Hormones are not 'artificial'. They are body identical and replacing what your own body will be missing.
By age 49, you will be deficient in all 3 hormones even if still producing some. And it's only going to get worse. Not wanting to be all doom and gloom about this but even if you don't 'need' it now, you will go through menopause.
Even if you don't have symptoms, you will have all the health impact of loss of bone density, increased risk of osteoporosis, heart disease, dementia, bowel cancer and more. It's totally up to you whether you take hormones or not, it's an individual decision. But it should be an informed decision where you know about the risks of not taking them.
It's way too early to know what is going on if you only had the Mirena fitted 26th April. In 99% of women, the Mirena totally stops all bleeding and periods. So soon you won't have that to worry about. It is probably the build up since the previous one was removed which is being shed.
The Mirena doesn't give you body identical progesterone. And the patch which you were given also had a synthetic progestin in it (not body identical). Only utrogestan or micronised progesterone is body identical. So even though you have a Mirena in, you MIGHT benefit from also having utrogestan. Some women can't tolerate it, some women really need it.
You may also need more estrogen. Getting HRT right can take a lot of tinkering and experimentation. If you're thinking of stopping it about a week after starting it, you maybe need to approach it all a bit differently... And with feeling 'tired and flat', testosterone would be very helpful.
