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[Dazedandconfused]

Hi ladies,

I've had the Mirena for a year now and overall things are really well settled.  However, I have experienced, and still am experiencing quite bad hair loss in the last year.  I also have very tender boobs. I've tried starflower oil for the last year which made no difference. 

Bloods and scans have all been ok. I'm only on one pump of estrogel so wondering if the hair loss and boob pain could be due to the Mirena (I don't absorb other prog). I'm finding both quite stressful and depressing.

I'm thinking it might be better to come off HRT.

I have a check up with the meno nurse in a couple of weeks so would welcome any thoughts 😊.  Thank you xx

[bombsh3ll]

It's difficult to know whether the mirena is causing these issues, the only way of finding out is to remove it.

Breast tenderness can also be estrogen related - have you ever been on estrogen without the mirena and did you have it then?

There are multiple other options for endometrial protection - which have you tried?

Also don't forget about tibolone as an alternative.

Only you can decide whether the benefits of HRT for you (make sure you factor in long term health as well as immediate symptom control) as an individual outweigh specific side effects, if these cannot be resolved by changing your treatment (they usually can).

[Dazedandconfused]

Thanks bombsh3ll,
I'm 61, 7 years post meno and been on HRT for two years, originally two pumps of gel and utrogestan. I didn't absorb utrogestan at all well and just bled a lot and got a thick lining so swapped to the Mirena a year ago.  I've not tried anything else but meno nurse is good so I want to go in to see her armed with info 😊

The only other time I've had sore boobs was in the early days of starting HRT and then it stopped after a couple of months, which is why I'm thinking the Mirena may be the cause.  Also had no hair loss until the last nine months or so. 😟

[bombsh3ll]

In that case it would be worth exploring other progestogens such as:

Desogestrel 150mcg
Slynd 4mg
Norethisterone (available as oral pills also in combination patch)
Dydrogesterone - only available in combination with oral estradiol but generally well tolerated.
Medroxyprogesterone acetate - least metabolically favourable progestin but still better than no HRT.

Tibolone - oral tablet with estrogenic, progestogenic and androgenic activity. Very bone positive. No increased risk of blood clots or breast cancer.

[Dazedandconfused]

That's really helpful Bombsh3ll.  Thanks 😊