I got regular spotting before the Mirena. I also didn't get on that well with the utrogestan. Mirena has been a game changer. Takes time to settle - about four months in my case - but since then, no bleeding/spotting, no drowsiness/low mood from utrogestan and its good for five years. I did have it installed under GA though - due to my propensity for vasovagal reaction. It was done at the same time as a hysteropscopy, but you can ussually get it done at GP surgery.