Hello, I have gone through your query and understood the concern. The spotting you are experiencing currently is more likely to be due to the hormone effect of the Mirena. Also, owing to some amount of instrumentation during the procedure, spotting is usually observed. There is no need for progesterone cream supplementation if you have been using it as an alternative to oral progesterone since the IUD supplies that. You can have further suggestions from your consultant and also have a follow up to ensure the device is in place. Hope this helps.