Menopause Matters Forum
Menopause Discussion => All things menopause => Topic started by: Dawncam on November 09, 2016, 09:30:46 PM
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I'm seeing my GP next week re. organising a fitting of Mirena. I've seen some chat on here about Jaycee but in the back of my mind I ruled it out as I though I'd read somewhere it was too weak for prog element of hrt.
Anyone know more?
Dxx
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I was told by my gp that it is not suitable for the progesterone element of HRT.
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Many thanks Tinkerbell. I thought that was the case. Mirena it is then.
Dxx
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I have had my Mirena since April and apart from the spotting for the first 4.5 months I have been happy with it....fingers crossed!
What was it about the Jaydess you preferred?
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Apparently it's just less prog, and that can only be a good thing!
Glad yours is working well for you.
Dxx
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It was me that mentioned as a possible option as I am very progesterone intolerant, it would require a yearly scan.
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Thanks Maryjane. Do nhs fit it as, quite frankly, I think I've paid enough on this journey so far!
Dxx
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It is available for contraceptive purposes on the NHS, don't know wether you could argue your case for HRT use.
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Thanks Tinkerbell, I'll ask anyway.
Dxx
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I am sure you would be able to argue the case with a gynae rather than your local GP - and I imagine it is an excellent alternative for those using low dose of oestrogen. The systemic concentrations of levonorgestrel, as expected are lower with the Jaydess, because the prog element is less than Mirena, yes, but if the Mirena can stop periods in normally menstruating women then surely a lower dose in menopause may well keep the uterus lining thin? I don't think the work has been done on post-menopausal women using HRT? However if they are prepared to scan you after a year that would be great wouldn't it? I see also there is another - new - product called Levosert produced by a different manufacturer but in fact this turns out to be the same dose as the Mirena.
Hurdity x
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Ooh Hurdity you got me in a spin there! Thought that new product might be HG - alas just the same as Mirena.
Also just realised I've been using the wrong name for Jaydess - doh! Bloody autocorrect!
I'm on 75 patch so prob too high for jaydess but no harm in asking.
Thanks for all the info.
Dxx
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Mirena is the only one that has a license for use in HRT, and that is for a shorter time than for contraceptive use.
I did read somewhere that there was a smaller one in the pipeline, but have not seen anything, unless it was Jaydess. I think that only lasts 3 years as a contraceptive. It is probably best to go for the one that would last longest anyway.
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Thanks Dahliagirl - I'll see what doc thinks.
Dxx
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If sensitivity to synthetic progestogens is what the problem is then it would be best if possible to go with the Jaydee if it was permitted - as it is lower dose - and that is why it only lasts 3 years (for contraception anyway). It may well be that a gynae would prescribe it for an even shorter time if allowing it for HRT, because it will run out sooner - but even 2 years would be amazing if it did the job with fewer side effects! Let us know the outcome Dawncam!
Hurdity x
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Thanks Hurdity - will do.
Dxx
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Woohoo - got email reply from my specialist who thinks Jaydee would be perfect for me! Delighted and thank you to whoever it was who first mentioned it.
Dxx
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Great news Dawncam - this is really helpful to other women although I expect it will only be prescribed off licence by specialist gynaes - or is yours on NHS through GP?
Also I suggest you ask Emma to change the title of the thread to replace "Jaycee" with Jaydess. I think you can change it yourself but the original thread title still appears as you wrote it and only the replies get changed?
For those who want to know the actual difference:
Mirena delivers Levonorgestrel initially at 20 mcg per 24 hours, reducing to 10 mcg after 5 years and extrapolated to be approx 12 mcg after 4 years (when it is recommended to be renewed for HRT purposes).
Jaydess delivers 13.5 mcg per day initially reducing to 5 mcg after 3 years.
Systemic concentrations with Mirena are approx: 276 pg/ml after 1 yr, 196 pg/ml after 2 yrs and 177 pg/ml after 3 years. With Jaydess the data give 162 pg/ml after 7 days and 59 pg/ml after 3 yrs - so much lower, but there is a wide variability in these levels amongst the women measured. All this info is from the Summary of Product Characteristics (SPC) on the web and possibly the company website (I looked it all up yesterday but then closed the tabs - hope I noted it down correctly!).
Hurdity x
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Thanks for posting all the pharma info. I think I've managed to change the name on the thread. My specialist is the one in London who rhymes with 'mud' so it's not all done and dusted as far as nhs is concerned- I'm seeing GP next week as 1st available appointment at Meno clinic isn't until 22 Dec and I don't want to be sticking my head in the Christmas turkey whilst it's in the oven because the coil is proving difficult!
Dx
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It was Mr Nick Panay who mentioned it to me as I have progesterone issues.
Just had my letter from him today , noting the part to use " vagifem 7 Xs a week ( which he says " is still not a large dose ) and a blob of ovestin 3/5 Xs a week " the blob he told me was a thumb nails worth.
He also said on examination " there was clearly an evidence of thinning of the scar tissue and scarring in the region of the left side of the posterior aspect of the vagina introitus " , the ovestin has to be massaged into the scars with a dilator to " soften up the area " .
It is a week since my HRT has been increased and I have had two days almost pain free , for the first time in four years , just slightly scars me how much HRT I need to have quality of life just for my flipping bladder/ vagina but as they say " we have to live in the now , as we don't no what tomorrow will bring "
I will discuss the Jay next time , as doing it all bit by bit at the moment.
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Oh that's great - many thanks Maryjane - so glad your new regime is working for you and here's hoping mine might too!
Dxx
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The pharma information is really helpful.
Let us know how you get on Dawncam with the Jaydess as it will be really helpful for women who are progesterone intolerant or suffer progesterone withdrawal like me!
Good luck!
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Thanks Mis71mum - I really hope it works. Can't really understand why more people don't know about it. Prob expensive and/or not enough trials for hrt use.
Thank the lord for this site!
Dxx
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For anyone that wants to look up the data and info that I quoted the SPCs (detailed product info) are here:
https://www.medicines.org.uk/emc/medicine/28672/SPC/Jaydess+13.5+mg+intrauterine+delivery+system
http://www.medicines.org.uk/emc/medicine/1829/spc/mirena/
You can see that from the start the Jaydess contains approx a quarter of the total amount of levonorgestrel that the Mirena has (13.5 mg vs 52 mg).
Yes it's amazing how much we learn from others on this forum :)
Hurdity x
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Jaydess thread bumped for rae123 - anyone - feel free to add anything about Jaydess and its use as part of HRT so that it can be found easily by those looking..... (maybe no-one is using it though). Dawncam isn't a member any more but she might have used it?
Hurdity x
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Thanks for the bump Hurdity, I will let you know how it goes
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Really interested in this too-please update xx