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[JGC]

Hello, I'm new to this forum and forums in general.
I am 37,and have been on HRT for 2yrs.i started having hot flushes at 32yrs. Underwent ivf 3 times, first time fell pregnant but miscarried, others unsuccessful (this was all after being diagnosed with being  perimenopausal at 32). Since then we have adopted a beautiful little girl!
My question is I currently have Evorel oestrogen patch (previously on tablets until 4 months ago) and mirena coil. I am finally not getting symptoms of menopause since the patch. I think I'm still perimenopausal, but I know from blood tests that I have very little ovarian reserve. The coil I understand is a contraceptive, but I would like to remove this and have progesterone in another way that doesn't act as as contraceptive. Not that I think I will become pregnant, but at the moment my very minute chance of pregnancy has been taken away. Where as if I have progesterone a different way it wouldn't be.
Is anyone else in this mindset, and does anyone have any ideas as to what progesterone I could be on that's not a contraceptive. Sorry if this is not an appropriate question, but thought I would ask.
Thank you x

[Conolly]

Hello  JGC,


I'm still a sort of newbie, just stopping by to say hello and welcome! I'm sure someone else will give you great advice. I know that vaginal Utrogestan (body-identical progesterone) is used for pregnant women with high risk of miscarriage so it could be an option for you after you have the coil removed. It is also widely prescribed for post-menopausal ladies. Hope you can sort things out soon. Lovely thing adopting a little girl, bless you! 


Conolly x

[CLKD]

Welcome.  Some ladies find Progesterone really difficult to cope with, hence Mirena coil.  You can find details by putting 'mirena coil' into the search button here to see what pops up.

Do read the green banner 'treatments' above.  Also, are you in contact with the Daisy web-site, for early menopause: details on the Forum. 

[Dancinggirl]

JGC - I wouldn't rush to have the Mirena removed if you aren't getting any side effects - especially if you have only just started to get relief from the menopause symptoms.  Taking progesterone in any other way can give more side effects and you would also have a period each month which you may or not want and resulting in fluctuations that can be a nuisance.  The Mirena is used a great deal as part of a HRT regime, even in post menopause - I had a Mirena in my mid 50s and I was very post meno by then due to POF in my mid 30s. The Mirena offers protection for the womb, delivering the progesterone where it is needed with minimal systemic absorption, so can be ideal for HRT use when women struggle with other progesterone delivery methods.

If you want to see if there is the smallest of chance you might fall pregnant then you would need to stop all hormone treatment I think - you need to seek advice from a gynaecologist about this. I fear that most progesterones would possibly give some contraceptive effect though - although I believe HRT doesn't necessarily prevent ovulation.  Ensuring a proper shedding of the womb lining each month is a very important part of any HRT regime or there is a risk of womb thickening (erratic and/or problematic bleeding) and a small chance of developing womb cancer.   Most HRT types don't give full protection from falling pregnant and I'm not sure if there are risks should one fall pregnantt while on HRT - I think you need to get specialist advice about this - so ask your GP for a referral to a gynaecologist for advice. 
You could try having the Mirena removed and stop the oestrogen to see if your periods return at all?  Get blood tests done after 6 weeks off HRT to see if there is any ovarian action (so any chance of getting pregnant). Then if blood tests show you are post meno perhaps have another Mirena fitted (simply because it's the least hassle) and resume the oestrogen patches.

I had my 2 children ‘just in time' before my POF started at 34 so I do understand why you want to ‘leave the door open' but you certainly don't want to have all the nasty flushes etc again - you need to feel good and enjoy your little girl. Both my sisters were unable to have children and they have adopted - my younger sister has surrogate twin boys!!! 
Seek specialist advice and weigh up the pros and cons of whatever you do. DG x

[CLKD]

DG - maybe another thread but were all your female relatives affected with difficulties in conceiving?

[Dancinggirl]

My mother had 4 children in her 20s but had her last period aged around 40. I remember her being very temperamental and complaining about being hot all the time when I was young.  My grandmother had one daughter and POF in her 30s. My older sister had Crohns and younger had ulcerative colitis so both had major surgery that meant they couldn't have children. I was the lucky one, as I only had POF in my 30s. DG x

[JGC]

Thank you so much for all your really helpful replies. It's definitely something I really need to think about, as I was given  the mirena coil as other HRT combinations were giving me lots of bleeding. And I obviously don't want my health to affect our daughter. The doctor who I see has offered me a hysterectomy due to bleeding etc, but over the past 4 months this has settled.... For now. So in a way I don't want to rock he boat, but also would hate to miss the opportunity to have a good pregnancy etc.
I have two sisters, one 15 months older and she has 3 birth children. She actually donated eggs to me on our last ivf cycle which sadly didn't work. My younger sister when I found out I was starting the menopause I suggested get checked (at that point had no children), Her ovarian reserve was low but not as low as mine, she fell pregnant 6 months later and now has 2 children.
Think I probably need to have another conversation which the menopause clinic, although she doesn't seem to give me any exact answers... I suppose she can't. Thank you for all your help x

[Hurdity]

Hi JGC

 

There was a discussion about this very subject just a few weeks ago - a new member asked if she could get pregnant on HRT - another who had an early menopause - and in fact she dicsoevered she was pregnant. I think she was taking Femoston. Here is the thread - do read it all through: https://www.menopausematters.co.uk/forum/index.php/topic,37826.45.html

It's a tricky one - you will definitely have no chance of getting pregnant with the Mirena but as you say it stopped the bleeding. Was the cause of your bleeding on the other HRT types ever discovered? - I mean this could be caused by fibroids for example or the dose of HRT not being right. I presume you were on cyclical HRT?

It is well known that for some women the ovaries can have a last fling - a surge in fertility - before finally packing up for ever - and as you are feeling - you don't want to miss this if it were to happen, but without HRT you may be feeling rotten and you want to be well for your daughter.

However in your position, if your womb is healthy (no fibroids, or endometriosis) and doc says it's OK I would have the Mirena removed and perhaps think either about Femoston or Oestrogen patch with utrogestan - and visit the fertility clinic as soon as you can to discuss this? A medium dose oestrogen with cyclical progesterone does not normally suppress ovulation that might occur - otherwise HRT could be used as a contraceptive. Progesterone ( in the form of Utrogestan) is the most natural as it is bio-identical but Femoston also contains Dydrogesterone which is very similar to our own progesterone. The idea would be to tie the progestogen phase (the combi part of the tabs) with the second half of your cycle when you would be producing progesterone anyway - but if you don't ovulate - or rarely do, then the timing is guesswork to some extent. Even if you don't get prgenant - which sounds fairly unlikely - you will at least know that you gave yourself a chance.

Hope this helps and good luck

Hurdity x