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[Dancinggirl]

Good to hear you are doing well anais.  The bleeding and spotting may continue on and off for a few weeks more and this is quite normal.  Some do get the odd bleed or spotting generally with the Mirena but usually once the progesterone in the Mirena has calmed the womb lining right down this seldom happens.
The Mirena can be the simplest option for HRT and it is not uncommon to get some slight sedative effects in the first few months as well - I slept like a baby in the first 6 months. A high percentage of women do extremely well with the Mirena and this is why it is so often recommended by gynaes.  Keep well.  DG x

[anais]

Just another update even though I started this topic in September.

The bleeding became progressively lighter, to light spotting after several weeks and then to minimal spotting with a one-off day here and there with no visible signs of spotting. So, just when I thought that the bleeding had stopped... the spotting started up again. Only light spotting for a few days, and then followed by about 10 days of nothing at all at around the three months point.

So that was great, the Mirena was doing it's job as expected. And then today and yesterday - spotting again. 

Perhaps, as you say Dancing Girl, a wee bit of spotting now and then is within the normal expectations of using the Mirena. I've been keeping a record on the printed calendar on the back of the Mirena information booklet and I'm seeing the consultant at KCH next month. I have a few more weeks to observe and record any bleeding and spotting which I will then take to my appointment.

So, at about the three months the bleeding/spotting stopped but after 10-12 days a wee bit of spotting has appeared. I was getting breakthrough bleeding oncontinuous  Utrogestan and was having a light bleed every 12-14 days for about 5 days. I have the option of 200mg Utrogestan daily but after going through all of this rigmarole of the Mirena, I'm more inclined to stick with it.

BTW, I had no improvement in sleep with the Mirena, nor did I have better sleep on Utrogestan. I have ME/CFS and my sleep pattern was disturbed anyway. My consultant says it only really helps sleep problems if they are caused by the hormone changes associated with the menopause so he warned me it probably wouldn't help in my case, and he was right.

I was a bit annoyed with the info on Dr Studd's website saying that HRT can help with CFS/ME. That's misleading. It can only address the problems associated with the menopause. If otherwise healthy women experience tiredness at the menopause that probably can be helped by HRT but there's a world of difference between that and someone with ME/CFS. HRT hasn't helped my ME symptoms one jot, but it's probably one of those situations where "your mileage may vary". I'm saying this for the benefit of other women with ME/CFS, not as a criticism of anyone here who genuinely wants to help people. I'm taking HRT because of osteoporosis not because of classic menopause symptoms so for me it's all about what the DEXA scan looks like rather than how I feel symptom-wise.

[Dancinggirl]

anais - so pleased to hear things are settling well.  Spotting now and again is quite normal with the Mirena and is rarely anything to worry about - only if it becomes heavy should one get things checked.
I do agree with you about HRT not necessarily helping other health conditions - sometimes it can help by reducing the meno symptoms but I don't think we can expect HRT to be a cure-all.  In time, together with other strategies, your CFS/ME may improve 'a bit' because meno symptoms are more controlled.  I assume you engage the usual strategies to help improve sleep e.g. good bed time routine, darkened room etc.

If you want to treat or prevent bone loss then you are doing the right thing.  Do keep us posted about your ongoing progress - there are so many women who are scared to try the Mirena and it can be a very good option as part of HRT.  DG xxxxx

[peri]

Hi Anais interesting post, I'm booked in for a mirena fitting on the 5th Jan (I'm currently on utrogestan) and am hoping I've made the right decision.  My main concerns are whether it makes me depressed or affects libido/response.  Have you noticed any difference in any of these issues?

[walking the dog]

Hi peri
I had mirena fitted in September and I was absolutely terrified it would make my mood and pms worse however its been the exact opposite I haven't had much pms and what I have had has been tiny compared to before
The only issue I have had with it is heavy periods lasting up to two weeks with a break of a few days before the next one starts but id rather live with that than severe pms
Xx

[peri]

That's comforting to know walkingthedog, thanks for that.  Unbearable pmt has been my worst symptom, I can cope with anything else if my mood is even x

[Hurdity]

The thing about CFS/ME that some of us are concerned about, is for women to be wary of being diagnosed with conditions like this for the first time when you reach or approach menopause - in lieu of a proper endocrine screening and treatment. We have seen that women are "threatened" with these diagnoses including myself - fibromyalgia was suggested to me for my persistent aches and pains and tiredness, and the doc was going to refer me on - and some of these women have in fact not had these conditions but some sort of hormone deficiency - whether it be oestrogen, testosterone or underactive thyroid. Unfortunately the docs don't often see a holistic picture - testosterone is not routinely considered, and many women experience symptoms due to mildly underactive thryoid ( but within normal, untreatable range), and low oestrogen levels are considered normal for post-menopause so in the absence of flushes and sweats would not necessarily be treated with HRT.

Those who already have these unfortunate conditions that are not due to any hormone disturbance as Dancinggirl says - may not see an improvement - although some women do report their symptoms abate somewhat with HRT.

I hope you see an improvement soon anais.

Hurdity x

[anais]

Hi everyone, thanks for all your responses, so I'll give you all an update.

I'm 6 1/2 months with the Mirena now and I've had no spotting for an entire month. So perhaps I've finally got there, but it took 5 1/2 months to get there.

I saw the consultant at KCH on 25 January. He was happy that the bleeding had stopped even if some light/minimal spotting started up again. After a couple of weeks the spotting stopped for maybe another 10 days or so. He was happy enough with that. He said just stick with the Mirena until my next review. If the spotting continues he said I could take Utrogestan in addition to the Mirena.

So, after some very light/minimal on/off spotting throughout February - sometimes just a tiny trace - I've been bleed-free for the past 4-5 weeks, no spotting. So far so good. I see the consultant again at the beginning of August for review.

I was also prescribed Ovestin to help a bit with the outside bits as I have been prone to dryness and soreness. It helps just a wee bit but nothing dramatic.

My current HRT regime is 3x doses of Estrogel daily, Vagifem on alternate days and Ovestin 3x weekly, and the Mirena of course.

Peri, the Mirena didn't really have any mood changes for me and sadly not much difference in libido or response either. I have hoped all along that each thing I try might restore some of that lost lustiness of my former self but sadly not. The HRT has definitely helped in that regard but emotional issues have far more of a dampening effect on my libido than they would have done pre menopause. Even relatively trivial issues. The only thing left to try is testosterone but I've had to get the bleeding sorted before I can even think about yet another change in my HRT regime.

[Hurdity]

Thanks for the update anais - very helpful to Mirena users

Hope you continue to see an improvement.

Hurdity x

[anais]

Would you believe it, I've had spotting today. First time in 5 weeks. Somewhat disappointing but I'm keeping a diary. I don't know if odd spotting now and again is to be expected on systemic HRT with a Mirena. I was scanned last August because the bleeding and spotting wouldn't settle on Utrogestan, hence the Mirena. Lining was 2.9mm and ovaries were small, so the docs were happy enough to diagnose 'breakthrough bleeding'. Not sure if I want Utrogestan on top of the Mirena but after all I went through after the fitting, the pain during weeks 2-4 and the constant bleeding that settled into constant spotting, then intermittent spotting, then none... until today. Grrrrr.

[Dancinggirl]

Anais - if you read the info about the Mirena onthis site, it clearly states that not all women  are completely bleed free when using the Mirena. You are using quite a high dose of oestrogen so maybe you are more likely to get a bit of spotting now and again. I had the Mirena for 4 years and occasionally got a bit of spotting. Try to relax - you're feeling better overall so this combo sounds good for you. There are no quick fixes. DG x

[anais]

Thanks DG. 

I can accept the odd few days of spotting here and there. It's just after the "miracle" of being bleed free for several weeks it's a case of "oh, THAT again..." <groan> 

At least I'm seen by a very good consultant at KCH. Anything that seems a bit atypical will be checked out. However, he did say that bleeding after the menopause isn't normal so if I'm having any bleeding it's impossible to know if it's breakthrough bleeding or a medical issue, hence why I had another ultrasound last August. So that's why he said give it a few more months and if it's still ongoing I could stick with the Mirena AND take Utrogestan. Like most women on here I don't want to be a walking pharmacy if I can help so I'd prefer it if the Mirena can do it without adding more into the mix.

The consultant was optimistic because the bleeding and spotting had actually stopped for a couple of stretches of about 9-10 days in December and January. February had more bleed free days than January, but I had no bleeding in March. I was feeling happy because I thought it was problem solved. Maybe. Let's see. My next review is in early August.