If you didn’t get on with urtogestan and you tried the mirena coil, how did that go?

[Menoooo]

I have an inflammatory autoimmune disease that’s definitely worse during my urtogestan cycle (I take it 14 days of the month). I am now considering trying the coil instead as I read that the hormone stays a bit more local.

Anyone who didn’t get on with urtogestan and tried the coil? How was it?

I used to have the non hormone coil when I was a bit younger and I absolutely hated getting it put in and for about six weeks after! So dreading that! But need to do something or come off HRT altogether.

You could also try the Progesterone vaginal suppositories. I had awful side effects from the tablets and none from the suppositories. GP had to look them up and was a bit ‘oh yes, look, you CAN get them!” There’s also often a bit of a wait whilst pharmacy gets hold of them but definitely worth a try

I lovely my Mirena coil and not having periods is great for my endometriosis. I would recommend going to a gum clinic rather than the GP if you get one. The nurses there are putting them in all day every day and know exactly what they’re doing.

Fantastic! I was on urtogestan for around six years with two pumps of gel. My bleeding was horrendous and becoming so heavy. I would have cramps and have to lie down. Not what you expect at fifty two years old! I had a coil fitted just over a year ago to stop the bleeding. Not had a period since. My moods have stabilised and I don’t get hormonal headaches, I wish I had had it years ago. Everyone I know that has had an easy menopause had a coil. Not for everyone though as I have heard some horror stories. Didn’t even fell it when I got it inserted.

Oh I didn’t know they stop your periods!!

Do you still feel “cyclical”? I have more energy in my mid cycle and don’t want to feel the sort of flat progestroney all throughout?

Good shout on the gum clinic. Do I still need to ask my GP? (Becuase I’m changing HRT?)

I have been trying urtogestan vaginally this cycle and it has made a slight difference to the inflammation but not a total difference.

I didn’t want the coil so I used the mini pill instead and had evorel conti patches. I have lupus. Just be aware that sometimes oestrogen can cause flares in that type of autoimmune issue. I have to say that I didn’t really get on with HRT in the end, I mean that combination worked in terms of stopping periods and less side effects etc but even after giving it a really good go for a few months I didn’t feel much better and it just made me put on weight. I went into early menopause aged 37 due to complex autoimmune issues and I’m now 45, been under 3 specialists for menopause and tried many different types of HRT.

Unfortunately you do still have a cycle of dips in mood/ energy without the periods. But even so not having periods is a great overall boost to my energy. I don’t know if you need to let your GP know or not but I think they are usually very happy to recommend the coil. They generally like to get women over 35 off of the pill because of BP and other risks.

You can take the mini pill forever, no age limit. It’s the combined pill they don’t want people on after a certain age.

If its to do with progesterone intolerance, then you might well find similar issue but to a lesser extent with the Mirena. It's often better tolerated.
I still couldn't tolerate the Mirena, and couldn't tolerate any of the progestogen parts of HRT.
I get on very well using livial tibolone instead of standard HRT, which I wish more people were aware of it's existence.
Only issue with that is that they usually want you to be menopausal and periods stopped, rather than perimenopause.
It boosts libido too

Are you menopausal? I haven’t heard of that one before! I did a very quick google.

I’m a bit scared to stop because I think the oestrogen side of it has levelled out my moods and also I was bleeding heavy clots and getting migraines before HRT. But I’m only 45.

But since taking it; I have been diagnosed with quite a serious autoimmune disease and the progesterone cycle seems to trigger a flare.

It’s like: which do I pick!!!

That’s interesting! I was diagnosed with my autoimmune disease (Ra and then MCTD) after starting HRT and the progrestrone bit makes me flare (joint inflammation) like clockwork every month and then when I’m finished with it, the flaring goes down.

this is the only HRT I’ve tried (oestrogel and urtogestan) and all was fine for the first year, then this autoimmune thing. I have only put the flare + urtogestan cycle together recently because I’ve been autoimmune symptom tracking.

My mood + heavy, painful periods + other things that I was suffering with in perimenopause have disappeared on HRT. But now this!

Hated utrogestan it caused hyperarousal insomnia, which was horrific starting and stopping it, but even used continuously and vaginally (so lower dose) it was a bit better but still not good.
I finally reluctantly got a mirena and i love it. My sleep is the best it's been in more than a decade. I am on mounjaro and intially my weight loss stalled and libido dropped, but this and a bit of spotting were all back to normal after 6-8 weeks.

@Periperi2025 I’ve also been on mounjaro for six months, three stone down, I also spotted after starting it but now nothing again. I have never felt better. Not sure if it’s because I’ve lost weight or my hormones are now level. It’s definitely the right combo for me. I really didn’t want a coil after all the horror stories I had heard. You can have it removed if it’s not for you.

It's amazing. Best decision I made. Took a while to settle but I was prepared to wait.

Got it inserted by a private GP who was able to spend time on it and made me lie on the bed for ages afterwards.

Yes I still feel cyclical and every few months I have a period that last a few hours and comes with a day of horrible cramps and backache. But literally I bleed after a wee, two wees later there's no blood.

I definitely still have ovarian cysts that pop every now and then, I recognise the stabbing pain down the inside of the top of my thigh. That's usually a precursor to a short period.

It's definitely made my HRT easier to cope with.

I still had awful side effects with vaginal progesterone, depression, utter exhaustion and bloating.

@Periperi2025 yes I agree with this. Since I fitted it, my sleep is like that of when I was in my 30s and pre children.

Can I ask what, if anything, you took instead of HRT after stopping it? I've been on HRT 1 pump estrogen and utrogestan 200 mg vaginally for almost 4 months. This past month I tried upping the estrogen to 2 pumps and all hell broke loose - I couldn't stay on it, even if it had calmed down after a few weeks (and there were no promises that it would). I had extremely dark thoughts, relationship catastrophising that disappeared overnight when I went back to 1 pump, bad acne, even increased BO. So now I'm back on 1 pump. It seems to help a bit, but not a lot. I'm considering coming off it altogether, maybe trying mirena, but it's so difficult to know what to do, especially considering the fear that hormones tend to cause me to react badly given that I can't just whip it out if things don't go well.

@atgnat those are all symptoms of progesterone intolerance, NOT oestrogen intolerance.

The mirena really helped me when I had the same issue.

In my book, oestrogen makes me happy. Progesterone makes me cry.

@Moveyourbleedingarse Mirena is progesterone but it still helped?

I wasn't in the utrogestan phase of my cycle when I changed to 2 pumps of estrogel and had the aforementioned symptoms. I'd started that on CD1 and the issues didn't start until about CD10, way after stopping utrogestan for the previous cycle. I'm now back on 1 pump of estrogel and am several days into the utrogestan phase of this cycle and my symptoms have abated. It doesn't seem like utrogestan causes me problems - at least not the severe, specific problems I was mentioning above that I can only associate with the estrogen.

I'm sure estrogen suits most people well, but it seems like I'm reacting badly to it for whatever reason.

@atgnat There are at least 4 types of progestins
Being accurate, only micronised progesterone is progesterone.

For simplicity many doctors call of them progesterone (but they aren't.)

All the others are synthetic progestins.
That includes the Mirena and (usually in patches) Norethisterone.

You just have to experiment. Utrogestan can build up over the 12 days of a cycle and many women find when they stop it they get a withdrawal symptom or two (I get fatigue and sometimes a migraine.)

It can take a while for it all to settle.

@atgnat yes mirena still helped.
The localised effect worked much better for me. Probably also the constant source of progestin rather than cyclical.

@JinglingSpringbells That's what I'm trying to do (experiment) but it's hard to make connections. I guess it could be utrogestan wearing off if it takes a while, but this was my 4th cycle and first severe reaction, whereas the only variable was extra estrogen.

At the minute I'm wondering if the estrogen is somehow having an androgenic effect on me (Chat GPT seemed to think this could be the case...) and I've read Mirena's progesterone also has an androgenic effect, so I'm being cautious, otherwise I'd have jumped into trying it already.

I have just had the Mirena taken out. I also used Utrogestan for 2 years prior both orally and vaginally. Utrogestan was fine at first but then started giving me reflux, Mirena gave me horrendous side effects for first 3 months (no sleep, heart palpitations etc) it then settled a little but badly affected my mood and sleep was still not great. I am trialling dydrogesterone next as a last attempt at HRT.

Had awful side effects on utrogestan, so went on the patches. Had a mirena put in to help with heavy bleeding but had it taken out after 4 months as I had awful side effects. Put on half a stone in less than 10 days, had continuous bleeding, developed cankles, bloating etc and it really impacted me mentally with awful PMT type symptoms, negative thoughts etc