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[bluebird68]

Hi,  From the age of 44 my existence changed forever.  Call it the change of life.  Im now 56.  I have a Mirena coil and I use a 100mcg patch and have been on this for some years now, every day is an effort.  How do I know if im getting any benefits? Ive had masses of symptom's, the one that is hanging around is feeling hung over all the time. In April 2025 my Oestradiol test was 303.4 pmol/l.  Not sure what this means? My ferritin is 44 and understand the range is from 30 to 250 so would having iron supplement help here?   Im not diabetic, eat very healthily, drink plenty of fluids, exercise regularly and sleep 8 hours a night but wake unrefreshed.  Would having a break help.  I'm wondering if the drugs are causing the fatigue as i do feel drugged up.  My thyroid test is normal.  anyone had a similar experience or have anything to feed back on.  Would it be worth removing the Mirena and switching to progesterone oral form.  Thank you for reading

[CLKD]

How long has your Mirena been in situ?

Thyroid function test mayb normal but the NHS will only do a certain level, U may need to go privately to get any deeper testing [can't remember what for] as U are showing signs of either thyroid disfunction or low VitD levels.

Hopefully some1 with knowledge about how to find the optimum 'normal' for thyroid function will be along.

I hate that hung over feeling.  Very rarely do I wake refreshed.  Do U dream?

[bombsh3ll]

As you are already on maximal NHS treatment it might be worth having a consultation with a private specialist if you can afford it - some women do benefit from a higher level of estradiol - personally I wouldn't accept less than 400-450pmol/L but this is very individual, and also you are on no androgen replacement which makes the world of difference for some as well.

There's also no harm in getting your ferritin up to a more optimal level, and also checking a vitamin D level.

[Moog77]

Don’t accept ‘normal’ or ‘in range’.

For your thyroid most healthy folks with no thyroid disease sit either a TSH under 2, ideally nearer 1. You also need to test FT4 and FT3 as these could be out. Most GPs test only TSH and will work on a wide range sometimes up to 4 or 5 and beyond. You also need to test thyroid antibodies.

Ferritin needs to be 50 just to support healthy hair growth. Ideally 100. Check Vit D, Folate and B12.

If GP won’t test these then Randox, Medichecks or Thriva will do private tests for you.

You may also need your oestrogen to be higher in range. It’s all v personal to the individual. Please don’t think you are ‘stuck’. I’d bet there are tweaks you can make to feel better 

[sheila99]

Was there a time when you felt good with the mirena? If there wasn't it might be worth removing it and using oestrogen only for a month to see if progesterone is the problem. Unfortunately fatigue is one of those things with multiple possible causes and it easy to find the cause of yours. Have they tested vit b12 and D?

[bluebird68]

Thanks all for the pointers
B12 top end of. Normal and vit d 80 which again could benefit from being higher.

The merina has been in place 3 years. I do have nightmares on occasions. I have considered having it removed to see if it makes a difference. Is it safe to stay on patch for a month to see if makes a difference.

I wasn't feeling as tired prior to the mirena. Have all different patches due to the unavailable etc no wonder all over the place. Fatigue is a complex issue. I understand that if we fix one thing it can bring all the other numbers up but finding the one thing. I have considered poor sleep quality aswell. Living has become an effort.  I'll see if I can find a menopause specialist. Otherwise I'm not getting anywhere and thanks all

[bombsh3ll]

Yes it is safe to have a trial of estrogen alone for a month to assess whether the mirena was having a negative impact on you.

The risk of endometrial hyperplasia with unopposed estrogen occurs over years, not a month.

However you would then have to decide on a progestogen and it could be a battle to get another IUS if you wanted that, having just had an in-date one removed.

I would seriously recommend considering testosterone. It can really help some women with fatigue.