Menopause Matters Forum
Menopause Discussion => All things menopause => Topic started by: Hannah50 on September 18, 2025, 07:55:32 PM
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I've been reassured by GP's 3 times since April that my very long episodes of spotting are nothing to worry about as my Mirena is still (just) in it's 5th year. I increased oestrogen to 100mcg patches at the start of May and have had increased spotting on and off since then. (I had cyclical spotting for many months before the increase in oestrogen, but at least had predictable gaps between this). I now have spotting for long runs of days - the latest is 28 days of spotting with just a few random days where there is none. I don't think this is linked to my cycle anymore. My spotting is almost always watery blood rather than bright, and some days it's enough to use protection - other days it's mainly just in the morning. I feel bloated too, my lower abdomen feels pretty solid much of the time. I'm due to have a new coil in mid Oct but I'm getting seriously paranoid that I just don't have enough progesterone for the high dose oestrogen patches and might have something sinister brewing. I'm going to ask for a scan - but I'm wondering if I should ask now rather than wait until my Mirena appointment? (I'm 51 and peri)
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I wouldn't worry at all about this.
Amenorrhoea is not universal on the IUS, it is a bonus not a given.
Secondly 100mcg estrogen is still relatively low compared to what a younger woman would have physiologically.
Thirdly you say you are perimenopausal - you will still be producing endogenous progesterone every time you ovulate, which the IUS doesn't prevent.
Finally whilst there is no official large scale published data on this, during the pandemic tens of thousands of women globally went overdue with an IUS for endometrial protection, and for up to 7+ years there were no additional endometrial cancers observed in this cohort.
By all means get a scan for reassurance but you don't need to lose any sleep over this. I would also make sure your cervical screening is up to date.
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Thank you! I think it's because the first few years I had no spotting at all but then as the Mirena has got older, spotting has become more regular (and now near constant) - which is why I was thinking the progesterone was getting low, at the same time as increasing the oestrogen patches. I hadn't thought about my own natural progesterone production, so that's reassuring. I'll wait until the appointment and mention it then.