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[Tootsie78]

I’ve been on Mirena and 2 sprays of lenzetto for a couple of years - the wonder combination. Added in the occasional bit of testosterone- minimal pea size once or twice a week for libido.
Last year I had massive personal stress with a marriage breakdown and other things. But, still managed to cope and not completely crumble.

 When I saw GP middle of last year and mentioned occasional spotting, she seemed unconcerned as long as only brown spotting…which it has been.

I have had a few period type instances the last six months, which were rare and red-ish but lasted a few days and then stopped for a month or so.

This month I re-had bloods done via medichecks (finger prick test) which showed ridiculously high oestrogen (to extent doc report suggested contaminated test and re-do
with venous sample). Consequently I’ve dropped Lenzetto down to one spray and stopped the testosterone but haven’t retested yet.

However I’ve been brown spotting for a week or so now and not sure if hormones just fluctuating due to so much stress over the last 12 months and the dropping of lenzetto, or something I should go back to GP and get checked out. I have no other symptoms.

I also started a semi low-carb diet a few weeks ago so effectively was treating my body a bit differently.

My period was very heavy before having Mirena and after initial settling didn’t have any bleeding whatsoever for over a year so these recent fluctuations are becoming frustrating!

Advice very welcome!! Thank you

[Jopurpose]

It sounds to me as if your GP should refer you for a trans-vaginal scan just to be safe. 
I’ve had 3 scans in the last 20 months for abnormal bleeding and all was ok. I had my 3rd scan a week ago but the first since I had the Mirena fitted in September and I’d only had a bit of spotting this time.

[Tootsie78]

Thank you.

[joziel]

I can pretty much guarantee you are spotting now due to LOW estrogen.

Lenzetto is an *incredibly* low dose form of HRT, to the point that it's not practical for most women because they just can't absorb enough from it. Moreover if you are only on ONE pump of it, you're getting hardly anything.

A huge cause of spotting is low estrogen, it's not all about high estrogen...

I can guarantee also that the ridiculously high E result was due to contamination because you should NOT BE USING finger prick tests if you are on HRT. Most of the online places that offer them now state that explicitly. They are not reliable and you WILL get a contaminated result back, which leads to this. If you want to do home tests, look at the Randox Tasso test which attaches to the top of your arm/shoulder (as long as that is not where you put the Lenzetto). Be sure as well, if you do a venous test, to stay well away from putting it in the fold of your arm where that blood is taken as well.... (You may want to use only one arm for a few weeks before a retest in terms of the application site.)

I would increase your Lenzetto back to the 2 sprays you were on previously and get your levels re-checked. Really, you should be on 270pmol+ for the bare minumum benefits of estrogen on bone density but really most women do best between 350-650pmol. It's incredibly unlikely you are anywhere near that on one pump of Lenzetto.

[Tootsie78]

Thanks. The spotting has stopped. I have recently become sexually active again with a new partner and haven’t been using protection, so have booked appt with GUM clinic for full screen just in case. I’ll see what they say and try for a transvaginal scan.
I’ve also read that some people get a thickened lining even with Mirena so I guess I’m a bit concerned about everything down there!
So far the drop down to one spray has increased palpitations, hair dry and falling out again but so far no night sweats….

[Tootsie78]

By way of an update - in case changes anyone’s views. Had full check and health screen - docs were amazing. Everything looked healthy but they couldn’t locate Mirena strings so been referred for ultrasound.
The spotting had stopped for a few weeks and I’ve been tracking on clue the last few months, which expected my ‘period’ to start yesterday and it did… it’s like a cycle has returned….but brown spotting only! After being spotting/bleed free for over a year or so.

I’m still back on one spray - particularly due to possibility of coil having fallen out as aware shouldn’t really be on any if Mirena not in. However, night sweat the other day, aching joints returned… so I do believe I should go back to 2 sprays or more when I can!
I guess my question is, if ultrasound comes back and Mirena is still in (less than 3 years old), any other reason why my cycle has returned …?  If anything I would have expected no spotting at all as I grow ever older and oestrogen dips more….

[joziel]

You have the Mirena in (somewhere), so you can't really call this a 'cycle' or wonder why it has returned etc etc. This isn't a 'cycle', it's blood coming out due to the thinning of the uterine lining from the use of a synthetic progestin.

[bombsh3ll]

If I were you I would use alternative progestogen cover whilst awaiting a scan in case you have lost your IUS, and continue on a therapeutic dose of estrogen rather than reducing your dose.

[Tootsie78]

You have the Mirena in (somewhere), so you can't really call this a 'cycle' or wonder why it has returned etc etc. This isn't a 'cycle', it's blood coming out due to the thinning of the uterine lining from the use of a synthetic progestin.

So, results are in and you were absolutely right - my oestrogen was only 168 and my FSH 26 (last year it was super low and oestrogen was reasonably high)!! I was shocked.

Coil is in place but I have a 3cm fibroid which may be causing the bleeding.

I’m currently back on the 2 sprays of lenzetto - it broadly fixes most symptoms but I am considering upping to 3 to see what happens. I love my coil as have bad migraines on other forms of progesterone - evorel sequi was a disaster.

Had a 2 day bleed this month (not postcoital) - tracking shows I’m on 25 day shedding ‘cycle’.

Such a relief to know it’s nothing sinister. Our hormones have a lot to answer for!

Thanks for your advice.

[joziel]

I think you will probably need more than 2 sprays of Lenzetto and that you had a contaminated sample last time. Even at the max dosage, Lenzetto is low dose and typically gives less than the equivalent in gel.

It's important that you keep testing. If you are reluctant to keep going to your GP, look up Randox Health online and their Tasso Female Hormones test. For about £50 you can test everything at home - from an arm. (If you put Lenzetto on your upper arms, maybe this isn't a good idea as you will get another contaminated sample.)

Newson Health told me that Lenzetto frequently results in contaminated samples because of where you put it on and where blood is taken from.

Have you considered switching to gel?