these are very good:

www.femal.co.uk/pages/is-femal-right-for-me

Also, vitamin b6 and b12, Magnesium (for energy) and cod liver oil for cognition. These help with bone and heart health but I don't know how they would measure up to HRT...

seven-seas.co.uk/products/omega-3/omega-3-and-magnesium-capsules

Sorry I can't be of more help x

Progesterone sent me crazy, I put on weight, my hair fell out & my mental health was badly affected, I attempted suicide 3 times. Have you thought of having a supracervical hysterectomy? They leave your cervix, it is supposed to reduce the chance of prolapse. I had mine done 12 years ago by keyhole, I was only in hospital 19 hours & other than lifting I could do whatever I wanted, I was back driving 3 days after I had it done.

I'm not having a hysterectomy!

This is exactly my issue.
After my recent exceptionally poor care. I don't have any hope I woukd be able to get a coil removed quickly.

I have never considered a hysterectomy.

The other options are my current situation of taking anti depressants to deal with the Utrogestan side effects or stop HRT.

Very likely I will stop HRT. I was trying to stay on it until I'm 55 but I think its very unlikely.

@Lioney hi how did you get on? I'm having the same problems as you. Tried vaginally; no good. Am on 3 pumps gel and 12 days of Utrogestpoisan. I've asked GP to try Slynd if that doesn't work I could try Mirena but vv reluctant as I seem to react badly to everything. Am thinking I'll just have to stop Hrt and worried how awful that will be. Hope you're ok and it would be great to hear an update