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[Fianna]

Just had a 2nd failed attempt to have a marina coil fitted. Apparently my uterus bends over to the side so they are just hitting the side wall of it when they try to insert. They will refer me to gynaecology for them to try but I have to have an ultrasound scan to check my abnormal bleeding before gynaecology will accept the referral.

There is a long wait so Dr advised I continue with Femseven but add in Utrogestan as well to try and stop the bleeding (currently a period every week weeks after 5 years no periods).

I asked about extra progesterone in another post a while ago as I'd read about the benefits of body identical progesterone and the replies alI got then are making me concerned about this.

Does anyone have any info/thoughts on taking 2 types of progesterone? I think it will make me feel s**t but I'm willing to try it. I would take the Utrogestan vaginally.

[sheila99]

If it isn't long til your scan I would wait, it might show a cause for the bleeding such as fibroids or polyps not necessarily a thickened lining. Unfortunately you won't know which progestogens will suit you until you try but the synthetic ones are often more effective than utro. You should be on the 2 week pathway for unexplained bleeding.

[Fianna]

I'm on my 3rd type of progesterone, I stopped HRT for 6 weeks at my GP's request and has no bleeding in that time so I'm sure it's just the HRT causing the bleeding. I really think the coil would sort it out but my anatomy is making it difficult.

[bombsh3ll]

Why not just switch to an estrogen only patch and use a decent dose of vaginal micronised progesterone?

Whilst this is not strong enough to suppress menstruation, which a cyclical bleed pattern is suggestive of - I don't know your age or type of menopause but in some circumstances ovulatory function can return - it may control bleeding associated with estrogen use.

If not I would then switch to a synthetic oral progestin such as desogestrel 150mcg or drospirenone (Slynd).

I have no experience with Slynd but very few individuals would bleed through continuous desogestrel at the 150mcg dose.

This can be bought over the counter (as contraception) if your GP isn't supportive. The dose for birth control is 75mcg so you would take 2 daily.

[Fianna]

100g Utrogestan didn't stop bleeding, 200g acts like a major sedative. I hadn't thought about my ovarian function returning! Entirely possible as my periods stopped when I was 46 due to chemo. I'm 54 now. I have been feeling very up and down emotionally recently which I thought was the femseven or maybe I need more estrogen but maybe my ovaries have cranked back up!!

Femseven has made me less sleepy than Utrogestan+ Evorel and Evorel combi but I'm bleeding (proper period amounts) up to twice a month.

[bombsh3ll]

Was that vaginal use that sedated you or oral?

If it was oral then you could try vaginal as the first option.

Given it is possible you have some return of spontaneous ovulatory function, a cyclical regime might be appropriate although in my experience this seldom leads to a regular bleed pattern in peri as it isn't strong enough to override endogenous ovarian activity.

If neither of these suits I would highly recommend the 150mcg of desogestrel continuously alongside your estrogen of choice.

This option is non-sedating and bleed free.

[joziel]

I think bombshell is on the right track. The Femseven and synthetic progestin isn't great for you, anyway - plus isn't even working to control bleeding.

I'd switch to an E only patch and then you can either get the Mirena fitted by gynae (eventually) or you can use utrogestan vaginally at higher doses, or you can use the regular dose of utrogestan and add in desogestrel POP. Even the usual 75mcg dose of desogestrel should do the trick and it is licensed to be used with HRT for contraception anyway, so you're not doing anything off-licence or weird there....