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[julesmull]

Hi all, I would ne graeful for your advice.
I am 49 and about 2 years ago started on HRT to counter the usual PM symptoms. Initially I was on Elleste Duet, which relieved some of the symptoms but also gave me headaches, so my GP suggested switching to Everol Sequi patches.
I've had a fantastic six or so months on these: headaches gone, no night sweats, irritability or brain fog. Only downside was heavyish bleed towards the end of each pack which seemed to last longer and longer.
However, in the past month or so my PM symptoms seem to have returned. I'm having palpitations a lot, my periods seem to come pretty much all the time; I'm not sleeping, my hair is falling out and skin is dry and itchy. Worst of all I'm battling with repeated bouts of cystitis, which is one of the main reasons I started on HRT in the first place.
My GP is suggesting I have a Mirena Coil inserted (I do need contraception and have been taking the mini pill alongside the patches for this) used along with the patches. Does this sound like good advice? I've heard mixed reports.
Or should I be increasing the dose of whatever is in the Everol Sequi patches as they no longer seem to be effective??
Any advice gratefully received! 

Or should

[Hurdity]

Hi julesmull - if you're taking the mini pill as well as Evorel sequi then you are probably getting an overload of progesterone which may well be contributing to your pms type symptoms not to mention the hair loss.

Yes - if you need contraception then the Mirena coil is a very good option because you would be getting less progestogen absorbed systemically than you are currently taking ( which mini pill are you on?). You would then be able to add oestrogen patches at a dose that suited you. Some women find that they need a slightly higher oestrogen dose when on the Mirena which may well also help you now - but better to do it all in one than have to take several preparations. Evorel sequi is a combi patch and comes only in one dose.

A Mirena will also help with any bleeding as it should eventually stop - a bonus!

Hurdity x