Hi angelindskie
I have no experience of fibroids but I understand what you are saying - basically she can't prescribe continuous combined HRT until you have been period free for 12 months, and prescribing cyclical HRT will aggravate your previously heavy periods due to fibroids.
The only way continuous progesterone is prescribed at any time is through the Mirena which as you say gave you pms symptoms.
She is wrong in saying that any progestin would give you the same symptoms unless you are progesterone intolerant. There are women on here who react to some progestins but not others - although with the Mirena less is absorbed into the system.
Micronised progesterone ( marketed as utrogestan) which is bio-identical, may not give you the same symptoms but is a far less powerful progestogen than some of the synthetic ones so may not be as effective at preventing growth of your fibroids - especially on a cyclical basis.
Here is what it says on this site about fibroids and HRT -a lthough I expect you've already read up on it:
Fibroids are benign smooth muscle tumours of the uterine (womb) wall and are dependant on estrogen. They tend to shrink after the menopause but shrinkage may not occur, or they may even increase in size with HRT use. Increase is thought to occur in 25% of HRT users and mainly occurs in the first six months of therapy. There is some evidence that transdermal (patch or gel) but not tablet HRT nor tibolone may promote fibroid growth. [ref 24] Fibroid size can be monitored by regular examinations and sometimes by ultrasound scans. There is some evidence that the use of the progestogen releasing intra-uterine system, Mirena may cause fibroids to reduce in size. Mirena is often used in the perimenopause by women who have heavy periods and/or require contraception and can provide the progestogen part of their HRT.
My view would be - if your overall health and quality of life is being affected by menopausal symptoms, and lack of oestrogen, I would be tempted to treat the problem which is preventing you replacing the oestrogen through HRT ie the fibroids which could flare up with added oestrogen.
Have you looked into treating these surgically rather than with a progestogen? If you don't then they will always be there ready to be stimulated by oestrogen, but you won't be able to take continuous combined HRT until 12 months without a period - and even then you may have some bleeding once you re-start the oestrogen.
I know surgical means are more drastic but may help you in the longer term?
I would definitely get a second opinion
Hurdity x
