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[Bracken]

Hi

Saw a Prof of gynaecology privately due to a long waiting time. He said I did not need to be in the coil as HRT was 3 times stronger than the pill and if I was taking it correctly there would be no chance of pregnancy.

Said the guidelines said different but he thought doctors were acting more from a legal standpoint worried about being sued rather than what was best for the patient.

Any views?

Thanks

[CLKD]

Gynaecologists may not be aware of the effects of HRT.

Hopefully some1 will be along with advice.  U could ask a Pharamist too.

I understood that 1 requires contraception whilst still menstruating.  I aren't aware of how HRT would override The Pill for example.

Let us know?

[bombsh3ll]

It really depends on your age, stage and what HRT you are taking.

Estradiol and micronised progesterone are NOT anywhere near as potent as birth control, and in fact young women with POI hoping to conceive are given estradiol with cyclical micronised progesterone to try and resurrect their menstrual cycle.

This slightly improves their chances of conception vs no treatment.

However most women experiencing peri/menopause at the appropriate age ie late 40's early 50's have such a low chance of conception that many decide it is not worth being on birth control unless they need it for medical reasons eg bleed control, or as their endometrial protection.

Some of the synthetic forms of continuous combined HRT eg those containing norethisterone 1mg, or 5mg or more of provera will prevent pregnancy (although they are not licensed for this).

[Hurdity]

Hi

Saw a Prof of gynaecology privately due to a long waiting time. He said I did not need to be in the coil as HRT was 3 times stronger than the pill and if I was taking it correctly there would be no chance of pregnancy.

Said the guidelines said different but he thought doctors were acting more from a legal standpoint worried about being sued rather than what was best for the patient.

Any views?

Thanks

Hi Bracken

 

I'm a bit confused as you also have another thread and I was going to ask questions based on this thread, like how old are you and where you are in menopause. Whether or not you need contraception will depend on your age and menopausal status if you know this. I see there is some information on the other thread but not sure quite what you're asking overall. Best to have all the information together,....

For example women are advised to use contraception for 2 years following the last period if under 50  and 1 year if over 50 (sounds arbitrary I know) but this is because there are some late random ovulations in women who think their periods have stopped - beyond the 12 month mark, more likely if under 50.

So that would be  my first question.

Also then depends on the type of HRT - in fact very high doses of estradiol do suppress the cycle though I understand they have to be pretty high ( that sounds very imprecise!). Studd used to use this method in women with reproductive depression - ie very high oestrogen doses to prevent ovulation.

Hurdity x

[Bracken]

Yes I posted about symptoms that have now reappeared but felt the issue of contraception would be better separate. I know there’s crossover.

I am 53 and I’ve been on HRT for 3 years. A scan showed I still had a follicle. I am still having periods although it’s difficult to know frequency as I had the Mirena coil, then had it taken out and copper coil put in and I’ve now had the taken out. It’s all a bit of a mess.

I’m now on 100 Evorel and 200 utrogesterone continually.

There is no way I want to get pregnant. It’s just difficult to know who is correct.

[bombsh3ll]

Clinical guidelines recommend using contraception for a year after the last period if over the age of 50, or up to age 55.

For most women this is major overkill however in very rare instances it does happen. I believe the oldest verified naturally conceived live birth in the UK was to a 57 year old.

If natural conception does occur beyond 50 it almost always ends in early miscarriage anyway, but this can still be distressing even if motherhood is not desired.

[Sophya]

This is such a tricky area, there’s so much variation in what individual doctors say versus official guidelines, and it really puts the burden on us to figure out what feels safest. Especially when you've already gone through different coil types and still have some cycle activity.

Also, just something I came across recently that might be useful for anyone who's had issues with IUDs in particular: https://federal-lawyer.com/injury-lawsuit/paragard-iud/fda-warnings/.
Worth a look.

[sheila99]

At 53 it's unlikely you'll get pregnant but not impossible. Utro isn't strong enough to stop it so perhaps it depends on how big a disaster it would be if you did get pregnant. Would it be an option to have another mirena? Because that would do both jobs.