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[Jinja]

So Ive had a mirena for nearly a year for heavy bleeding and the progesterone part of hrt and use 2 pumps of oestrogel, I've also been on the mini pill for 2 months to stop the cramps and bleeding that I've been having. The cramps have decreased in frequency and painfulness, to become more like a niggling headache in the background the bleeding is now occasional spotting, but since starting the mini pill I have now had 2 migraines, they are optical migraines usually with a mild headache but the effects often last 3 or 4 days with my eyes feeling like they don't quite work together, I usually have about 1 a year but have now had 3 in 3 months.
So my question is should I stop taking the mini pill and see if the bleeding and cramps have settled, my GP is not clued up she gave me the mini pill as she said she wasn't really sure what else to do

[dahliagirl]

As far as I understand, migraines are only a contraindication for combined oral pills, and not POP or HRT. This is because COC contain a larger amount of hormones, and are associated with in increase in risk of stroke.

When you are using HRT, some methods are supposed to be better than others for women who have migraines (in terms of being less likely to cause migraines).  Unfortunately I think it is supposed to be transdermal  Hopefully someone who knows about this will come along.

[Hurdity]

Hi Jinja

That is an awful lot of progestogen you are taking! No wonder you are getting migraine headaches! I would suggest the high dose of synthetic progestogens is causing these. Mirena is already delivering a high dose of progestogen locally to the uterus with some systemic absorption very roughly at a similar level to something like Femseven conti. You are adding more with the POP - which kind is it you are using?

If the Mirena is not controlling your bleeding I think you should be referred after 6 months - rather than given another pill to stop it - according to the info about Mirena on the web. This would be to exclude other causes of the bleeding which the Mirena could mask. However it does also depend where you are in menopause - if peri-menopausal then it doesn't necessarily stop periods nor suppress ovulation.

I would go back to the doc and mention the headaches - and yes I would stop the mini pill and take it from there. If you still get bleeding then I would suggest asking for a referral for an alternative treatment if you are peri-menopausal, and the bleeding is heavier than a normal period and is not at normal period times? If you are post-meno then defo you need to be referred for investigation in my opinion.

Sorry if that sounds garbled - I'm tired after too much gardening!

Hurdity x