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[sheila99]

GP failed to insert a mirena today because the cervix wouldn't open. She's referred me to a specialist who may (or may not) be able to get it in. Currently on utrogestan but suffering side effects. So she has offered me either Provera or noresthisterone. Is there any picking? Any difference from the safety point of view? Apparently noresthisterone has only recently been added to the list. I've been on evorel conti patches and had no reaction to the noresthisterone in it but had to change because of an allergic reaction.

[CLKD]

   was it painful?

[bombsh3ll]

If those two were my only option I would take norethisterone hands down.

Provera should be considered a treatment of last resort due to its deleterious metabolic effects.

However these aren't your only options.

You could also choose from desogestrel 150mcg (off label but supported by the BMS) or slynd.

If you were open to a combined oral product, dydrogesterone is very favourable metabolically and anecdotally better tolerated than other synthetic progestins.

[sheila99]

Not too bad thanks CLKD, she put some anaesthetic on the cervix so once that kicked in it was OK.
Bombsh3ll, thanks for the info. I'm on 100mg oestrogen now so I think anything combined is out. She won't prescribe anything off label so it looks as though noresthisterone is favourite for now. Hopefully the specialist will get the mirena in, if it looks as though I'll be on an alternative long term I'll have to think again.

[Nik2502]

Hi Sheila

After trying everything I’m on Provera now and really settled on it.

 I can’t have a mirena as my body keeps rejecting them.

No side effects from the Provera.

Nicola

[sheila99]

Thanks Nicola, glad provera works for you. I'm hoping if they ever get it in there'll be less chance of expulsion but perhaps that's just wishful thinking.

[ElkWarning]

Hi Sheila, I used to have GA for Mirena insertion.  That worked when nothing else would.

[sheila99]

I didn't know GA was an option. Was that to relax the cervix or for some other reason? If it's to relax it do have similar problems getting it out again?

[Hurdity]

My specialist gynae GP recently suggested to me she would recommend Provera over norethisterone especially at my age, and mentioned stroke risk with norethisterone - though I haven't looked this up. I did counter with suggestions of breast cancer risk with Provera.....

Hurdity x