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[Applecake]

Hello
I’m 48 and recently had mirena progesterone coil removed after 5 years. When implanted I was having periods. I haven’t had a period since but wasn’t sure if menopausal or because of coil.

Had started to have brain fog and fatigue and for about a year had one pump of oestrogen gel which managed things.

Coil removed in May and had to stop oestrogen gel as no progesterone cover. Thought I would wait and see.

Three months later (last month) I descended into terrible extreme fatigue with dread symptoms and depression. Started on combination patch (continuous) and oestrogen vaginal cream for painful intercourse.

All well for a few weeks and then last two nights descended into the dread, insomnia. Palpitations, depression, sweating. I was about to contact GP to say I needed an adjustment but when I looked back I realised it was a month to the day(s) I experienced this last month.

I therefore think I am having a cycle of sorts (though no periods). What does this mean for HRT? Do I need more or less or should it adjust for those times in the month or should I be on it at all?

[Hurdity]

Hi Applecake

Maybe you are still having some sort of natural cycle?

Why not have another Mirena inserted and then take a separate oestrogen - gel if this suited you, and then you can adjust the level according to symptoms ie arrive at a dose where you feel consistently well?

Hurdity x

[Applecake]

Thank you. When the mirena was removed I initially felt great and then realised how off I was feeling with it so decided not to re-implant.

Does the monthly PMS suggest I need more oestrogen at that time of the month? If so - is it the done thing to add a bit of oestrogen gel once a month to top up the patch?