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[lizziejt]

Hi, I'm hoping someone can give me some advice. I am 56 and was on HRT tablets since age 47ish. Femoston 1/10 and then 2/10. I am under the menopause clinic and they were keen for me to change the route so in March this year I had a Mirena fitted and have Evorel 50 patches. For the last month or so I have increased stiffness, especially in the morning and after sitting for a while. I have looked in to the Mirena and was worried to read that it may increase risk of rheumatoid arthritis 😳 but also i remember stiffness before i started HRT. Is it a good idea to try Evorel 75 to see if it helps, or is that a very high dose?

[CLKD]

Why did you feel it necessary to change HRT regime if it was working 

As oestrogen levels drop so muscles may become lax = aches and pains.  With the hotter weather, we are inclined to change our footwear which can cause pain and stiffness.   I have a lovely pair of sandals worn every day last Summer but they hurt my feet now 

Dropped arches can happen as we age. 

Why would a Mirena increase the risk of RA?  That's an auto immune condition 

[lizziejt]

Hi CKLD
I was strongly recommended to change by the meno specialist because of the higher risk with oral tablets. And if you google Mirena risks you will find many lawsuits and some info about RA linked to Mirena. As for dropped arches, I don't personally think that would have such a sudden onset and i also have general stiffness in my legs/joints which i didn't have before. I think it's either linked to lower oestrogen dosage/absorption or Mirena side effects. Thanks for your opinion though 😊

[CLKD]

I wouldn't google unless it was via the NHS web-sites ;-).

Sounds like you have found a US-site?  RA is an auto immune disease which causes painful, swollen joints which are hot to touch.  Dropped arches can happen in weeks ...........

You alerted my urge to learn more from the NHS:

Rheumatoid arthritis is an autoimmune condition, which means it's caused by the immune system attacking healthy body tissue. However, it's not yet known what triggers this.

Your immune system normally makes antibodies that attack bacteria and viruses, helping to fight infection.

If you have rheumatoid arthritis, your immune system mistakenly sends antibodies to the lining of your joints, where they attack the tissue surrounding the joint.

This causes the thin layer of cells (synovium) covering your joints to become sore and inflamed, releasing chemicals that damage nearby:

bones
cartilage ? the stretchy connective tissue between bones
tendons ? the tissue that connects bone to muscle
ligaments ? the tissue that connects bone and cartilage

If rheumatoid arthritis is not treated, these chemicals gradually cause the joint to lose its shape and alignment. Eventually, it can destroy the joint completely.

Various theories of why the immune system attacks the joints have been suggested, such as an infection being a trigger, but none of these theories has been proven.

Possible risk factors

There are several things that may increase your risk of developing rheumatoid arthritis, including:

your genes ? there's some evidence that rheumatoid arthritis can run in families, although the risk of inheriting it is thought to be low as genes are only thought to play a small role in the condition

hormones ? rheumatoid arthritis is more common in women than men, which may be because of the effects of the hormone oestrogen, although this link has not been proven

smoking ? some evidence suggests that people who smoke have an increased risk of developing rheumatoid arthritis

Further information

NRAS: possible causes and risk factors

[CLKD]

Interesting that there is no mention in the NHS information suggesting that a Mirena will increase the risk of developing RA.  Did U read the American information 2014?

[sheila99]

Are other meno symptoms under control? If they are I would be inclined to think it might be the mirena rather than low oestrogen. Because the mirena is designed for contraception it contains a much higher dose of progesterone than you'd get on hrt. Some people find it can take 6 months to settle, some people just can't tolerate it and have it removed. It would be worth trying more oestrogen to see if it works. 75 isn't an unusually high dose. If you decide the mirena isn't for you you could try utrogeston and take it vaginally. Of course it could just be coincidence it's started now.

[lizziejt]

It was a research study of around 1000 women, I'm very capable of discerning valid sources of information. I already know what RA is and I work in the NHS.

[lizziejt]

Thank you Sheila99 - I haven't had hot flushes coming back although am possibly sweating a bit more which was a symptom in the past. I didn't know the Mirena dose was high, that's interesting! Am wishing i had researched it a bit better before agreeing to it. But i might try the Evorel 75 to see if it helps. I really remember being very stiff and achey pre HRT.

[Raztac10]

Hi I’m on exactly the same as you. I had sequi patches which were fine but then was struggling to source so had Mirena fitted in March and progynova 50 patches. These ran out recently and I’ve now got evorel 50 which I don’t think are as good, or maybe I’m imagining it! progynova only need changing once per week. With evorel I’ve had some spotting, period type pains and my knee joints are aching a bit. I think I’m going to add another half patch and see if that helps.
I hated Mirena at first as I bled for ages but I’ve been very happy until recently. 

[sheila99]

They use different carriers so it might be that you absorb less with this brand, or it could be coincidence and your own body is producing less. I hope the increased dose works for you.

[Raztac10]

Thanks for info. How do I find out which has same carrier as Progynova? Their patches are only available in 50 and 100 so if I ever needed to increase I’d like to go to something similar.

[sheila99]

The patient information leaflet should tell you what's in it but if get on well with this type of patch it might be better to cut a piece off a higher dose patch rather than change completely.

[SueLW]

i remember stiffness before i started HRT. Is it a good idea to try Evorel 75 to see if it helps, or is that a very high dose?

It's a menopause symptom and Evorel 50 is quite a low dose.  Sounds like you need to go up to 75, which isn't high.  I'm on a 125mg patch + a spray at the moment and might need to go up further.  Don't worry about the size of the patch.

[SueLW]

Hi CKLD
I was strongly recommended to change by the meno specialist because of the higher risk with oral tablets. And if you google Mirena risks you will find many lawsuits and some info about RA linked to Mirena. As for dropped arches, I don't personally think that would have such a sudden onset and i also have general stiffness in my legs/joints which i didn't have before. I think it's either linked to lower oestrogen dosage/absorption or Mirena side effects. Thanks for your opinion though 😊

There are millions of us happily on the Mirena coil.  Don't read the scare stories.  Your symptoms are the symptoms of low oestrogen. 

I was going to give you a link to a fact sheet about it.  But there are many fact sheets you might find interesting on this part of the Newson web site.  Have a read.

https://www.menopausedoctor.co.uk/resources/fact-sheets