Some guidance on whether I should consider HRT or Mirena please 🙏

[Mammamanic]

Hello!

Im 50 with periods still. They are generally regular but do seem to be getting slightly closer together so 26 day average rather than the 28-30 days it’s always been.

Looking back I started with some peri symptoms around 46, mainly being anxiety linked to a series of close bereavements and a job change. My digestive system has also been majorly affected with very unpredictable bowels (mainly loose stools and diarrhoea) and episodes of extreme urgency and incontinence occasionally as I’ll panic if toilets aren’t available.

Im often anxious and get a feeling of being wired when trying to sleep, I often have internal tremors. I also sleep really badly, often waking 2/3am and unable to go back to sleep (covers on / covers off as I get hot).

Im definitely more short tempered, often tired and achy joints. I’ve gained about a stone in weight over the last year and I feel like I’ve aged 10 years in the past 3.

Sex drive is definitely lower, I’m often sore down below, I feel dry and stingy. I get very painful ovulation and period pain, periods are heavier and I feel absolutely worn out by them.

My vision is deteriorating and my eyes are often dry and itchy, skin is itchy too.

So, thoughts turn to HRT and whether I need it / will it help things. I absolutely cannot risk anything that will make my bowels worse - my muscle control is poor from having big babies and if I have diarrhoea I’m unable to hold it.

Why do some people have the Mirena and what will that do? Can HRT help me? What is the common prescription for this and how long does it take to start seeing a difference?

Will I continue having periods if I take HRT? Do they stop at all or if you’re taking it you still get them?

lots of questions sorry!

The Mirena can be used as part of HRT - the progesterone part - and then you have oestrogel as well for oestrogen. If you have a womb you need some form of progesterone (mirena coil, mini pill and utrogestan or just utrogestan etc) as it helps to prevent the lining of the womb becoming too thick which is a cancer risk. If you have no womb you just have oestrogen for HRT - ie gel. Some people prefer patches. Ideally you need to see a menopause specialist. Newson health website / balance has lots of information.

I have been on HRT since 37 for autoimmune reasons and I take the mini pill, utrogestan 100mg every night and oestrogel and I don’t have any periods / bleeding at all.

The Merina provides the progesterone part, which you need to keep your womb healthy. It can lesson bleeding and cramps too and is a contraceptive.
Your symptoms sound like low-estrogen peri symptoms. I would recommend booking an appointment with your GP (I would ask for the GP at your surgery most experienced in meno if that’s an option) to discuss trying HRT. You really need to read up as much as you can about it first. I also took a list of my symptoms and handed it to the GP, which I think helped her time-wise and helped me as I was flustered! My HR started working within a few weeks. Good luck

if you have a womb you need oestrogen and progesterone. Progesterone protects your womb lining. Oestrogen can be in the form of patches gel or spray. Progesterone can be in a combined patch with oestrogen or as the marina coil or as separate tablets. If you are still having periods, you usually go on cyclical HRT, with this type of HRT, you take progesterone for 12 or 14days of the month and you do have a monthly period or withdrawal bleed. if you have not had a period for over 12 months, so are classed as postmenopausal, you usually go on continued HRT which is continuous oestrogen and progesterone, and with this type of HRT, you don’t have a period. It does sound like per menopausal symptoms you are having.
I have oestrogen patches and utrogestan progesterone for 12 days a month.

This is really helpful as I'm similar and hoping to get an appointment this week with my menopause specialist at the GP.

Only difference is I'm younger (44) and cycle is all over the shop. 63 days, 16 days, 29 days so how would I manage something that was supposed to fall within a cycle? Or would the mirena regulate the cycle then add the 2 week bit on top?

@FusionChefGeoff The HRT usually creates its own cycle.