Irregular bleeding on Mirena and HRT in perimenopause, feeling worried

[Cld9]

I’m scared something is wrong with me and need help. Please.
I’m 43 in perimenopause. I got the coil 3.5 years ago and took about a year to settle into it with lots of random spotting. I’ve always had a light period with it.
Six months ago I started HRT. One spray of lenzetto and 100mg progesterone.
As I said, I have a monthly bleed but last month my period lasted 12 days. It was light and sporadic but I contacted my menopause doctor and she wants me to take out the Mirena and get a pelvic ultrasound.
Now today, a week later, I’ve just had a light bleed again. It’s red and light.
I’m away for the summer so there isn’t anything I can do until I get home but I am really really scared this is something more serious. It’s today’s random bleed that has really scared me.
If anyone could offer words of support or if they’ve been through similar I’d really appreciate it.

I am on oestrogen gel
and progesterone tablets part of the month as I was still having regular periods when I went on HRT. I was fine for 5 months- bled once a month- then had additional unexpected bleeding. Saw the GP who referred me for an internal ultrasound and all was ok. Sadly no one on here can say you will be fine as you need to get checked out but alot of the time its nothing to worry about

Thanks a million for replying.
I did have a vaginal ultrasound a year ago to check on the spotting and it was all clear.
I suppose it’s just that I had settled down a bit over the last year and now I seem to be a bit random again.

Op, why are you taking progesterone tablets as well as the oestrogen?

That's a lot of progesterone for a small amount of oestrogen.

Likely to be causing the bleeding?

She said she wanted to get rid of my periods so she gave me progesterone on top of the Mirena coil. I didn’t question her.

Fwiw I am on 100mcg patches, plus mirena. And I have a tiny period every now and then, plus sometimes I bleed after a heavy weights session or sex. I put that down to ectropian cells.

I did have regular periods for the first year with mirena, then nothing for a year, then a run of periods every month, and nothing again for three months. I assume it's because hormones are still up and down?

All the bleeding I have is red and light. Like raspberry sauce colour on an ice cream. Very different from my periods pre HRT.

Do you have ectropian? Or is it a lot of bleeding?
Could it just be your own hormones going in peaks and troughs?

I’ve never heard of that ectropian before but I’m going to ask my doctor as sometimes I’ve noticed my period will start soon after an intense pilates session or strength training.

I’m someone who likes to have control over their body and fully know what’s happening and why it’s happening so I’m finding the unpredictability of perimenopause really challenging mentally.

@Cld9 this! It happens to me often. I bleed with a smear test too. Deffo look into it.

It came as a surprise to me that on HRT your hormones are still in flux!

I am on 2 pumps Lenzetto with the coil. It is very unusual to get additional progesterone so I would be questioning that.

I bled on and off for a year, upped the Lenzetto from 1 to 2 pumps and stopped. I started spotting again and have been checked out. As long as there are no other symptoms it is highly likely this is just your body still doing it hormonal thing and nothing to worry about. But I would definitely go back to query the progesterone.

That seems to be the common consensus! I’d say I just have the balance wrong. But I think I’ll get the coil out anyway as I just never settled into it and it’s just annoying me now more than anything.
I’ll talk to my doctor and see if there’s another way to lighten my periods maybe.
I’m just so over this whole thing.
I did get a vaginal ultrasound a year ago for this exact reason so I’m sure everything is fine. Nothing else has changed since then.

I’m definitely going to ask about it because it’s 100% a thing for me. Thanks for sharing x