Menopause Matters Forum
Menopause Discussion => All things menopause => Topic started by: Nas on August 17, 2022, 04:34:15 PM
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Well, I am at a crossroads.
I feel wretched. Pmt type symptoms, cramps, irritable, nauseous, achy.
Its either the mirena coil or lack of oestrogen causing this. I thought I was post menopause ( no period for 27 months) but I’ve just had a huge fluctuation. As in libido, happy, energy.. then bang yesterday... it went. Now in the depths of despair.
Been on the 75 patch for nearly two years ( give or take).
No idea what to do any longer.
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When R U due for a review?
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It's probably easier to try increasing your estrogen than doing anything about your Mirena - that is a bigger and more permanent decision.
Plus if you have been on the same estrogen dose for 2 years, it's likely you could need more - perhaps your own contribution from your ovaries has decreased more...
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I can't really offer any advice as am still trying to sort out my own oestrogen levels so am in a similar position which is why I just wanted to say so sorry you are suffering and send you love and empathy and do hope you start to feel better soon xx
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Review due later in the year CLKD.
Think you are right joziel, probably easier to increase Oestrogen, than meddle with the Mirena mid way through the ‘ settling in period’.
I hadn’t considered that that ovaries might be producing less.
It’s almost like a few days ago, they spouted out a huge spike of Oestrogen ( hence libido etc) and have now shut down, all in the space of a few days, is this even possible??
Thanks Pippa, I know you have your own issues to contend with, but I do hope you can get sorted in due course too. It’s a totally unrelenting journey ! X
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Yes, that's very possible Nas. That's what they do in peri. :'(
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Oh my... I’d forgotten all this.
It’s exactly what happened during peri ( what i thought was peri at least!)
A huge spike of Oestrogen with a huge libido and then... it was gone... over a few days! The exact same thing has happened again, 4 years later!! :(
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Interesting!
But yes, that’s exactly what’s happens naturally in our cycle. Also on a daily basis.
Spike and libido, then decline.
This constant drip when on patches or gel is not natural.
This needs further thought…
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I agree Marchlove, because that is one little theory I have about why some women like me find it so hard to tolerate estrogen from anywhere except our own ovaries.
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This is why, I believe, estrogen implants are supposed to be the best way for ERT.
Apparently it’s something about it releasing from the implant as the body perceives it’s needed.
A long time since I read the article, but from memory more is released during time of energy requirement.
The only message I get from this in terms of how we can apply this to our own situation, is that we should try and mimic this as best we can, by creating a peak and trough. Albeit not perfect! X
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I think I'd be too scared to try an estrogen implant after just what happened to me ;D
Really, why don't they measure our individual estrogen fluctuations during a few cycles of peak reproductive health (ie 25yo) - and then replicate that using estrogen when we become menopausal! ;D ;D ;D
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What you describe does sound exactly like an Estrogen spike. Regular PMT is caused by the sudden drop in both Estrogen and Progesterone before a period, so it totally fits with what you're saying.
I would also be too scared to go down the implant route - I've read too much about addiction problems with them, but this is particularly relevant to me because of how my body reacts to Estrogen and may not be a concern to others.
Do you think you could wait it out and see if it was just a one off? The only other suggestion I could come up with is if it happens again, to temporarily increase your HRT for a few days to get yourself over the hump - not easy on the patch, you might need to add something else in and there's a chance you may end up creating more instability for yourself I guess, as you'd have to then reduce it again.
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Do you take testosterone Nas? xx
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Nas, I think an increase is needed and I’d say you are peri. I have horrific low Estrogen symptoms basically all of them but I still get spikes, I had one on Monday where I had that sudden libido and felt good generally then gone again. The ovaries can spurt out huge amounts as they are packing up.
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:bighug:
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Thanks all
I’m pretty depressed about it right now, as feel my body is causing real issues for my poor brain!
I know you peri ladies have to deal with this constantly, but after 4 years, I wasn’t expecting this and for the foreseeable future! 😬
Erm , what do? Well I started testosterone yesterday March... I am not sure that was a good idea ?
Can’t really increase the oestrogen, as have the 75 patch on repeat now ( after much chopping and changing hrt).
I have the coil, so why would the progesterone drop ( or has my own dropped too?).
What is causing this pmt? Is it low o and p together then?
Still feeling grim and feel I want the coil out now.
😥😥
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I think you just need more estrogen. Were those bloods in 2019 on the 75 patch?
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Oct 2019
771 was 5 months on gel x 3 pumps
Dec 2019
118 was on x 3 pumps
Feb 2020 88 on x 3 pumps
No period since aug 2018.
Then the levels reached 400 when I started the patch in October 2020 and only recently have dropped to 300 whilst on the same 75 patch.
Until now, symptoms were reasonably stable, no pmt. So I’m wondering about the coil now causing issues?
I don’t know how to get more oestrogen right now. I could add gel, but not sure if it’s that right course of action.
It’s like I get a high when I first put the patch on. Then a low the day after and that’s how it goes!
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Just to add since starting yasmin pill, today I have had ylthe libido increase this morning... First time for me and my partner in a long long time ....probably about 12 months.
I'm only on day 5, could this indicate the pill is working for me?
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Nas
I do think testosterone will be of benefit to you given time.
I’ve found I’m less irritable, don’t have low mood and more energy.
Have more of a read about it. Remember testosterone is more abundant in a healthy younger woman than estrogen.
Some will aromatise to estrogen, so for you that will be a good thing.
Some might convert to DHT, but there are a couple of supplements you can take to minimise potential increased hair and possibly acne. Doesn’t happen to everyone anyway.
https://www.londonpmsandmenopause.co.uk/women-and-testosterone.php
X
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Nas, I dont think you absorbed much gel based on those bloods but if the bloods since patch are from the patch then an increase will probably sort it seeing as it was working until your own levels dropped perhaps.
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Nas, a few things...
If you are around 400-300pmol of estrogen, you could well need more estrogen. You could try adding in one pump of gel if you have it, or you could cut a quarter of a 75 patch to add on - as long as you always measure the same amount (in mm) it will be a consistent amount.
I think it's good you've added the testosterone, that isn't going to interfere with the estrogen-progesterone thing and it could well help - but it is a slow burner as it can take 1-6 months to see any difference, it's not immediate.
Progesterone: I think you are misunderstanding things. The coil does not contain progesterone. It contains a synthetic progesTIN. Which doesn't function in the same way as body identical progesterone - the only way it imitates body identical progesterone is that both thin the uterus lining. In every other way, it functions very differently. If you want more information on that, get a copy of Lara Briden's Hormone Repair Manual. She briefly addresses it here: https://www.larabriden.com/the-crucial-difference-between-progesterone-and-progestins/ You can also check out her podcast where she has an episode on the difference.
You're not getting any progesterone from the coil. Besides which, the coil is designed to deliver progestin locally to the uterus and the amount which reaches the blood stream is very very low. So - you may well not have enough progesterone.
If you want to see if progesterone is causing your problems, you would need to use utrogestan/body identical progesterone. You can use this along with the coil, although you may find that some GPs resist because they don't understand that progesterone does much more than just thin the uterus lining and if you have a coil in, they might just think you are covered for that. But if you want to explain that you want to try adding it in to see if it helps with mood, you could do that. I think you've taken it before, did it improve or worsen your mood then?
If your previous problems with HRT have been ongoing problematic bleeding, I really wouldn't recommend removing the coil. Because you will just get that back again and it could make it difficult for you to take any HRT at all. Instead, you could add in utrogestan as well as the coil, see if the testosterone helps at all, and try increasing estrogen. Maybe don't do all that at once, as you won't know what is doing what ;D I'd suggest doing all that before considering removing the coil, especially before 6 months on it.
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There is a new member who may benefit from your recent comments Joziel ........ Kitty4
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Thanks all again, much appreciated.
I will continue with the testosterone then, it’s tostran x 3 pumps a week. Can’t do much harm I guess.
Joziel, wow, you have an amazing insight into this meno lark and for that, I would like to thank you. I am woefully ignorant when it comes to progestin and progesterone and honestly thought the two did the same thing. But you are right, I COULD be low in progesterone and have lots of utrogestan left over, which I could start taking each night.
It never even occurred to me that my ovaries might be producing less than almost two years ago and it may be that more oestrogen is required now. Joziel, which would you do first in my situation? Increase oestrogen, add in testosterone or take utrogestan?
The coil had better stay in situ for now then. The last thing i want is fortnightly bleeds again! I just didn’t know how much of three progestin entered the blood steam.
Floo, it does sound very peri I agree, or the ovaries are having a last blast?? It’s so complicated to try and fathom out! The patch was working well for a long time, but obviously levels are dropping again. I’m not convinced I absorb well from gel, so once I reach the maximum licensed dose on the patch, I guess tablets may be the next trial?
March, which testosterone do you use? How long until you started to see the benefit?
Once again, thankyou so much for your input, it really helps.
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Hi Nas
Yes Joziel has made a good point there!
I’m on compounded 5mg and use it every other day. But I’m way post menopause so my testosterone levels will be much lower than yours.
Everyone is different about how long it takes to notice a difference I’m afraid. X
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Nas, did you have any emotional/PMS type side effects taking utrogestan before? Was your only problem with it the fact that it didn't control your bleeding?
If so, that would be a pretty safe thing to try in the first instance. It's not going to give you nasty high/low estrogen side effects. The continuous dose is 100mg nightly. If it doesn't work you can just stop it again because you've got the coil in now.
I thought you'd already started testosterone? I wouldn't stop that if you've started it. You likely need it, whatever, if your levels show that you do.
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No emotional issues on utrogestan at all joziel. Just that it didn't control the bleeding, as you say.
I will start the 100mg tonight and see how I go.
The testosterone I started yesterday, one pump three times a week it is.