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[Champers101]

Hello hoping someone can help! I increased my HRT to Evorel 100 around 4 months ago and everything seemed great. Until about a week ago when I started getting a constant period-type ache all over my abdomen, lower back and around my thighs.

The only other times I’ve ever felt like this before was when my Mirena was depleting around the 4 year mark. But this time it’s only a year old. Argh!

Urine test was clear. I had a better couple of days and was over the moon, but today it’s all come back full force. And panic has majorly set in re what it could be and the prospect of it never going. We’re due to go on holiday soon and I can’t face travelling when in this pain and state of anxiety! I was so hoping it was just IBS, or a temporary hormone fluctuation. But those don’t seem likely now

Thanks in advance for any help.

[Dierdre]

Have you had the Mirena checked to make sure it's not moved?

[joziel]

If you have endometriosis (whether diagnosed or not) or adenomyosis, high estrogen can cause it to grow/develop. Since you just recently increased your estrogen, that would be my guess. (I have endo.)

The solution is more progesterone. Even though you are on the Mirena, you can have utrogestan as well. The thing with the Mirena is that its effect is localised to the uterus. Which is fine if you don't have uterine tissue outside your uterus, but if you have endo and have it elsewhere, then the Mirena may not help control that in the presence of high estrogen.

You need to try a systemic progestin or progesterone.

Utrogestan taken continuously at 200mg/night should do it, or you can just add in a POP like desogestrel - because you have the Mirena in the uterus so you've ticked the box for HRT progesterone requirements. Vaginal progesterone probably isn't going to work for the same reason - it's localised....

I'm on 3 pumps of gel now and just started taking 300mg of utrogestan sequentially day 15-26 of cycle. It seems to be working fine but, if it didn't, we'd move to continuous 200mg/night.

[Nas]

Hi
I’ve got the same issue.
On 100 patch and have a mirena, which has been in for a year.

I’ve got an ultrasound booked next week, to check for coil position and other gynae issues, as I’ve also got a sharp pain in my left side.

Joziel is right, oestrogen can feed endo/ fibroids/ adenomyosis etc, so adding in more progesterone could help.

I would push for a scan, just to see what’s going on.

[Champers101]

Thank you all. I actually have a scan booked next week too. I’m praying the Mirena has moved as that would be the simple answer/ solution. Although with a tilted cervix, getting someone to fit a new one wouldn’t be easy! And none of it would be done before we go on holiday.

I’ve never had endo, but I know it is possible for it to develop later, so will bear that in mind as a possibility.

Nas, I can’t believe we have exactly the same situation!! Can I ask how long you’ve been getting symptoms? And do they fluctuate? I was really sure they had all gone the other day, but didn’t take long for them to return.

I also have terrible bloating and my IBS is terrible so it’s hard to work out what’s what. I just pray this will end at some point as it’s so frigging relentless at the moment and I can’t see an end in sight.

[Dierdre]

If it is the coil once it's removed the pain should stop straight away, my body rejected one once and the pain stop once it was out.
Just have another fitted after your holiday,    if it's only a couple of weeks.

[Champers101]

For me, the twice previously that the Mirena needed to be replaced, removing it made everything worse but the moment a new, fresh one was in it was bliss! If only it would work like that this time…

[Nas]

Well we do appear to have similar symptoms. I’ve also got the bloating and slight nausea.

For me, this has been going on did a good few months on and off. It’s when I am on the 100 patch. When I reduce dose, it does subside somewhat.

I had a CT scan last month, which did show the coil within the uterine cavity. I’m also praying it’s just shifted a bit and pressing on a nerve ( or something!) If not, I’m going to put a bet on fibroids ( god I hope not!!)

Im also very fed up with it all now!

Let us know what the scan reveals won’t you. Mine is Wednesday, but the radiographers are striking so results could be delayed 

[Champers101]

Thanks Nas, my scan is on Thursday. I hope you get the answers from yours!

It does seem possible that 3 months in to 100 patches I’m now paying the price for the increased dose, as it’s all properly in my system. I would be tempted to go back down to 75 but fluctuations bring on horrible migraines for me so I can’t do it lightly. And I was a mess on 75 - crying nonstop etc. No period pain though!!

Do you take extra progesterone as well?

Thanks for your help

[Nas]

Yes Im not great on 75, my anxiety goes through the roof!

I don’t take additional progesterone, but I do have some utrogestan. I think once I’ve had my scan and I have an
idea what’s going on, I will make a decision as to what to do.

It’s all very tiring this x

[Nas]

I’ve ripped the patch off!
Here we go.. by tomorrow I will be all jittery.

[Champers101]

Ooh brave!! I hope it reduces your symptoms - please let me know!

It’s so hard carrying on with life with this ck stand nagging pain. Esp if you don’t know what is causing it.

[Nas]

I know what you mean re: the pain. Maybe it is actually the increased patch dose? How about snipping a sliver off, so it’s more than 75 but less than 100?
It might ease the pain, if it is that?

Are you aware of any fibroids/ cysts/ endometriosis at all? The ultra sound will pick any of that up anyway I expect.

Hope you get relief soon.
Keep us posted.

[Champers101]

Never had endo. Not aware of fibroids etc but as you say will hopefully find out soon!

It’s tempting to reduce the HRT dose - but I am so scared of making things worse! And of going back to the endless crying etc.

Argh!! What to do…

[Nas]

Yes I get what you mean.
Maybe try and power through the pain with pain killers.

Eventually things should settle with the new increased dose. They do say to give it a few months with each increase.