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[Lizab]

Why is it acceptable to use the mirena and a patch in peri, but other continuous combined therapies aren't given until post menopause?

I was offered a continuous, but requested cycles because I haven't been a full year without periods. I will not use mirena, as I had a negative experience with it in the past. I'm kicking myself now for not taking the continous. The ten days of progesterone seemed to help me, and I'm wondering if perhaps I need that more than the estrogen.

[Dancinggirl]

There is info on this site about Mirena if you look under TREATMENTS.  Basically the Mirena can used as a contraceptive as well and will often control heavy and problematic bleeding so is ideal for all sorts of things.  Many specialist gynaes really like the Mirena as it is so versatile and gives relatively fewer problems than other forms of BCP or HRT. When used in peri or post meno it allows women to use as little or as much oestrogen as needed while keeping the womb lining thin. If you are not truly post meno then the other continuous HRT pills and patches can result in problematic bleeding. 
If you don't want the Mirena then many women prefer to keep to a sequential HRT as it means there is less progesterone used.  It tends to be progesterones that give side effects and when taken continuously this can be more of an issue but if you feel good on the progesterone I'd stick with you current regime and perhaps in 6-12 months try the continuous version. Most of us would love to be just on oestrogen alone but this isn't possible if you still have a womb.  DG x

[Lizab]

Thank you, Dancinggirl. I don't understand how the Mirena stops bleeding (it eliminated mine) but continous HRT causes bleeding.

I can't say for certain that the progesterone portion was helping, as I'm only 4 weeks into hrt and still very up and down. But after two nights off the progesterone I'm feeling some low level anxiety creeping in that seemed to be improving during the course.
I was just curious.

[Briony]

Why not go for a half way measure like I do  (and a number of others). We are still having periods but dont like the dip after sequential hrt, so take progesterone for 25 days. I have 100mcg patches and take 100mg of Utrogestan (vaginally) for 25 days. I dont get spotting (still early days, to be fair) and this month only had a very slight bleed on day 27. x

[Lizab]

Ooo, Briony, I wasn't aware of that option! I wonder if it's ever prescribed that way in the US? I have some research to do.

[Briony]

After researching it on here, I decided that I'd approach my GP and if she said no, I'd say I was doing it sequentially (ie 200 mg for 14 days) and instead take 100 mg for 25 days. As it happened she was fine about it. This is from the medical guide NHS GPS in the UK often refer to:

http://www.mims.co.uk/drugs/obstetrics-and-gynaecology/menopausal-disorders/utrogestan

[Lizab]

Thanks. I'd have to get my doctor's blessing to do it, as my Prometrium is in 200 capsules.

[Briony]

Sorry about the link. It opened when I looked at it (so you could see the 1-25 dose) but it wont show it now. I would try researching it online and then print off and show your doctor. Mine was really amenable to it - I was amazed!

Alternatively, if you cant have that but want more continuous progesterone without using synthetic estrogen, you could try one of the new bio identical birth control pills. Qlaira/Natazia and Zoeley are the ones nearest to continuous hrt. 

Good luck x

[Nina]

Hello I do the same as briony apart from I use 75mcg patch and take utro orally. Am 44 too x