Heavy bleeding on Mirena late 50’s, is this normal?

[cluttered]

Hi,
I don’t know if anyone can offer advice as to whether this is normal or not? I’ve been on HRT for about 10 years, started taking it when I was having peri-menopause symptoms of night sweats hot flashes etc but still having periods albeit heavy and very close together. Was doing fine on cyclical HRT with topical oestrogel and Utrogestan (2x 14 days) however it was suggested now I’m 55+ to try continuous with the oestrogel and 1 capsule Utrogestan daily.

Since I’ve tried that (2years ago) I’ve never managed to go more than a few months without bleeding so I’ve had investigations (ultrasound, blood tests, hysteroscopy etc) and there doesn’t seem to be any problem. So in September they suggested a Mirena and told me to take 2 x daily Utrogestan to manage the bleeding (which it does) then after 2 weeks reduce to 1 x Utrogestan with the aim to rely entirely on the Mirena after 6 months. However this weekend, after not even 2 months on 1 x Utrogestan plus Mirena, I am flooding even wearing tampons. My question is, is this something I should be concerned about? I was told that I should go back for investigation if I was getting any bleeding after 6 months but this is heavier bleeding than I’ve had for many years.

Thanks in advance for any advice.

I would go back OP. Are you seeing a GP or a consultant gynecologist? It sounds like you're having a terrible time 💐

Why don't you go back to using it on a cycle if that suited you?

It's not mandatory to use progestogens every day. It's more about convenience and many women prefer that.

The other thing you could try is reducing the estrogen.
Depends how much you need to control your symptoms.

If you use 2 pumps have you tried 1?

Bleeding is directly related to how much estrogen.

When i had a mirena i also bleed continuously doctor refused to remove it and 3 months later had a massive hemorrhage where it came out it doesnt suit everyone.

@JinglingSpringbells do you still take HRT cyclically? I’m not sure how usual it is to do this post-menopausally? For some reason the gynaecologists want me to move to a no-bleed regime and I think it confuses the situation when I go for a smear and they ask if I’ve had any abnormal bleeding since they assume I’m post-menopausal.

I’m currently taking 2 pumps but still having a few symptoms such as night sweats so loath to move to only 1 pump. The whole situation came about because I asked the GP if it was normal to need to take double the daily dose of Utrogestan to prevent any breakthrough bleeding. Since it seems to be the progesterone component associated with increased breast cancer risk I didn’t want to do this without reassurance plus I wasn’t being prescribed enough to double the recommended dose.

Subsequently I was referred to first the community gynaecologist and then, after having an equivocal ultrasound result, to a hospital gynaecologist for a hysteroscopy. When I went for my follow-up with him I was put on the spot and urged to have a Mirena inserted there and then. I wonder if they might get some sort of incentive for this because he was so keen! I guess the reason I agreed was that it does make sense to have the progesterone targeted locally rather than taking it systemically which may cause side effects.

I’ve been told that if I continue to have bleeding in 6 months, when the Mirena should be supplying sufficient progesterone to prevent it, that I’ll need further investigations. It probably will take the best part of 6 months to get referred back again anyhow as the waiting lists for gynae are so long, unless I could convince the GP that it was urgent!