Dienogest with mirena coil

[Maxyy93]

I had a 2nd laparoscopy in March 2021 where I had the mirena fitted at the same time. I had bleeding for 6 months after and I started to get pain again when my consultant informed me I could take dienogest 2mg alongside which could help settle the pain. I have had to get it from abroad due to issues with drs prescribing it here in the UK. The first month of taking it I had the most horrendous pain than I had had without taking it.

I have been taking it since February this year and in March I had no bleeding at all and thought great this will manage my symptoms. But since the end of April until now, I have been bleeding/spotting non-stop. I had a review with my consultant in June who said that the bleeding showed that the “endometrium was active” and just left it at that. One of the things specified on the dienogest information is not to take it if you have the coil. But the consultant said it’s such a low dose and should not be a problem. Over the last 3 weeks the bleeding has been getting more heavier. I don’t have a follow up appointment until November and not sure what I should do. My consultant has advised having surgery to remove the endo as the other 2 were with different drs and were more to diagnose location of endo. Any advise would be helpful.

[Hariyama06]

Hi Maxyy93, sorry to hear about your situation. I hope you are coping somehow. I am on visanne/dienogest same as you but i opted out of the mirena coil as i have heard alot of unsatisfactory experiences from endo sisters who were on it and had theirs removed. Dienogest works very well for me as i have had alot of experimentations on treatment pills and injections alike.

Since you cannot remove mirena from the equation and observe your symptoms, i would suggest stopping dienogest for a week or just about time you see any change in your condition. You seem to be double dosing on progesterone or progestogen. Somehow, i have learned that we have endo of different levels but our bodies react

Differently to treatment. Some don't like pills with estrogen some don't. Some need Gnrh injections some a simple diest change works.

You know your body best. Let it talk to you. Take notes of your symptoms. Surgery ia not always the answer until you have tried all possibilities. Complications from surgery are irreversible so you need to exhaust all possibilities to find what works for you first.

Btw, just wondering how you get hold of your dienogest. I get mine from my Gyne in Singapore which is often difficult. Would appreciate if you can let me know if getting yours is easier.

[Maxyy93 in reply to Hariyama06]

Hi Hariyama06

Thank you so much for your response. I thought no one would reply as I feel I am in quite a unique position to most ladies on here.

I had already had the mirena fitted in. I think if I didn’t have the coil in, I would be getting on better with the tablets. But I think you are right that my body is not happy with the double dose of progesterone. But with the coil only I was still getting bleeding and pain.

I’ve had the injections before as well and normal contraceptives so I was really hoping this to be what works. I’m still on the fence about this surgery as you said that the effects would be irreversible. I am worried about taking a break as I think it does help relieve most of my pain so I worry what would happen if I stopped.

Oh it’s a struggle getting the visanne/dienogest. I have family coming and going from Africa so I tend to ask them to get it for me from there. It’s a shame there is no easier solution here.