I think it's like all hrt, it's absolutely fine for most people but a small number have problems. I've had one for 4 months and it's great, I wish I'd had one sooner. If you're worried about removal ask your surgery, often they have a nurse who can remove it at short notice if you can't tolerate it. It's often the best for sorting out problem bleeding but there are other (oral) options if you really don't want one. You will need oestrogen only patches with it.