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[helen63]

I was using oestrogel and mirena coil for hrt but came off oestrogel in July as I wasnt feeling any benefit and hrt caused bleeding issues despite being post menopause. I have tried different types and dosages of hrt but its not for me. My Doctor has said I should keep the mirena , but I'm wondering if it is it of any benefit to me as I'm 57 and post menopause?I didnt have any bleeding issues before starting Hrt but I do have small fibroids. I have recently had spotting again, could this be the mirena causing this as not using any other hrt ?  I'm not sure whether I should request the mirena be removed or is it still giving me some hormonal benefit even though not using as part of hrt? If I had it removed would I get a mirena crash or does that not happen if you are post menopause? Many thanks for any info and advice

[Hurdity]

Hi Helen63

The progestogen in the Mirena is a synthetic one and the only benefit from it is protection of the womb when taking hRT. It also keeps the progestogen levels stable compared with cyclical forms of HRT and possibly also might help buffer the hormonal fluctuations when ovulating - during peri-menopause or when fertile.

Because the Mirena produces a high concentration of the progestogen directly to the uterus, without added oestrogen, this can caused over-thinning of the uterus which can cause ulceration or spotting. Depending when the Mirena was inserted  (which will determine how much progestogen is still being released) - this might be the cause of the spotting? I can't imagine why any doctor would suggest retaining a Mriena coil in post-menopausal women, without oestrogen - for this reason - but then - I'm not the expert 

If you have it removed you would likely experience a few days of progeserone withdrawal as your body re-adjusts - like pms - but this would pass and you would be back to normal...

Hurdity x

[helen63]

Many thanks for your reply it is very helpful and answered many questions for me . I now have a gynocologist appointment mid Nov and have had an intenal scan due to this spotting. I'm thinking it is the Mirena causing the spotting then and I will have the Mirena removed if its not giving me any benefit now not part of HRT. Will discuss with the Gynea at my appointment. It was actually a nurse that advised I could keep the Mirena indefinitely as she was calling me back on behalf of my Doctor, but she said she was passing on the message, so not 100% sure that was the Doctors advice.  What you say makes sense as i've only had it since Feb 2019 so still quite new and could be thinning the lining now as stopped HRT in July. Many thanks again