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[Bomber]

Recently had to have my Mirena coil removed as it's time was up and fully intended to have another put in to go with my Everol 50 Oestrogen patches. However, removal was so painful, I couldn't face having another one put in so opted for Everol Conti instead (I'm 53 yrs). I was told that dosage of progesterone was comparable so wasn't expecting any problems, but over the week or so have experienced some pretty extreme depression, very fierce hot flushes and a recurrence of my gastric disturbances. Could it be that the doses aren't comparable after all or is it all in my head ? Coil was removed 17 days ago.
 

[Jellyb]

Hi Bomber
I'll be interested to read the replies as I'm in a kind of similar situation: 44, Mirena removed but the couldn't get another one in.  Having a scan next month to see if it's still possible to have one.  Otherwise I'll be asking for another form of HRT.

[MIS71MUM]

Hi
I have no direct experience but know from personal experience, the progesterone in evorel conti is norethisterine and is the least tolerated.

The Mirena delivers progesterone straight to where it's needed, whereas the patches have more circulating through the body. Maybe it's the norethisterine that doesn't agree with you.

[Burchers]

I started Evrol Sequi patches last week and have noticed anxiety levels have increased. I'm debating whether to stop using it.

[Bomber]

So it's now been just over a month since my Mirena coil was removed and I started Everol Conti. Still getting regular, but moderate hot flushes around dawn, but the aches and pains are still pretty bad and my mood is quite low. Definitely not feeling as good as before this change, but thought I'd give it a couple of months before I think about another one.
What has been quite a shock to me is how quickly and how significantly a change in HRT can impact on my overall well being. This is the second change I have had and both have been quite a shock to me.

[Hurdity]

Thanks for the update and sorry to hear this Bomber. The oestrogen doses are definitely the same and it's the same patch - Evorel - but some women find that synthetic progestogens especially can interfere with the beneficial effects of oestrogen and experience flushes during the oestrogen/progestogen part of HRT. Some find they need to add in extra oestrogen at this point if they are taking separate oestrogen and prog - Stellajane is one who has reported this. As you are taking this permanently it may well be that this is happening to you all the time but you are unable to increase the oestrogen dose separately. The progestogen from Evorel is all getting into your system whereas with the Mirena only a tiny amount does, and it is a different progestogen too (norethisterone with the Eovrel, and Levonorgestrel with the Mirena) and you may well be experiencing the different effects of these. See how it goes but if it doesn't settle then maybe grit your teeth, take lots of painkillers and have another Mirena put in., Even if it is painful - this will surely ease and may be worth it for the 4 years of beneficial HRT that works for you? Do you also use vaginal oestrogen - could this have been the cause of the painful removal or was it lack of expertise? Hope the flushes have eased - if not maybe time to have a re-think?

Hurdity x

[Bomber]

Thanks everyone for your responses.
Decided to grit my teeth and stick with the new regime for 2 months so thought I would give you an update.
So, hot flushes, depression and gastric problems seem to have settled down mostly, but joint pains (hands and spine) are really bad and sleep quality is very poor. Can get off to sleep, but wake around 5am most days. It's like someone has turned the lights on and I'm wide awake, but don't know why. Also, not feeling quite so responsive in the bedroom dept. which is important to us.
Overall, I feel that I was much better with a Mirena and oestrogen patches so in spite of the anticipated difficulty of the fitting, think I'm going to go for another coil in the New Year.
As an aside, when I went for a hysteroscopy about 4 years ago, they told me that they couldn't find one of my ovaries on the ultrasound and that it has probably shrivelled which can happen. Could this be why I've had such a horrible time ??
Happy Christmas everyone!

[Dancinggirl]

Bomber - Hurdity has explained things well - whilst in theory the patch should give you the same as the Mirena and oestrogen patch, I believe far more progesterone is absorbed systemically with the combined patch.  The Mirena delivers progesterone more directly to where it is needed and less goes around the body - therefore fewer progesterone side effects.
You may well find the patches settle with time but many of us find the higher level or progesterone used all the time can give more PMT symptoms.
The shrivelled ovary probably meant you became oestrogen deficient earlier but how each of us responds to the decline in oestrogen will vary greatly - this is why we all experience the menopause differently.
The waking in the small hours of the night is common I'm afraid - HRT makes sleep better but I have found that as I get older a good nights sleep is rare for me.  DG x

[Bomber]

Having thus far been unable to get a new Mirena inserted, I decided enough was enough and went back to the doctors to see what other options I could try. So now I've started on Fem Seven Conti patches on the basis that like the Mirena they deliver Levonestrogel as opposed to Norethisterone which is in Everol Conti and let's see if it gives me any improvement. I'm determined to get back to the good place I was in before my Mirena was removed. Wish me luck !

[Lanzalover]

Hopefully Femseven having the same progesterone as the Mirena will help.

Good luck !

[Hurdity]

Good luck Bomber and hope it does the trick for you

Hurdity x

[Bomber]

Hi Everyone,
Just thought I'd update this post as I finally have very good news.
The Everol Conti didn't work for me so I switched to Femseven Conti which were better, but a nightmare to source and would not stick on, despite my various efforts. I also put on lots of weight and had quite a lot of breast pain with them. In the end, I got an appointment at the Family Planning clinic to have another Mirena fitted with local anaesthesia and went back to my Everol 50 oestrogen only patches. Life has returned to normal. I am sleeping well, anxiety gone, joint pains and nausea and acid massively improved and I'm starting to lose some of the weight I gained with the combined patches. I also found a new site for my patches which is the best ever as they stick really well - inside leg just above my ankle.     
We're all different so my experience may not mirror that of others, but my HRT vote goes to Mirena coil  and Everol 50 despite the difficulties of getting the coil in. It really has been worth it. 

[Hurdity]

Thanks for the update and glad it has worked out for you - but the application site would be problematic for many in the summer - eg I rarely wear socks from May to October - and either wear shorts - of varying lengths, skirts, knee length dresses or cut-offs/leggings so the patch would both show and also be rubbed off with gardening and various activities. Could be a great idea for winter months though, for those who have trouble with patches sticking. 

Hope it continues to work for you and I am sure this advice will be helpful to others

Hurdity x