Menopause Matters Forum
Menopause Discussion => All things menopause => Topic started by: ann58 on October 25, 2019, 09:35:52 AM
-
I'm considering coming off hrt due to my TIA/mini stroke. I need to stop the oestrogen first then have the mirena coil removed. Post menopause am I likely to get the mirena crash that many talk about? Not sure I can cope with that along with the TIA symptoms.
-
I think you're more likely to get a crash from stopping the oestrogen. I felt marvellous within 2 days of my mirena removal as it's effects left my system x
-
Thank you. I decided rather than stop the oestrogen straight away that I will do it gradually. I'm down to 25mcg.
-
Hi ann58
I feel you may have less side effects if you tail your oestrogen off to coincide with having your mirena removed. That way you're not left with progesterone only x
-
That's what I was thinking. When I was just told to stop the patch I panicked. I think even though I had a TIA that the risk of low dose oestrogen whilst taking blood thinning medication would be very low. I'll ask my gyneacologist to remove the coil at my next appointment in 3 weeks and stop the oestrogen completely at the same time.
-
Hello Ann
Sorry to hear about your health problems. I have been on the 2 pumps oestrogel/mirena for almost 3 years but had spotting throughout. Almost a month ago I started bleeding so I made the decision to stop the oestrogel cold turkey and the mirena was removed during a hysteroscopy early this week, which was done to find out the cause of the bleeding - nothing abnormal was found thankfully. Stopping the oestrogel made me feel light headed and more anxious for about 2 weeks but I got through it and feel better - hot flushes haven't returned. The mirena has only been out for a matter of days and the only difference is that I've not slept very well since it's removal. I haven't felt a crash to be honest but it may be to come, the oestrogen withdrawal was worse.
Dolly x
-
Thank you for your reply Dollydream. I'm struggling with the symptoms of the TIA and now having the added worry of hrt withdrawal. I'm pleased to know your experience of it hasn't been too bad so far.
-
Hi Ann - the only issue I had after Mirena removal was a very heavy bleed. I felt much better as the prog didn't suit although I stayed on oestrogen and it was high dose. You might get a bleed so don't be surprised it's just prog withdrawal.
-
Thank you, I'll be prepared for that.
-
Hi,
I don't have a coil but I'm trying to stop HRT too. I've not had progesterone since August and no bleed since July. To be honest I felt a lot better than I had in a long time. However, I've reduced my oestrogen patch from 50 to 25 and I m not feeling to great. Hopeful I can ride it out and then reduce it to nothing, but only time will tell.
Good luck with it all.
Spangles
xXx
-
I'm thinking that in a few weeks if I cut the 25 in half so it is even more gradual.
-
I'm considering coming off hrt due to my TIA/mini stroke. I need to stop the oestrogen first then have the mirena coil removed. Post menopause am I likely to get the mirena crash that many talk about? Not sure I can cope with that along with the TIA symptoms.
Hi ann58
Sorry to hear about yout TIA/mini stroke. Did you get told any reason the docs suspected this happened? Did the docs also say you should stop HRT? As far as I understand it is oral HRT that can lead to a higher clot/stroke risk rather than the transdermal preparation you are taking. There are other risk factors as I'm sure you know and have been told - ie being overweight - higher than the normal BMI range, a smoker, certain diets, high cholesterol, lack of exercise etc. I don't want to pry if you don't want to share but if any of these apply to you maybe these could account for your TIA, or maybe you have a medical condition predispoing towards this or genetic factors?
I am sure you have been through all of this but it may be that you can continue safely with a low dose oestrogen patch and especially if you minimise any other risk factors?
Re the Mirena withdrawal. What you will feel depends a lot on your age/menopausal stage, how long you've had this one in place and the reasons for having it! eg if you are post-menopause and having it for HRT and haven't had any bleeding and it's been in 3 years or so - there is no reason why you should have a withdrawal bleed. This is more likely to occur during peri-menopause ( as the Mirena stops periods eventually), or if you have eg fibroids ( which have shrunk or been prevented from bleeding by the Mirena), or if your endometrium ( womb lining) has not stabilised on the oestrogen dose you are taking so that you have bits of lining build up. However in this case you would normally have experienced spotting. Maybe you don't know quite where you are in which case - yes as said - as well to be prepared!
As for the "Mirena crash" - any form of progesterone withdrawal can cause pms type symptoms in some women and sometimes it can take some while for the prog to leave the system in the sense of reversing the changes caused by the Mirena - so whatever happens expect some pms for a few days or so at least. These will go though! The newer the Mirena is the more progestogen it gives out and therefore the bigger the withdrawal potentially...
I agree with Perinowpost - try to reduce oestrogen to coincide with Mirena removal if you can.
Good luck :)
Hurdity x
-
Thank you Hurdity,
I weigh 9 stone, I have never smoked, I don't drink alcohol. I have quite a healthy diet (I stick to the FODMAP diet due to ibs).
I exercise by walking but admit maybe I should do more. I have also been under a lot of stress this year.
I have my second mirena for hrt and have had one for hrt total of 6 years.
I spoke to my gyneacologist and he checked with a colleague in haemotology who said if it was her she would come off the hrt even though it is a low dose patch.
I do have a fibroid but because I am quite a few years post meno my gyneacologist doesn't think it will cause me any problems.
-
Thanks for the info ann58 - sounds like it wasn't a definitive answer as to coming off HRT?
I presume you're doing the low FODMAP rather than FODMAP? It was suggested that I did this after first trying gluten free - the latter which seems to have improved my symptoms no end. I looked up the high FODMAP foods and it seemed so illogical that I couldn't bear the thought of doing it (the low FODMAP) so I'm glad I am improved without it! There are so many foods that you can't have that I normally eat!!
Anyway if you've decided to go for it re stopping HRT and are happy with your decision then all the best and hope the withdrawal goes smoothly without too much of a crash. :)
Hurdity x
-
Yes low FODMAP My doctor recommended it for my bowel problems.
If life becomes too horrendous coming off hrt I may have to rethink but I will give it a try.
-
I had my mirena coil removed today and have also stopped the oestrogen patch.
I noticed bleeding as soon as I got home from the doctors and I'm assuming this is normal? Still bleeding tonight. I am 7 years post menopause and age 61
-
I had a Mirena a few years ago and had it removed as it made me feel awful - exacerbating peri as it tunrs out!
Anyhow, a few days later I had a bit of bleeding so popped my mooncup in. Then later that fternoon I had an enormous bleed. Blood running down my trouser leg in H&M and a long walk to the toilets in the shopping centre. I was soaked by the time I got there and thank goodness for individual cubicles with toilet, sink and hand dryer.
Be prepared!
In better news I felt a lot better without it almost immediately. I'm progesterone intolerant though so that may not be how you feel if you've been ok.
Have you seen a haematologist following your TIA? I have a blood clotting disorder and had a DVT at 30. My team are happy for me to have transdermal oestrogen and a Mirena-light called Jaydess. I take Dagibatran, brand name Pradaxa.
My new GP is freaked out by this arrangement and questioned the haematologists' support. GP thinks clot + hormones is a bad combo full stop. Haematology's rationale is that pregnancy is 100+ times the increase in hormones compared to non-pregnant but they don't advise not being pregnant, they prescribe anticoagulation to minimise risk of clotting.
With HRT, the added hormone is very small compared to pregnancy and as I am already anticoagulated (15 years and counting) I am minimising risk.
Clots are scary and for a whil it will feel like it's the only thing you think about - like a big black balloon right in your face. With time, it will drift away and be more on the edge of your vision. It takes a while and comes with feeling stronger physically and getting back to doing more normal things. Be patient with yourself and let anyone who offers you help, help.
-
ann58 - bleeding is absolutely normal after Mirena removal and in my case it was quite heavy. It's just prog withdrawal so nothing to worry about. Mine lasted a good week at a very heavy fliow.
Orangefoot - I've had 2 Mirenas and found the dose too much, I'd love to hear your comparison with the Jaydess.
-
I had my mirena coil removed today and have also stopped the oestrogen patch.
I noticed bleeding as soon as I got home from the doctors and I'm assuming this is normal? Still bleeding tonight. I am 7 years post menopause and age 61
Interesting that even at age 61 you have had bleeding - and I presume it is not heavy? If it is then it possibly shows that the Mirena was not actually controlling the growth of your womb lining from the oestrogen. If it was then there would be nothing to shed as you are well post-menopause. I can't remember what dose of oestrogen you were on? If it is very light then probably just as a result of the slightly invasive procedure - of coil removal. For example any vaginal treatment or procedure has the potential to cause bleeding, due to physical trauma - which would be more likely if you have a degree of vaginal atrophy and your tissues would be very thin and fragile? Do you use any topical/local oestrogen?
Hopefully the bleeding has stopped now?
Do let us know!
Hurdity x
-
The Jaydess has been fine. Mirena gave me awful peri symptoms before I realised that's what they were. Utrogestan made me rage and took my mind to such awful places my family asked me not to put another tablet in me.
My bleeding is now very very light and I've had no migraines or breast weirdness that were the most obvious issues with the Mirena.
I had mine fitted at the suggestion of the menopause clinic at the sexual health clinic as my GP wouldn't do it. The sexual health clinic had me agree that I needed it for contraception as they aren't licensed for HRT treatments.
You'd think that a clinic that deals with women's needs would be the natural home of menopause support, but no, that is too logical for health commissioning bodies to contemplate!
-
Orangefoot - many thanks for your reply. I've found it incredibly difficult to have the Jaydess prescribed on NHS, in fact they just won't and there's no way at 57 they'll prescribe it for contraception! I'm using alt day vaginal Utro just now and getting on well with it but I'm still interested in a Jaydess as I'm not particularly charmed at having to stuff more things up my nounou every other day. I saw a gynae a few years back who said he'd fit one for me so I'm keeping that in mind and just wanted to hear of others' experience. Would you mind telling me what dose e you're on and have you had any issues at all with Jaydess?
-
Orangefoot, thank you for your reply. The heamatolist advised that if it was her who had the TIA then she would stop hrt so I followed her advise even though the risk of it causing problems is low.
Hurdity..I had totally forgot I had mentioned on here about the bleed from mirena removal and started a new thread which I am unable to remove. I am still bleeding 5 days later.
Kiltedcupid How many years post menopause were you when you had the mirena removed?
-
Orangefoot - many thanks for your reply. I've found it incredibly difficult to have the Jaydess prescribed on NHS, in fact they just won't and there's no way at 57 they'll prescribe it for contraception! I'm using alt day vaginal Utro just now and getting on well with it but I'm still interested in a Jaydess as I'm not particularly charmed at having to stuff more things up my nounou every other day. I saw a gynae a few years back who said he'd fit one for me so I'm keeping that in mind and just wanted to hear of others' experience. Would you mind telling me what dose e you're on and have you had any issues at all with Jaydess?
I had mine fitted at the sexual health clinic and they would only do it because I hastily agreed I needed contraception! I'm 46 and still getting bleeds.
The consultant at the menopause clinic said I could have it fitted there if there was a problem locally. The private menopause GP I saw before getting to the meno clinic can fit them in her NHS practice but is only licensed to remove them in private practice.