No periods due to Mirena, so how do I know if I’m peri?

[giantchocchipmuffin]

I’m 44 and on my 3rd Mirena coil, which I got for heavy periods.

For the past 6 months I’ve been experiencing crushing fatigue and basically napping at every opportunity including work lunch breaks (wfh). Spare half an hour before I need to start getting ready to go somewhere/meet someone? Then I nap.

My sleep at night hasn’t been great for years but it’s so much worse now.

Daily headaches. I’m prescribed regular pain medication for back pain but finding my head is sore as the next dose time approaches. Clock watching until I can take my next dose.

Joint pain which is getting worse.

Brain fog and word finding difficulties.

Constant lack of motivation. I do have depression which is treated with medication but I can’t seem to shift this dark cloud these days.

Constantly feeling hot. Even over winter I’ve had my bedroom window open and a fan blowing on me, in t-shirts.

Feeling like I just can’t be arsed with anyone.

Despite no periods, I’ve been having some light spotting over the past year.

I know nobody can give me a definitive answer but my GP is a pain in the arse and just very dismissive a lot of the time. I remember years ago when he was new to the surgery and seemed very enthusiastic, but over the past few years he seems very fed up and, as I said, dismissive. (Other people I know under his care say the same). I just don’t want to go along and end up fobbed off by him. My confidence has been quite low lately too so I know I’ll end up just scuttling off instead of properly advocating for myself if I’m feeling somewhat doubtful.

Ive read it on here too many times, about women being fobbed off in these situations and I would like to try avoid it, especially if my symptoms sound like this could be peri and HRT may help.

Thanks in advance!

Sounds like textbook perimenopause symptoms OP. 💐 I started HRT at 44 - you should have no trouble getting a GP to prescribe it for you if that’s what you want. In your position I would go to him, tell him what you’ve told us, and see what he says. If you’re not happy get a second opinion. Wishing you well.
PS. I have the Mirena and don’t bleed and it is really annoying not knowing when I am just sad/ rage-filled or have PMT! The question for every woman in her mid 40s to 50s… Hormones or Life? 🤔

Yeah I didn’t have periods due to the implant so for me the big clue was the night sweats.

i did get very anxious but put that down to Covid.

All those symptoms suggest you are peri. The best way to know is to try menopause hormone therapy (new name for HRT) and see if it helps.

How close to 45 are you? If it's not far away you might find it a simpler process if you wait as the guidelines say no blood tests are needed once you are 45 with symptoms but if it's a while then presenting all those you have a good case to argue.

Even without a Mirena, you don’t have to have changes to periods to be perimenopausal. Periods stopping is often the last symptom to appear. If you think you’re peri then ask for HRT and see how you go!

Thanks everyone! It’s so hard isn’t it? Menopause just wasn’t talked about in my family when I was younger so it’s a bit of a minefield. Plus my GP’s overall manner makes me question whether I meet certain health thresholds.

Quick question…..my paternal aunt had breast cancer. Would this impact me being prescribed HRT? Thank you

I’ll be 45 in October.

That's a long list of perimenopause symptoms! I would recommend using the Balance app for a few weeks to keep a record of your symptoms, sleep, mood, nutrition and activity. This will help you to build up a picture of what's going on in your body

Your GP should be willing to prescribe HRT. I started HRT at 44 and I highly recommend it

I’m 38, just for my second Mirena and don’t want any more babies so plan to continue with the Mirena until menopause. I also don’t have periods with it so have been wondering how I will know when I’m perimenopausal (although I of course might have a few years yet!) so thanks for starting this thread! The replies have been helpful especially the one about periods often being the last thing to go.

Ooh thanks for this, will definitely download!

Yup it’s a hard one isn’t it? Almost all the threads and online resources talk about changes in periods being a big indicator, so I was second guessing myself and getting confused about my symptoms. Almost gaslighting myself into thinking it’s probably my mental health.

I would mention about the pain and headache. You shouldn’t be needing to clock watch and there are better things for headaches. Same with back pain - have they referred you to a physio if appropriate?
Night sweats should also be checked out. Please don’t assume all symptoms are related to peri menopause and get each one checked x

Just to add, when my perimenopause started my periods were as normal. They only went haywire about a year before menopause. I had so many symptoms but had no idea what was happening. 14 years ago it just wasn't discussed.

My back pain is related to a car accident years ago and I have had physio for this on a few occasions, last time being about 18 months ago. Weekly for around 3 months and I still do the exercises (when I have the energy).

I have new-ish joint pain in my wrists and right ankle, more of a dull ache.

Regarding the headaches, I wear contacts and glasses and my last eye check was 2 months ago and all good.

Im on paracetamol 4 times a day, naproxen twice a day and gabapentin 3 times a day for my back and I’m finding the headaches are more pronounced when the paracetamol dose is next due. And taking this does help but obviously just masking it.

What other causes are there for the night sweats? The sweating is mainly under and between my breasts . I’m hot all day long though. Currently in a short sleeve top with window open and mini fan blowing.

Ok glad you're being seen although if your last check was 18 months ago, I would perhaps see if they can do anymore or see someone different. That must feel exhausting dealing with that.
I wonder if you are getting withdrawal type headaches caused by the painkillers for example. Its often one of those awful things where one medication gives you a side effect elsewhere. For daily headaches (have this myself) I would want more checks, they gave me a CT scan and then MRI for example.
You're right - its just masking it so I wonder of anything better can be done? Please do push for more support. There are meds which aren't painkillers which can really help with headaches for example.

Night sweats are likely hormonal but can also be for example a cancer symptom. I don't think you have cancer, but it does worry me when I see so many women online assuming (and not saying you are) that all their symptoms must be peri menopause. Please continue to get checked out as you would if you weren't thinking about that, is all I'm saying :)

I think its also so easy as women to assume that being tired is just being a mum/our age etc. It may well be! But no harm in a second opinion. And it is really hard to know - I'm also on the mini pill so no periods here either!

I came onto this as my mirena is due to be changed in a few months and I’m having almost constant spotting (am 45) but no other real peri symptoms BUT I just wanted to say your headaches could be Medication Overuse Headache caused by your painkillers, it’s worth speaking to your GP about that (or is there a different GP you could ask to see at your surgery if yours is difficult?)

I am in the same position - I looked at the NHS symptoms list & could tick so many of the other symptoms that the period/no period due to Mirena did not really matter

Something to think about, thanks for this!

The symptoms can be gruelling can’t they?! The exhaustion is hands down the worst for me

Could you change your GP? Some practices have GPs with a special interest in menopause.

You dont have to see your specific GP. You can request a different GP and i’d ask for the one most experienced with dealing with women’s health (presuming you’re not at a Surgery with only one GP ofcourse).