Experiences of HRT with an IUD and gel or patch?

[YourChicShark]

I'm well into menopause (2 years) and after discussions my GP has suggested that I try HRT via an IUD combined with gel or a patch. I've had migraines all my life and this seems like a good option that will keep my hormone levels stable and avoid triggering hormonal migraines. Has anyone (with or without migraine) had experience of this? I've never had an IUD, never had a child, no hysterectomy, and not living in the UK currently, if any of that's relevant. Thanks!

Yes, I have Mirena plus 100mcg oestrogen patch plus testosterone.

Its absolutely brilliant.

But I've never had a migraine though so can't comment on that.

I am progesterone intolerant and Mirena has been a godsend as I couldn't cope with micronised progesterone.

The Mirena has really improved my sleep without the grogginess of Utrogestan.

I have a Mirena (on my 2nd) and I love it. I am also using the gel (have just switched from the patches as I found they didn’t stay put and left a sticky residue). How hard was it to get your gp to prescribe testosterone too?

I’ve just filled in the online form to ask my GP to switch from the patches to gel. This week I’ve used one nearly every day because they are not sticking properly and I’m worried about how well I’m absorbing the patches when they are not staying stuck. I’ve also got the Mirena, I was dead against it but after trying everything else and not tolerating it this was the only thing left. I haven’t had it long but so far so good, with the patches and micronised progesterone I could tell instantly that it was having a bad effect. Insertion of the Mirena was totally different than when I had my copper coil a few years ago. My GP used a numbing spray and I honestly didn’t feel a thing, it was a very positive experience for me.

I’ve had Mirena and gel for 8 years, so far so good.

You've just got to try it and see.

Although the Mirena is promoted as only adding progestin in the womb, it is systemic and some women will get side effects- often weight gain,acne or mood swings. Having said that some find it wonderful and don't get any.

When you say you are two years into menopause, do you mean you're in peri for 2 years or you've not had a period for 2 years?

If you're in peri, it's correct that the Mirena will be a low, constant level.
If you're post menopause, you have the option of all the other types of progesterone, used every day. These don't necessarily cause migraines.

I have had migraine since I was 12. (I'm now late 60s and on HRT.) I don't get hormonal migraines on sequential Utrogestan.

Thank you, this is helpful. It's two years (plus) since my last period.

My GP suggested that this combination was the easiest and least finicky (if that makes sense) given my hectic professional life. I'm nervous about it, as the very short time I was on an oral contraceptive back in the day I'm fairly sure it made me depressed. I know we've come a long way since the 90s but it's good to hear from others about their experiences, both good and bad!

Tried patches and I didn't absorb well plus they were annoying and itchy. Moved to the spray and recommend highly. Easier than gel and no residue and less than 60 s drying time. Think many moving to alcohol based spray as very easy to adjust dose too.

I wish I’d had my mirena coil years before I did, it’s wonderful. And I use gel as I’m in control of the dose that way.

I don't know where you live overseas or what the provision is but here on the NHS some women find they have to wait a long time for it be removed. So bear that in mind and ask your dr? The usual guidance is give it 3 months.

nice to hear about all these positive mirena experiences. I am on HRT in Peri, Oestrogel & just switched from sequential Utrogestan to Mirena which was fitted a week ago today. To help with very heavy painful periods & adenomyosis.
Fitting was fine, just a few seconds of discomfort. First few days were fine, hardly any spotting or cramping bar the first few hours - but I am experienced strong cramps on and off since day 4 and more and more
spotting. Not a period as it was fitted end of my last ‘period’ (withdrawal bleed technically).
Hoping it’ll settle sooner than later..

This is really good advice, thanks. I'll check with my GP.

I’ve had a mirena and 100mcg Estradot patches for years and it’s great.

I much prefer patches to gel. Far less faff, I’m not bothered by the sticky gunk and haven’t had a problem with them coming off or causing a reaction.
One of the huge positives for me with a mirena is that I don’t get any bleeding. With progesterone pills you do, and who wants to carry on with pretend periods when you don’t have to? Plus you have to remember to take the pills on certain days, and the ones you get in the UK are not vegetarian.

I got quite heavy spotting for about 6 months with my first mirena to the point where I had an ultrasound to see if there was anything sinister going on - there wasn’t. It obviously stopped just before the scan. 😂 After that I had occasional but cyclical very, very light spotting.
Have just had a replacement fitted and only had a couple of days of spotting.

Thanks for sharing Magpie. Did you have much cramps with all that spotting? I am spotting and having pretty bad cramps 60/70% of each day which is actually interfering with work and life.
An seeing my GP tomorrow as I just want reassurance.

I tried the Mirena as part of my HRT but didn't get on at all well with it. It caused me massive anxiety and a lot of tearfulness, which was not like me at all usually. Also it gave me painful abdominal cramping when in situ. I was back to normal within a few days of its removal.
Some women love them, but they definitely do not suit everyone.
Also medics never seem to mention the risks of having them, such as possible uterine perforation, embedment, expulsion or infection so please do diligent research and not just rely on your doctor or NHS info, as there is bias from them, due to financial incentives from manufacturer.

I'm on my fourth Merina, this time as part of HRT.

For me, it's OK. However, they have never stopped my periods and they certainly have not helped my hormonal migraines, in fact I had one last week. I'm 58 and still seem to have periods.

10 days in and This is exactly how I am feeling. I am getting the vibe that i am just one of those it doesnt suit

Mirena coil and estrogen gel - brilliant.

Barely a period for maybe once every 6. Months, very light and barely there.

have tried estrodot conti 30/90 very low dose and after 6 weeks I had the most god awful bleeding huge flooding and clots. I had to come off it.
micronised progesterone gives me raging anxiety and low blood pressure.
no idea what I’m going to do now!

No, I don’t think I had any cramps with the first one, definitely none with the second, but I never had noticeable period cramps before so I’m not sure if that has any bearing.

I went on this combo largely for migraine and it has helped dramatically, I rarely get them now.

I have always been advised to avoid attempting IUDs as I haven't given birth vaginally. Apparently its difficult and more painful. So HRT gel and tablets for me.

My GP told me the hormones in HRT are bio identical to our own, whereas those in hormonal contraception are not, so HRT should be tolerated better. (I also hated hormonal contraception)

i have Mirena plus patches. I had the Mirena alone for two years first, I had it fitted to manage heavy flooding periods. The actual insertion of it was painful, and I did find it took 2-3 months for my body to get used to the hormones- by which I mean I had some minor PMT like symptoms.
however if you go straight to Mirena plus patches or gel for oestrogen, that could be irrelevant

@Maria1982 The Mirena is not body-identical.('Body' has replaced 'bio' as it's more accurate.) It contains a synthetic progesterone.

The only body-identical progesterone is micronised progesterone- one of the brands is called Urogestan.

I'm veggie so this is especially good to know!