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[Whereismysleepgone]

Hi,

I'd be very grateful to hear from anyone who switched successfully from Utrogestan to the Mirena please.

I am on Evorel patches and trialling utrogestan 100mg daily with a 3 day break. I already tried 200mg for 12 days and suffered migraines and felt awful the whole time. I am unable to take Utrogestan orally due to feeling extremely tired and generally very low but I am also getting side effects vaginally such as very low mood, irritability and slow gastric movement. Taking it every other night vaginally helped the gastric symptoms but I understand it isn't safe long term to be on such a low dose. I reduced Evorel from 50 to 37.5 due to extreme swollen painful breasts and bloating/weight gain. I am generally very sensitive to hormones and never took the pill for this reason. I now need HRT due to peri and poor bone density.

Has anyone who suffered symptoms on utrogestan done better at tolerating the Mirena? My menopause specialist is urging me to switch but I am concerned about the side effects and not being able to remove it quickly if needed.

Appreciate any comments. Thanks.

[CLKD]

Morning.      can't help much, hpefully some1 will be along but didn't want to cut and run ;-)

[kittydaydream]

I had mirena for 2 years but had anxiety so thought Utrogestan would calm me - the opposite happened! It’s god awful stuff! Also tried Provera and that was even worse! I bitterly regret having mirena out as it had been the most stable I’d been and  the anxiety was at least manageable then - my experience of mirena was actually good and I’m trying to get an appointment to have it fitted again 😊

[Mary G]

I had my first Mirena coil fitted in 1998 for contraception and I had no problems with it.  I only started experiencing problems (vaginal infections etc) when I hit the menopause and my own hormones started plummeting. 

One observation I would make is that once I was menopausal, the Mirena felt better when it was running out of steam at the five year mark.  For that reason, I would personally go for a lower rise coil like the Jaydess or the Kyleena, particularly if you are sensitive to hormones.

[sheila99]

If you get on with noresthisterone in evorel patches another option would be to take it orally. According to my gp it's recently been added to thd list.

[bombsh3ll]

37.5mcg is such a low dose of estrogen that SOME private specialists would allow this without progestogen.

Taking 100mg vaginal utrogestan alternate nights is almost certainly sufficient and you could get a scan periodically for reassurance.

There are multiple other options not just mirena- norethisterone has been mentioned either as combi patch or oral tablets, desogestrel, slynd or you could take the lowest strength femoston - oral estradiol with dydrogesterone which is usually well tolerated compared to other progestogens.

Many people love the mirena, however it is invasive and as you rightly point out it cannot be easily or independently stopped if it causes problems.

You would need to wait for an appointment and sometimes clinicians can be very resistant to removing them, particularly on the NHS, which is understandable to a degree due to the cost of the device.

[Whereismysleepgone]

Thanks everyone. I appreciate your comments.

Interesting to know that my dose of oestrogen is quite low so I might not need much progesterone - I will speak to my doctor about this further. At the moment I am trialling utrogestan vaginally every other day and I am feeling a little better. I know my doctor won't be happy with this as she has already made that clear.

Norethisterone was intolerable in the past when I used it to delay a period to go on holiday. I didn't sleep the whole time, felt awfully anxious and irritable and suffered sever constipation for the whole two weeks. It was awful and ruined my much needed holiday.

Thanks again for your help. I will consider the mirena once I have spoken again to my doctor.

[Hurdity]

37.5mcg is such a low dose of estrogen that SOME private specialists would allow this without progestogen.

I have never encountered this before - would this be regularly on NHS? I wouldn't say it "is such a low dose" though I see it is classed as low. Nevertheless we haven't heard of women using a patch of this strength without progesterone maybe except in very exceptional circumstances of extreme progesterone intolerance (there was ONE woman on here some years ago) but in such cases would be monitored very closely with regular scans, on NHS, as she was (Panay's clinic).

For example even with the Menostar - which was and maybe still is available in US, at 14 mcg, which was recommended to be used generally without progestogen, an annual course of progestogen was advised.

I do agree that  a lower dose of progestogen may be fine and alternate day vaginally may be sufficient though you won't know without a scan.

Incidentally if you have poor bone density., 37.5 mcg is not licensed for protection against osteoporosis, the minimum being 50 mcg, though some oestrogen is better than none, so I would suggest you ask for your estradiol levels to be checked for this reason. If they turn out not to be sufficient then I would urge you to do all you can to try to attain the level needed and see if your doctor will work with you to enable off-licence regimes (of progestogen) to be used with regular scans in order for you to get maximum protection?

Your painful breasts and weight gain (bloating) could also be due to progesterone because you are taking it continuously?

Hurdity x

PS where is mysleepgone 

[Dazedandconfused]

I am post meno and had a Mirena inserted as I don't absorb utrogestan well so was having bleeds.  I did quite a lot of research and asked lots of questions as I was hesitant. 

However, it's been great, it settled after about four months.  I'm now 10 months in and I feel much better than I did on utrogestan, apart from tender boobs.  I'm only on one pump of estrogel and everything has checked out ok re boobs but I've been told it can be a side effect of the Mirena and I'm happy to live with it 😊