Levosert as part of HRT ?

[Camelialilly]

I had a levosert fitted in 2023 as a replacement for a copper coil. This was due to new onset left ovary type pain for the 2 yrs prior. After some investigations and seeing a gynae consultant they said I probably had Endometriosis. I didn't really want surgery to assess further / treat so opted for conservative management.Tried a progesterone only pill which made me ragey but this coil has worked a treat. Have been experiencing a range of likely perimenopause symptoms now for maybe 12 months and want to consider HRT. I know the levosert is not licenced for use as part of HRT so my GP is unlikely to offer this option but has anyone done this privately - my understanding is that this is possible? trying to avoid having the levosert out ( it's good til 2029) or taking oral progesterone as think I might be a bit sensitive to it based on experience with the pill.

You could ask your GP to consider it as it is supported, for up to 5 years, by these guidelines.
https://www.cosrh.org/Common/Uploaded%20files/documents/fsrh-clinical-guideline-intrauterine-contraception-mar-23-amended.pdf

Could you swap to a Mirena instead? that is licensed for hrt

It may be that the dose is too low to be used with HRT @Camelialilly

Can you do a comparison online between the two sorts of coil- Mirena and Levosert? Do they both give the same amount of progesterone?

That's your starting point. If they are identical, then you should be able to use it but if it's weaker, maybe not.

This seems to indicate it can be used for hrt and is the same dosage as a Mirena, so maybe it can be used off license for five years

https://www.drlouisenewson.co.uk/knowledge/coils-for-contraception-what-you-need-to-know

This is really helpful thank you - table two absolutely seems to suggest it is licenced so will go armed with this as needed. Thanks all for the suggestions- I've nothing against switching to Mirena but it's quite tricky to get the appointments here for coil removal and insertion as they don't do at my gp surgery and based on previous experience don't do in the same appointment.

Just to be clear, that brand is not licensed for HRT, only Mirena brand is licensed as far as I know, but using other brands that contain the same amount of progesterone and release at the same rate, (ie that can be considered equivalent) is supported by faculty of sexual and reproductive health guidance.

It would be up to the GP if they were willing to use your existing coil as HRT, outside it's license, but the guidance should go some way to reassuring them that it isn't uncommon and if they ever had to defend that choice in a medico-legal sense (the biggest worry for a prescriber when using something outside it's license) it wouldn't be considered bad practice / negligent.

They should consider the risk of unnecessary removal/ insertion of a Mirena and hopefully conclude it's reasonable/ better to leave your existing coil in place for 5 years before changing to Mirena next time.