Menopause Matters Forum
Menopause Discussion => All things menopause => Topic started by: honorsmum on March 09, 2015, 10:54:54 AM
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Maybe it's because I'm feeling a bit wobbly generally at the moment (PMT, I think), but I'm getting myself into a state over the prospect of having the Mirena coil - I get tearful even thinking about it.
It's not just the insertion, it's the possible side effects (moods,in particular) and the risk of it moving/getting embedded/rejecting - as well as the thought of it being in there.
I'm not usually funny about internals, smears etc but the whole Mirena thing is really freaking me out.
Problem is, I don't know what the alternative is, as tablet progesterone is a no go because of having Crohn's.
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hi there
I have had two Mirena coil and feel so much better for them, no issues at all ...good luck with you choices xx
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Thank you for the reassurance, Mrs January.
I was offered it 9 years ago, after my second child was born, but was reluctant then too.
I just feel so anxious about it, which is odd because I don't feel in any way anxious about starting HRT - it's a complete physical fear of the coil.
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I have been offered the Mirena coil a couple of times and refused it, but my reasons and situation may be very different from yours. I would only say, if you are so worried about it, to either have further talks with medical providers to put your mind at rest, or trust your instincts and not have one fitted for now. Good luck with it. xx
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Would using Utrogestan vaginally not be an option for you. That way you remain in control and can stop if it doesn't suit you which is a bit of a problem with the coil.
If you use vaginally then you are bypassing the gut so there would be no absorption issues.
Honeyb
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I must admit I turned down the 'offer' of a Mirena when I was told I could no longer stay on the pill. It was certainly not what I had in mind, I was very cross about the pill thing, and the whole idea freaked me out. It is quite hard, in my mind, to get from going into the doctors just to have your BP checked to suddenly consenting to this. ::)
I sort of came round to the idea and tried a pop with levenorgestrel in it. I didn't get on with it as it added another 3 days to my intestinal transit, like the other pills I tried, and at the time I was having a small rectocele repaired, so shelved the idea. The GP who fitted them retired, and the only way to get one would have been the family planning clinic, and I don't even know where that is..........
I don't know if I would have been better with a mirena. I do quite fancy the idea of having one with gel or patches. I am sure it is better for you long term, than taking tablets as they have to be processed through the liver.
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Hi honorsmum
I can understand your feelings - I was offered one a couple of years ago when I had a hysteroscopy - it would have been very easy for the gynae to pop it in at the same time. I refused but my reasons different from yours. I'm not bothered about having a physical thing up there, but I was worried about the systemic absorption of the synthetic progestogen, levonorgestrel.
The advantage for women in peri-menopause is the continuous progestogen which regulates the bleeding. Tou wouldn;t want to use utrogestan vaginally all the time ofr obvious reasons ( ;)) and using it for half the month will not regulate heavy bleeding in the same way - in fact at your stage bleeding could be even heavier until your ovaries begin to decline, due to the added oestrogen.
The other alternative is a non-licensed progesterone which doesn't tend to be used now - Cyclogest - which are waxy capsules used as pessaries or suppositories (the latter not to everyone's taste ::)). I used these for several years before the advent of Utrogestan and was prescribed these by my GP. With a suppository there is systemic absorption but not the digestive issues although interesting effect the next morning :o !!
No need to work yourself up about it and cause yourself extra stress, if you are not happy with the idea of a Mirena - and why not wait a while and see how you feel generally? In the end you may find the decision is made for you in that you decide you are prepared to try something to enable you to feel better?
Try not to worry...
Hurdity x
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Thanks, all.
The vaginal progesterone option was touched on briefly in my appointment with Annie Evans, but she felt the Mirena was a better option, not least because of its use as contraception.
She said that while it is synthetic progesterone, only a very tiny amount gets into the bloodstream - so it shouldn't have the same side effects I experienced with Cerazette.
I have friends who have or have had the Mirena and like it a lot - I think I'm probably over-thinking it and focusing on worst-case scenarios.
I'm waiting for the oestrogen gel to arrive, and understand I can start it in advance of getting the Mirena - maybe the oestrogen will make me feel so much better that I'll happily plump for the coil if it means I can stick with the gel?
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Just to add - this is one of the cons of private consultations: not being able to contact the consultant outside of appointments.
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The Consultant will have a secretary so you could phone the dept.?
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The Consultant will have a secretary so you could phone the dept.?
As far as I understand it, the secretary only deals with booking appointments.
I'd need to get a new private prescription, and then be able to collect it - not sure how private prescriptions work? (Assuming vaginal progesterone would be the right choice for me, which doesn't seem clear.)
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She's not a secretary then ;) ………. worth giving her a ring though with your query? wonder who does the typing of reports etc. ……...
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Well honours mum if you end up getting it and you like it please let us know. I know I for one am another struggling with decision to try mirena. Pros and cons... As always.
Tara
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Well honours mum if you end up getting it and you like it please let us know. I know I for one am another struggling with decision to try mirena. Pros and cons... As always.
Tara
It's so hard, isn't it?
I have a complete mental block about it.
The thought of struggling through without HRT is too gruesome to think about on my bad days...but so to is the thought of suffering horrible side effects from the Mirena.
Rock and a hard place springs to mind.
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So did you decide ?
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So did you decide ?
Me?
I change my mind every hour.
Things not helped by trying to change surgery at the moment - I would like to see a new GP to talk things through before making a decision, but got to wait until we've moved to the new surgery.
I guess there's no rush - I'm not going to die by doing nothing for now.
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When do you get to register with the new Surgery? No one said Life would be easy but hey, we sometimes need a break ::)
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DH went into the new surgery last week to get the forms to register...receptionist was new and didn't know where they were kept, and couldn't find anyone to ask.
He went back in today, and has the forms for all of us to register. Not sure how long it will take once we've returned them?
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A positive then? Poor Receptionist - I remember those feelings don't you, someone asking the 1 question I was unable to help with ::)
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Honorsmum- just caught up with your thread.
I have the mirena and am very happy with it,no problems at all :)
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Know exactly how you feel. I'd originally planned on getting a Mirena (well, doc kind of coerced me). He then announced, because I have not given birth, I would have to see a specialist for insertion. Despite hearing lots of positive reviews, the day before I was due to have it fitted, I got really, really panicky and cancelled. I was convincedI would faint or bleed for months.
I went on to change docs and have Utrogestan vaginally with Evorel patches. Now that I have been having hormones of one kind or another for several months, I sort of regret not trying the Mirena. Looking back, I think my reticence was mainly due to the low estrogen and how this made me so anxious about anything and everything. I feel a lot more balanced now in my thinking (most the time anyway!) even if the HRT hasn't totally helped the physical symptoms.
Really hope that you get some relief soon - though be patient. It often take months rather than weeks. Xxxx
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Briony - how do you find the vaginal utrogestan?
I am leaning towards trying that first, before considering the Mirena.
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Hi Honorsmum and Briony,
I too am terrified of the mirena coil, it has been suggested over the years for me and I do know people who are happy with it,,,but its the thought of the insertion for me.I have no children and believe it to be very clampy and painful whilst going in.
I have just started recently on HRT at 48 and prob in early perimenopause.,,,but terrible fatigue and flushes. I am using oestrogel and ultrogeston and for this my second month taking ultogeston vaginally to try and minimise side effects.
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Hi Honorsmum and Briony,
I too am terrified of the mirena coil, it has been suggested over the years for me and I do know people who are happy with it,,,but its the thought of the insertion for me.I have no children and believe it to be very clampy and painful whilst going in.
I have just started recently on HRT at 48 and prob in early perimenopause.,,,but terrible fatigue and flushes. I am using oestrogel and ultrogeston and for this my second month taking ultogeston vaginally to try and minimise side effects.
Thanks, Hayjude,
I am trying to weigh up the pros and cons of Mirena versus vaginal utrogestan.
I don't have heavy bleeding, so that's not a consideration .
My main worry for both is the risk of feeling worse, mood wise, and things like migraine.
How are you finding the regime you're on?
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I'm only on second month so not really given it enough of a chance yet. I liked just being on the oestrogen gel and felt better and slept better. Not too keen on oral prog, so thats why I'm trying this month vaginally.
It is all a learning process for me and a lot of trial and error probably too. I too don't have heavy bleeding, but if i was to tolerate the mirena progesterone ok I would maybe consider this as a last resort....presuming no-one would give me a hysterectomy meanwhile ( v unlikely I know).
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honorsmum - a top gynae who is specialist in the meno has suggested that a Mirena would be good option for you. You have had children so fitting will not be an issue. Thousands of women are extremely happy with the Mirena and once fitted it causes few if any problems for most women.
I'd give it a go - bottom line, if in 3 months you are not happy it is really easy to remove. At the end of the life of mine it slid out really easily.
You do have other options but I'd go with the recommendation because a Mirena is less hassle in the long run and there is a very good chance you will get on with it fine.
I hated the idea of having the Mirena but at the time it was the best option for me. DG x
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I'm sure you're right, DG, it's just the huge number of horror stories and the long list of side effects that put me off.
I just wonder whether there would be any reason not to try utrogestan first? Apart from the obvious application issue, are there any drawbacks? Is it actually kinder for being bioidentical?
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honorsmum - I'm using Utrogestan but orally and I'm finding it great - it helps me sleep so well - I actually get 5 whole hours sleep after I've taken the pill. You would be using it sequentially and at a 200mg dose (I'm using 100mg) which can have quite a strong sedative effect.
I think your issue is around your Crohns and I'm not sure whether Annie would sanction you using the Utrogestan vaginally. Some women do report that Utrogestan aggravates the bladder when used vaginally and that for me would be disastrous as I get up at least twice a night anyway.
Just like HRT in general, we tend to only hear about the horror stories with anything. I doubt very much whether highly respected gynaes would be recommending the Mirena if they knew they caused problems.
If you weren't allowed to use Utrogestan vaginally (it's not licensed to be used for HRT purposes in this way) then you have the issue of absorption if you use it orally. Your alternative would be patches and they contain the synthetic progesterones and these combined patches only come in medium dose which may be too high for you at the moment.
I really understand your anxiety over this but some women can't get on with Utrogestan either - we are all different but do look at the info about the Mirena on this site as it is a strong contender when it comes to choosing the right HRT combination - firstly because it controls and eventually stops all bleeding, secondly because it offers birth control and thirdly it has the least systemic absorption of progesterone. The down sides are: the possibility of initial side effects from a boost of progesterone which may make you feel rather too relaxed (I got this a bit - I slept sooo well), you can get some stomach cramps occasionally and a bit of spotting now and again. I very quickly forgot I had it in.
Your other alternative is to wait and see how things go. You've been experiencing some ups and downs and you are still in early peri so there is no rush to try anything.
The danger of over thinking is it tends to stop you doing anything. If Annie had said she would fit the Mirena then and there you probably would have just gone ahead?
It is a shame that there aren't some better transdermal ways of giving progesterone - at one stage I would have given anything to have a hysterectomy as I used to get such horrible period pains even on HRT. I've been on hormones most of my life, initially because of the period pains and then later the premature menopause. I am grateful I was able to have my two kids - neither of my sisters could have children as my older sister had Crohns and my younger sister had Colitis and both had major surgery that prevented them from having kids.
Find out if you can get a Mirena fitted locally (there may be a good family planning clinic and they would be fitting these all the time) and perhaps discuss it with the doctor or nurse who would be fitting this first before making a decision either way. DG x
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Only problem is if you ask your GP for Utrogestan you will have to say nothing about using it vaginally. It's not licensed for use like that in this country. If you can get your specialist to prescribe it then fine.
A lot of us have just used it vaginally with our GPs being none the wiser.
Not sure if you realised this.
Honeybun
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We posted at the same time DG.
Honeybun
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Thanks DG and Honeybun.
I had read other posts here that said it was only licensed for oral use, but hadn't really thought about e implications of that, re GPs.
I'm sure I must sound pathetic and I apologise.
The whole issue of perimenopause has got to me the last few days. I'm pretty sure hormones are making me feel more sensitive than I need to - period arrived today, 20 days after the last one, and I have had a week of PMS. I just feel like I'm in a long tunnel, not able to think of much else but how I feel and what to do about it.
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Hi there - re utrogestan - most gynae specialists should know about vaginal use of utrogestan as this method is widely known and used (and licensed on NHS) in this way for fertility, as well as on the continent for HRT. Once your specialist has prescribed it this way anyway the GP should just accept the prescription, since many gynaes (and GPs in the know) prescribe stuff off licence - because they've read more about it. eg cutting Evorel conti in half, or using Cyclogest as HRT progesterone.
I have never visited a private gynae nor meno clinic but my GP knows I use it vaginally and have discussed with her, and my knowledge of this use, and she just puts on the prescription "Use as directed". I can't see any problem with this nor keeping it secret! However as honeybun says if you preferred you can just go ahead and use it in this way! Really - don't worry about the GP! I mean they're not going to refuse to prescribe it are they, if that's what you'd prefer?
I can see the advantage of trying this first - ie don't have to go for a fitting - but I think you may end up with heavier bleeds if you use it cyclically on 11/12 days per month, as you are very early on the menopause journey - but then again you may not!
Hurdity x
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Hi Honorsmum and Briony,
I too am terrified of the mirena coil, it has been suggested over the years for me and I do know people who are happy with it,,,but its the thought of the insertion for me.I have no children and believe it to be very clampy and painful whilst going in.
I have just started recently on HRT at 48 and prob in early perimenopause.,,,but terrible fatigue and flushes. I am using oestrogel and ultrogeston and for this my second month taking ultogeston vaginally to try and minimise side effects.
That's my fear too - not having had children apparently makes it more of an ordeal.
I had no issues at all with Utrogestan used vaginally. In fact, I would have used it every day if I could. However, overall, I needed more support to control my hormones so I have now switched to Qlaira, which is designed specifically as a more HRT style COP. So far, I am feeling miles better psychologically, though a few minor physical side effects - normal for month one (I hope!) x
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honorsmum
I think your real dilemma is the fact you are in limbo over your GP - or have you been able to switch now?
I actually wrote to my private gynae for further advice after my visit - so can I suggest you write to Annie, explaining your concerns about the Mirena (all the horror stories you've heard etc.) and ask if you could try Utrogestan instead as you understand it can be used vaginally. Hopefully she will change her prescription and ask you new GP to prescribe Utrogestan instead. DG x
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You are NOT pathetic and no need to apologise ;) - asking, sharing, deciding which advice to consider - takes time and a lot of brain power ::)
Are you eating regularly as PMT symptoms can be eased ……… maybe go the 'non' invasive route first and keep the Mirena coil in the background ………. as Dancinggirl suggested. Let us know how you get on!
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Thanks for your patience, ladies.
Hurdity - would potential heavier bleeding be influenced in any way by my current bleeds (which are light)? My cycles are all over the place, anywhere between 28 and 20 days - how would the uterogestan work with this?
DG - I have the forms to register with a new surgery. Not sure how long the actual move over will take, once they have been handed in?
Annie Evans said not to mention that the Mirena was for HRT, but to say it was simply for contraception. She was definite that oral uterogestan was a no for me, but only said that some women use it vaginally. I think she felt that the Mirena would kill 2 birds with one stone - HRT and contraception.