Brief Answer:
Modulation of progesterone doses is likely to work
Detailed Answer:
Hello,
Thanks for posting your query.
The fact that you started bleeding while still on Mirena, needs to be considered. At your age, combination pills are usually not advised. If you did not have a complete gynecological exam, I would suggest one including a sonogram and a
pap smear.
If no other cause for the bleeding is found, hormone supplementation with dose modulation can help. As
estrogen is not tolerated well by you, please continue with progesterone.
Medroxyprogesterone is a better alternative with convenience of use and lesser androgenic side effects. Weight gain also is not a significant feature with this treatment.
Concerning diet and exercise, there is not much to be suggested as you are already into it. Please use nutritional supplements to manage any
anemia. Once the cycle regularization is achieved, you may stop the medication. If your system needs continuous hormone supplements, you can consider
endometrial ablation.
Hope your query has been clarified. Please feel free to contact for further clarifications. I will be happy to help.
regards,
Shanti.V.
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