Progesterone rage - is Mirena the answer?

[AnyOtherNameButMyRealOne]

I am perimenopausal. I have been taken 2 pumps Oestrogel daily for 12 momonthsi have seen a benefit from the Estorgen support.

I was originally prescribed 2x progesterone orally, but I absolutely couldn't get on with the side effects. I agreed with my Dr to try 1x progesterone vaginally, but it hasnt helped and I still suffer terribly.

The main issue with Progesterone is a feeling of absolute, total and unbelievable rage. I am angry and irritated by everyone. I want to physically lash out (I haven't) at every frustration. I hate everything, nothing makes me not angry, and I can barely look at my family. I frankly turn into a horrible, nasty piece of work with no patience whatsoever.

This is TOTALLY NOT who I am, or how ive experienced my period/PMT/PMS through the years - I'm known as the chilled one who goes with the flow.

I can't handle it. I want to cry, wrap up in my bed and not leave for weeks. I can't remember the last time I experienced contentment, let alone joy.

The drs have said that the next step is to have a Mirena coil fitted, even though i dont require contraception protection or suffer with heavy bleeding.

Anyone had success with the coil for dealing with rage?

Or have an alternative suggestion I should be thinking about?

I'm at the point where I'm just going to stop progesterone completely and live with future consequences. I know that's bad, but I just don't know what else to do?

It sounds like PMDD

I'm no expert, apart from being menopausal and on HRT, but why do you think that the progesterone is causing the rage?
I was absolutely furiously out of control with the rage whilst on an enforced break from HRT, and before I started taking it.
I'm now on 2 x progesterone, 75 mg oestrogen patch and a bit of testosterone. The rage is under control but the break through bleeding is not.
Something needs adjusting for you. Good luck.

I've had a coil as contraception since 2004. Out in 2007 for 3rd child. Then back in since. Then no peri, just sledgehammered into meno. Never anxious before, anxiety ridden in meno and although I've always been hot tempered, the rage was crazy. And I mean raving lunatic crazy. Almost split with my partner just a year ago after 11 years. All this was with coil. I finished periods about 2 years ago. On patches about 18 months tweaked up after 6 months. So currently on my dosage and Coil still fitted. Much calmer now. Wedding on for this year.

If you don't want a Mirena could you move to patches with have doses of both in?

You really can't have only oestrogen, it carries a serious risk of uterus lining thickening (& I have experience of this happening as I was prescribed wrongly) and a significant risk of cancer (which thankfully a biopsy has confirmed I'm clear of)

I sympathise with the utter rage! Patches definitely helped with that

@SorrowsPrayers I only experience the rage day 4-end of the progesterone. And I've never experienced the rage before.

@jackstini I didn't know there were patches with both in. I will ask the Dr about that.

@AmIever I haven't heard of PMDD but reading NHS page and the Mind page, it does sound very similar. I think a new dr appointment to discuss that might be in order.

@Mrsdht you've kind of nailed how I feel, 'lunatic crazy' except this is completely new behaviour. I've never been hot tempered, or rage-y before. Do your think the rage was part of your meno kicking in, and did the coil help or hinder?

Yes, I had exactly the same experience as you with progesterone. I felt completely out of control, full of anger and rage. I stopped hrt for a while at that point. My only other option was a Mirena, but I was so scared in case it made things worse or caused the same issues as other progesterones had. I had it fitted about 8 months ago and it has been fine. No rage or anger at all.

Btw…I tried many types of hrt including patches and the progesterone element was always a problem.

I’m having similar problems (patches were the worst) so also following to see if Mirena could help. I have a diagnosis of pmdd which is an adverse reaction to progesterone so it’s not surprising I am finding the same problem with the add bk.

I struggle with this too (although haven't even tried Utrogestan yet - I was like this on the tablets). I find the patches way better for all symptoms (sore boobs, too). Unfortunately, I'm allergic to them! But most people aren't, so maybe try them.

reverse - how did you get diagnosed?

So. I had the coil as contraception for 20 years and it has worked amazingly well for me. You only hear mainly horror stories and no positives. I'm a positive story for mirena as contraception. When my rages and anxiety were high, losing hair, putting on weight, mood swings an actobat would envy, and after a holiday last year when I was off the scale and a relationship on the rocks...I went to the nurse at my surgery. I was 50. She didn't even do the test. She said you're in the middle of menopause . We spoke of options. Some people are against patches and that's their perogative of course. I thought they would be best for me. The mirena was needed for the other element. So I just kept it in as no hassle. So although the coil has not helped me in my menopause with symptoms...the patches alongside the coil have most certainly helped me a lot.

I struggled with progesterone for different reasons, mirena coil solved this for me.

@jackstini I know you right. But fuck it's tough. I can't come off hrt completely, the estrogen is having a positive impact. But i just can't take the progesterone side effects anymore 🫤

That's really helpful to know @TravellingIncognito . Thank you

@Reversetail I'm interested too!!!

I was told the mirena is a lower dose and because it’s there all the time you don’t get the rage. Patches give yoh a big dose of progesterone that tapers off, so if you are sensitive to it then, you know, banshee

I don’t believe the mirena makes you happy. Sorry I’m just mixed after a fairly good week not snapping at family I feel totally down and different today. It’s not the first time in 4 months since life changing mirena I just want to spend the whole day crying.

I really cannot say if it’s make the mood better or worse. And why getting the irregular periods back of a 42 year old, heading for peri-meno is only known to the male gynaecologist.

Re PMDD it’s probably unlikely actually reading again and having no severe pms before etc, but it’s often worse in peri (mine is). Anti depressants have sorted it for me but I’m too scared to go back on any HRT as I was on the floor unable to cope - and that was under a very good menopause specialist. The trial and error was too much to take. I’m not sure if I’m sensitive to oestrogen or progesterone, seemed like both. Nervous of Mirena in case it exacerbated it (plus the procedure freaks me out!)

I went utterly crackers for the first month after having a mirena fitted for HRT. Couldn't sleep, total despair.

However soon after that first month it has settled down and I'm ok on it now, sleep back to normal.

Isn't being a woman fun

@AnyOtherNameButMyRealOne Had a read of all the posts and just a summary -

The first thing to consider is upping your estrogen to 3 pumps. This may override the effects of Utrogestan. It's quite unusual to feel the effects (mentally) if you're using it vaginally because it's not absorbed by the nervous system.

The second point is that it may not be Utrogestan at all, but your own hormones as you're still in peri. It's well-known that worse PMS happens for lots of women in peri as we approach menopause.

There are MANY options and you've not really started on any of them.

The first, as above, is an increase in gel. Try that first.

The second is possibly to change to a longer cycle so you use progesterone less often. There is a tablet form called Tridestra which is 12 weeks as a cycle and only 2 weeks on progestogen.

You could also create this with gel and Utrogestan although you would be best to do it with a (private) specialist to oversee it and perhaps have scans to check the womb lining now and then.

The other options are a tablet form Femoston which many women tolerate well. The progestin in it (dydrogesterone) is almost as body-identical as Utrogestan (therefore slightly less risk of breast cancer) .

Then there 's the Mirena coil which is hit and miss- love/hate and only way to find out is to try it.

Someone mentioned patched. Most patches contain Norethisterone as the progestin. This is androgenic (more aligned to male hormones) and has the possible side effects of bad PMS and also skin issues like acne.

Femseven Sequi patch has the same progestin as the Mirena.

As you can see (!) there are plenty of options but it's a case of working your way through them.

The easiest way is to go up to 3 pumps of gel when you're using Utrogestan and you only need 12 days a month (not 14) as per the patient leaflet.

I am not premenopausal or menopausal however I have a mirena coil and I rate it highly. I'm coming up to my 5th year of having it in and it doesn't cause me any problems whatsoever.
I think where the hormones are 'localised' they don't cause any problems in that way.
I'd recommend, for sure.

Really feel for you, it is awful. It could well be that you ate ultra hormone sensitive rather than progesterone sensitive. My expeirence is having extreme pms (possible pmdd) and being prescribed hrt for it - i always thought that the progestrone symptoms were slightly better than the off hrt symtoms so just put up with it. Mirena was awful for me - depression which I never usually experience . As others have said prob best to optimise your oestrogen absorption and take it from there. I think only a private doctor will
allow taking much less progesterone with regular scans to check lining

They aren't as localised as the manufacturers like to say.

There's info online (medical info which was looking at risks of different progestins) which says that the Mirena releases the same amount of estrogen systemically as a low dose combined patch.

Its so tricky to tune hrt, for me it was def any progesterone, orally, vaginally or transdermal. All of it made me full of rage. The progesterone in Mirena just doesn’t have the same awful side effects for me personally.