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Menopause Matters magazine ISSUE 81 out now. (Autumn issue, September 2025)

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Author Topic: Mirena/estrogel - anxiety/fatigue  (Read 1545 times)

Katykitykat

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Mirena/estrogel - anxiety/fatigue
« on: November 14, 2025, 01:05:59 PM »

Hi all, I had a mirena change a year ago and haven’t been right since- simmering anxiety (1st one I had was fine) along with it I was on (4pump) gel but I thought a patch (100) might be better so I tried for a while but turns out I wasn’t absorbing so I went back to gel (3pump) I was not too bad the 1st three weeks but now I have awful anxiety and fatigue plus I wake at 5 every day! I have two months of the three left to give it but that feels like eternity! If I wait the three months and no improvement how do I know whether to go up or down a pump? I’m nervous to have mirena removed as I tried several progesterones in the past and they were awful.

Any advise greatly appreciated
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bombsh3ll

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Re: Mirena/estrogel - anxiety/fatigue
« Reply #1 on: November 14, 2025, 05:48:50 PM »

You have no androgen replacement which can make a big difference to mood and energy.

Anecdotally testosterone also makes the progestogen component easier to tolerate.

So you could consider adding testosterone to your current regime, or trial tibolone which is a great androgenic threefer often better tolerated than progestogens.

If tibolone suits you could then get rid of the IUS.
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Katykitykat

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Re: Mirena/estrogel - anxiety/fatigue
« Reply #2 on: November 14, 2025, 06:09:57 PM »

Thank you, Sorry for the ignorance, I googled tibolone and it says it’s for post menopause? I’m not sure if I am or not due to the coil stopping periods.
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bombsh3ll

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Re: Mirena/estrogel - anxiety/fatigue
« Reply #3 on: November 15, 2025, 05:40:38 PM »

What do you think would happen if you took tibolone and your own periods hadn't quite stopped?

The only reason it is not generally prescribed before menopause is because teratogenicity is unknown. This concern is easily eliminated by not becoming pregnant!

Additionally it "might" cause menstrual irregularity. This is also a hallmark symptom of untreated perimenopause.

So I personally wouldn't be concerned about this if I were considering tibolone.

However if your prescriber was particularly inexperienced and sticking rigidly to guidelines without any understanding of the physiology, it might be better to just say you were postmenopausal.
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Katykitykat

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Re: Mirena/estrogel - anxiety/fatigue
« Reply #4 on: November 17, 2025, 12:45:40 PM »

I just don’t know anything about it, the dr knows I have mirena which stops periods and he always goes by the book so I doubt he’d give it to me. Is there anything I can do meantime? I have night sweats as well as the anxiety and it’s killing me! Someone suggested Utrogestan on top of mirena but the dr already said no! Is it worth going up or down with the gel? It’s impossible to tell which way to go though!
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