Menopause Matters Forum
Menopause Discussion => All things menopause => Topic started by: Ljp on December 12, 2019, 06:47:34 PM
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Hi all.
Today I went to see an NHS menopause specialist in my local area, I had no idea we had one! I was referred by my GP as my mirena(used alongside oestrogel, estring and tostran) needs replacing (had it 4 years) and the strings have twisted up inside my cervix.
Well, the specialist was lovely, and spent time listening to all my history of menopause symptoms, VA, Mona Lisa, and still having bladder issues.
Initially she was going to replace my mirena, then she suggested rather than replace it yet, that I try utrogestan daily to see how I get on with it, as she said mirena, although very good, isn't body identical progesterone and very little gets into blood stream, where as the utrogestan, which is body identical, will benefit my whole system, hopefully including my bladder.
If I tolerate it well, she will remove my mirena at a later date.
She has also prescribed me intrarosa to try to see if that, alongside my estring, can help bladder and VA flare ups.
I'm feeling positive, but also apprehensive about taking utrogestan, worried I might get side effects?....how do you fare? If you are on it?
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Also - what are you using for the VA?
Glad that you managed to get a sympathetic medic - hang on to her ;-). Let us know how you get on.
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I was prescribed Utrogestan daily, i lasted 8 days, the side effects were so bad, disturbed sleep, with vivid dreams, needing to keep getting up for toilet in night, hot flushes so bad that my sheets were soaked. I had to stop as i was zombie like in the day and i had to do school run and go to work, maybe i would have got used to it but as i didn't feel i should be driving i had to stop it, i then went for the Mirena.
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Also - what are you using for the VA?
Glad that you managed to get a sympathetic medic - hang on to her ;-). Let us know how you get on.
I've been using estring for 4 years
I will be also be trying intrarosa DHEA as from tomorrow
I was prescribed Utrogestan daily, i lasted 8 days, the side effects were so bad, disturbed sleep, with vivid dreams, needing to keep getting up for toilet in night, hot flushes so bad that my sheets were soaked. I had to stop as i was zombie like in the day and i had to do school run and go to work, maybe i would have got used to it but as i didn't feel i should be driving i had to stop it, i then went for the Mirena.
Blimey that's concerning! Hope I don't suffer such side effects 😟
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There are stories for and against, so fingers crossed you'll be ok. I'm okish on utrogestan. It can make you feel a little foggy but you won't know till you try it. Try not to worry!
I was like a miserable, knackered old hag on the Mirena.
Thanks Birdy, I'm terrified to try it, I've been doing ok an my oestrogen and mirena, the Tostran has helped my bladder since September and all good.
But I hear what the specialist was saying regarding my age and VA and how removing and inserting mirena coils can be problematic as we age and uncomfortable (mine was very painful
being inserted)
I'm so worried the utrogestan is going to start cramps, bleeds, fogginess etc 😩
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I love the Mirena but others hate it, same as with utrogestan, so you don't know until you try and you can always go back to the Mirena.
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I have no problems with Utrogestan. Try not to worry x
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So no to using it vaginally then
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I did ask the specialist regarding how best to use it, orally or Vaginally, she said orally, so feel I should do this way first.
Maybe if it all goes well and I have mirena removed, then I can ask about trying vaginally.
Although I already have estring and starting intrarosa tonight, not sure if vaginally would be wise, quite the chemical concoction 🤔😀
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Did you ask it just do it?
Do you insert it daily I'm on Conti
I am worried that using it Vaginally might be risky with already having estring and now using intrarosa too? Plus how it could affect my VA
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Hopefully Hurdity will read and reply x
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I didn't know the Utrogestan can act as a diuretic, explains why i was up about 3 times a night whilst i took it, prior to starting it i never needed to use the toilet at night.
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LJP,
When I started on Utrogestan I did it alternate days 100mg, so the body gradually gets used to it, maybe this will help, do say first couple of weeks alternate days and see how you get on. I had a bit of headache and feeling itchy initially but soon passed. In fact my mood improved with this prog (had been on oestrogen only for 2 months first to get the right dose).
So its not all bad!
Rhiner
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I've used Utrogestan vaginally on a cycle for 8 or 9 years now - Hurdity and I started around the same time. Yes, it does minimise unpleasant side effects such as sedation but for some it acts as a diuretic (which is a natural attribute of progesterone) and can tend to irritate the bladder (in some people) so you're up and down to the loo during the night. I definitely wouldn't want to be using the capsules vaginally every day. Hope that's clear now.
Yes! THis! Was it really that long ago stellajane? Now I come to think about it, was Sept 2011 when I started long cycle vag Utro having just done a few months of conti with 25 mcg patches and every third day Cyclogest, then thanks to this forum discovered utro had been licensed for hRT in UK since I started hRT....
Yes like Marmite whoever said that - you love it or hate it (Utro that is). My experience I think I posted today on another thread? Never taken it orally as I've always been HRT = nil-by-mouth - most natural way to get the stuff into your body. It does give me bladder irritation as normally now I sleep so deeply ( too deeply - no proper cortisol awakening response or something) so I don't wake up easily. When taking Utro I wake in the night to pee. When I didn't sleep so deeply I would sometimes need to get up twice. I always read in bed ( actual book!) so just before I turn light out I nip out to loo so hopefully then it's only just the once!
Also it dometimes gives me labial irritation (upper labia just below the mons - becomes very itchy) - so I use thrush cream if so and despite the fact that the utro oozes out - try to make sure there is nothing tight around that area at night. Sooo much better with only 100 mg though ( but if cyclically this must be supervised medically ie with permission of your doc). also side effects so much better (or rather less bad) with 100 mg compared with 200 mg but like I said in other thread I plump up with Vagifem daily during the week leading up to vag utro and during it when I can (Vagifem in the morning 12 hours after the utro).
Gosh LJP I am wondering why you will be using Intrarosa + the Estring as well as systemic oestrogen? Problem with intrarosa is that the licensed dose is daily to give the same effect as twice weekly Vagifem 10 mcg so it's weaker. However probably in conjunction with other HRT it may well help. There is also the newly licensed Imvaggis (drum roll!) an estriol pessary made by Besins.
Foggy head? Yes to this ie I get it with Utro, but much more with 200 mg. This is the worst symptom along with fatigue and occasional migraine but I must stress it is very individual as you can see from the replies.
Don't think I can add anything further except to agree with all the excellent replies :). Research shows that for a given dose more gets to the uterus when used vaginally than orally as it goes straight to where it's needed. Orally there are more metabolic byproducts. I think the effect of it will vary according to where you are in menopause and perhaps your general hormonal "milieu" not just HRT. As I said I sleep too deeply so can do without the extra sedative effect. If you are generally hyped up and over-stimulated it may well have a calming effect before it gets to be too much and have the depressive effect - so maybe this accounts for the differences?
Sorry I'm rambling - had my Fri night tipple and not enough sleep last night due to momentous events ::) :(
Hurdity x
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Thanks Hurdity and all for your replies.
I'm definitely feeling very confused and anxious about all this change, and unsure of safety etc.
My mirena is still in,had it 4 years although they now say 5 years is ok for meno use.
I think the specialist saw this as an opportunity for me to try utrogestan, but I'm worried about my liver taking it orally, and wouldn't want to use it vaginally due to my VA and bladder issues.
I do have moderate to severe VA at 55 😩 and specialist suggested I try intrarosa alongside the estring to see If it might help the Labial irritation I still get at times, and the urgency and urge incontinence I still get, some dats worse than others though, tostran has helped I think.
I'm just in a state thinking about it all, how to take, what to take,....thought I was doing okish on my oestrogel/estring/mirena regime 😥
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Why not stay with the Mirena then if it suits you, i have a Mirena and use Estrogel and for me it is a great combo.
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LJP,
Just to add to my previous post, I take it orally, started alternate days (now Im 2 days on one off on 100mg). I have never tried vaginally as its worked OK for me orally and it sounds a bit messy, There is still a systemic effect vaginally (but bypasses the liver as others have said).
Good luck with whatever you go with.
Rhiner
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Had a better nights sleep last night.
Don't let it stress you out. Maybe you should opt to stay on your current regime if it is working.
The reason for specialist suggesting that I try utrogestan, and to take it orally, is firstly, the problems with VA and everything shrinking etc, is there is increased risk of problems inserting the mirena, as it is, the one I currently haves strings have gone awol in my cervix
Secondly she Prefers women use natural body identical progesterone if possible, and thinks the oral route is better as progesterone has uses throughout the body, not just for protecting the uterus.
She suggested I try now as my coil has been in 4 years, it was initially said that as part of HRT, a mirena should be replaced every 4 years, however, current guidelines suggest it's ok for 5.
What she said was, before removing mirena, I try the utrogestan for 3 months, she'll see me again in 6 weeks, see how I get on.
She said coils aren't great past mid 50's, looking for long term Plan now 😊
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That's bad news then, i am 56 now and my Mirena will need replacing next year, i hated the Utrogestan, looks like i am doomed then :'(
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I have no shrinking or signs of VA accoring to GP now i have VA controlled, but i think the uterus shrinks, is that the reason why they can be difficult to fit?
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everything shrinks and sags !
lol the joys and i had to have this all 15 yrs early !! haha 😂
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Great! I will have to cross my fingers that the replacement due next year works and worry about what to do after that :(
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So far so good with utrogestan and intrarosa 😊
First night had rubbish sleep, but I think that was due to anxiety of starting new regime, and having read so many differing experiences and opinions.
Second and subsequent nights I've slept well, after second night, I felt a bit nauseous, and dull head, but not since, in fact I'm feeling good, but it's only been 4 nights lol!
I'm happy to continue taking utrogestan 100mg daily orally at present, I still have my 4 year old mirena too, so until I see my meno specialist again in 6 weeks, I'll do exactly as she suggested.
Tinker bell, I have no “obvious†signs of VA either, having had 7 Mona Lisa treatments, estring and HRT for last 4 years, it's been a lot better, plus I definitely think the tostran is helping.
However despite all that, the meno specialist suggested the intrarosa to further help bladder and VA, and she said mirena isn't advisable from mid 50's due to shrinkage 😩....don't like this ageing lark!
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Does anyone know likelihood of me getting and spotting/bleeding now I'm taking utrogestan for the first time and still have mirena?
Had very little in last 4 years, although did have a bit last month for a couple of day's, suspected maybe due to mirena reaching retirement age
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It's depressing, I will be 57 when my Mirena needs replacing and was hoping to have another one, so don't know what I shall do if it's a no no!
Good to hear that you are getting on with the Utrogestan.
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Re the mirena not being advisable from the mid 50's I totally agree. I had a really traumatic experience, trying to have the jaydess (mini mirena) fitted earlier this year, which had to be aborted. I went into shock and it's not something I'd ever put myself through again.
My friend however, had hers done under anaesthetic, so for those who prefer that option there is a way round it x
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Thanks Birdy, we put ourselves through so much on this meno journey trying to find a solution don't we?x
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Tinkerbell, I'm 57 and my Dr said he would be happy for me to have a mirena fitted. In fact, I got the impression it was his preferred option, maybe because it offers good value. I'm currently on evorel sequi.
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It's depressing, I will be 57 when my Mirena needs replacing and was hoping to have another one, so don't know what I shall do if it's a no no!
Good to hear that you are getting on with the Utrogestan.
If you've not used utrogestan for all the years you e had the coil, you may we'll find you can tolerate it now you are further into postmeno? Just a thought x
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I hasten to add, my meno specialist didn't put rule the mirena, she just suggested now was a good time to try utrogestan as mirenas aren't recommended after mid 50's due to internal shrinkage making them more difficult and uncomfortable to fit.
She did say though that if I don't get on with utrogestan she could give local anaesthetic into cervix and change mine
Hope this helps..
Anyone answer my question regarding likelihood of having a bleed please?
Does anyone know likelihood of me getting and spotting/bleeding now I'm taking utrogestan for the first time and still have mirena?
Had very little in last 4 years, although did have a bit last month for a couple of day's, suspected maybe due to mirena reaching retirement age
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Hi Ljp
No-one can tell you when or you will bleed on your new regime but if you are post-menopausal and any initial bleeding has stopped with the mirena (for some time) then the extra progesterone (from the utro) should not cause additional bleeding. Sometimes too much progesterone can cause the lining to atrophy and become overthin - which can lead to bleeding and spotting. Also depends on your oestrogen dose too. Did you get the spotting etc checked out with your specialist? As you are post-meno and you had no bleeding on Mirena then any bleeding after a long period of time of none should be checked out with the doctor.
Re putting in Mirena at an advanced age ( ::) ) I was offered one at 60 when I had a hysteroscopy for spotting ie the specialist recommended it to stop any further spottting but I declined and carried on with the utro.
All the best Ljp and do keep us updated :)
Hurdity x
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Yes my specialist said it was likely that the coil was less effective as it's 4 years old.
I have had odd times of spotting during the 4 years, only ever got a day or two. GP and specialist not concerned x
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Hi all,
I'm now 2 weeks in to the 100mg utrogestan every night regime, all seemed good, but since monday I've had tummy issues, dull ache, sometimes burning like acid, plus feeling of trapped wind into my back.
I've had to take buscopan and omeprazole to try to relive it.
I'm not yet sure if it's the utrogestan, I had been fine, and the other thing of course is Christmas eating!.....prior to Christmas, I had been intermittent fasting and eating low carbohydrate foods, for quite sometime, so this could also be the cause....just thought I'd post though, as unsure if it could be the utrogestan, or if a lot more likely it's dietary related?
I have another 4weeks before I'm due to see meno specialist again, and will be back on my healthy diet again before then.
I had to stop the intrarosa as is caused flare up of my external soreness,as does anything that leaks! Taken a week to try to settle that down too!