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[Ljp]

Hi,
I've used mirena coil and oestrogel without problems for 4 years.
I was referred to see menopause specialist/gynae at a local surgery before Christmas to supposedly have coil changed as original guidelines stated 4 years as part of HRT, long story short, strings from coil have gone up inside my cervix, hence referral.

Saw very nice specialist on December 12th, she explained that mirenas become increasingly difficult and potentially more uncomfortable to fit as we age, due to shrinkage etc, and aren't recommended past mid 50's, I'm 55.

She suggested leaving coil in for time bring, and trying utrogestan, she said coil would be good for another year, but good chance to try utrogestan.

I've been taking 100mg utrogestan every night on a conti regime for almost 4 weeks.
Generally feeling ok, but back at work today, I teach dancing, struggled with brain fog!....had issue over Christmas feeling very flat, depressed and anxious, all things I had prior to starting HRT 4 years ago.

I'm seeing specialist next Tuesday, and will tell her how I've felt, thing is I lost my mum at Christmas 12 years ago, so subconsciously not a good time, and lethargy from different diet and not working could be a contributing factor,
I'm unsure what do, if I'm going to stay on utrogestan I want the mirena removed, I do wonder if having both could be making brain fog etc worse, so it's whether to ask for another mirena and risk the pain if insertion, it was very painful 4 years ago.
Or whether to have it removed and continue with just utrogestan and see if brain fog, anxiety, depression settle down?

Not happy to use utrogestan vaginaly as I have VA and very sensitive vulva

Any thoughts please

[Ljp]

Hi birdy,
 yes I would, but very unsure as my vulva is very sensitive, and I have estring?
I would prefer it to be under the blessing of my specialist too.

But wondering if just have the mirena removed might improve the mental issues again?

[Tinkerbell]

I got Vulval irritation form using Utrogestan vaginally.

[Ljp]

Yes I was ok on the mirena, and felt really good when I added the tostran in September, but I've had to reduce tostran to half a pump every other day, was on every day, as blood test I had done via online company came back as high 6.2 but that's total testosterone not free, but advised to reduce 🤷‍♀️

[Ljp]

I was debating asking for testim which is a weaker testosterone to see if I can use it daily.
It's just deciding whether to have mirena removed so I can see how I feel on just utrogestan, or whether to dump that whole idea without knowing, and ask for another mirena 🤯

[Hurdity]

If you felt well with just the mirena and estrogel then why not stay with it? After all you are still young. I had barely started HRT at your age and as Birdy says I was offered a Mirena at age 60 when I was referred for spotting.  There was no mention of difficulty in fitting or anything like that. There is also the Jaydess which has a lower dose  progestogen (same type) although not licensed for HRT, not sure what physical size it is compared with Mirena though. I would not want to take (and have never taken) daily utrogestan nor orally and like Birdy suffer brain fog when on it so I take it cyclically.

Testim was unavailable, but I think it is now being produced by another company so you could ask for it - if not there is Testogel  1% (sachets - not the pump pack which is more concentrated - less than Tostran but pumped dose is large compared with Tostran).

Hurdity x

[Ljp]

Thank you, overthinking everything at the moment....another side effect? 🤷‍♀️🤯

Considering a tiny amount of tostran daily again?

Wonder if she said what she did regarding coil due to my VA?

[Ljp]

It's a gynae/menopause specialist that I saw in December, and will be seeing again next Tuesday

[Ljp]

Yes, she suggested I try utrogestan to see how I got on.

Like I said, I dont know how I'd be on ‘just' utrogestan

I am anxious about removal and replacement of coil as it was very painful first time 4 years ago.

But I'd not been using much vaginal oestrogen then, so might be better now?

[Perinowpost]

Ljp if you want another mirena you could always ask to be put out to have it fitted x

[Ljp]

Ljp if you want another mirena you could always ask to be put out to have it fitted x

that does seem a bit extreme, she had said a local anaesthetic could be used, but the pain as I remember wasn't from my cervix, it was more in my uterus.

Birdy, yes I've been using estring for the past 4 years for VA

[Sammiejane]

Ljp

i would see about when u go have the coil removed and try utrogestan on it's as you are going to have to have it replaced any way i know this means having it removed and then having to go back possibly to have another fitted but at least you can try the utrogestan on it's own and u never know u may feel fantastic and not need mirena again x

[Ljp]

Ljp

i would see about when u go have the coil removed and try utrogestan on it's as you are going to have to have it replaced any way i know this means having it removed and then having to go back possibly to have another fitted but at least you can try the utrogestan on it's own and u never know u may feel fantastic and not need mirena again x

Thanks Sammiejane, I was thinking the same, at least I'll know then?
it's all so scary sometimes, I read things from others like “I'd never take utrogestan orally everyday”...why not? I don't understand, if that's how it's “meant” to be used? That's how the gynaecologist told me to use it, it's a body identical progesterone? .....I find it all very confusing and worrying and constantly question what's right and what I should or shouldn't do 🤯 and what's safest.....I have felt fine on the mirena fir 4 years, but it was very uncomfortable having it fitted, so that's worrying me, I had spotting for several months, another concern.....but didn't have brain fog or low mood or anxiety and overthinking.....I need to decide what to do but I'm really struggling to do so 😥

[Ljp]

So if I was to try it Vaginally, firstly is it ok to insert it with an estring already in place?... and secondly do I just start as from tonight for example?

I am worried it might aggravate my VA and bladder frequency and urgency, but I guess I won't know until I try and I have a week to figure this all out before my follow up appointment with gynaecologist/menopause specialist