Hi! If the Mirena is 'wearing out', could that be why you have periods? If you are bleeding after a break, has your GP sent you for a scan of the womb to check lining?
Menopause - the last monthly period however; until we've been at least 12 months without a bleed, we don't really know
. Mother Nature can throw in a curved ball, i.e. one can miss lots of periods until 10/11 months then she decides that the ovaries should start again! Don't panic though. They do finish. Eventually.
Gel mayB the way to go. Which symptom do you want to ease first? Some find that keeping a mood/food/symptom diary of use.
Let us know how you get on.