Mirena

What is it?

An IUS (intrauterine system) device comprising a T-shaped unit containing 52mg of levonorgestrel (a progestogen) which is slowly released.

Medical Uses

Contraception, menorrhagia (heavy menstrual bleeding).

Dosage

Device is inserted by trained doctor into womb within 7 days of start of period and left in place for 5 years. Should not be inserted until 6 weeks after childbirth.

Special Care

Breastfeeding, diabetes, chronic corticosteroid treatment, thromboembolic and arterial disease, disease of heart valves, liver disorders, previous ectopic pregnancy or ovarian cysts, hormone dependent cancers, very severe headaches. If fitted for menorrhagia, remove if no improvement within 3 to 6 months. Also, remove in event of pregnancy, partial expulsion from womb, recurrent pelvic infections or endometritis (inflammation of endometrium), perforation of womb, serious acute infection.

Avoid Use

Pregnancy, abnormality of womb, genital infections, pelvic inflammatory disease, ceryicitis (inflammation of cervix), cervical dysplasia (presence of abnormal cells as revealed by smear test), bleeding from womb of unknown cause, cancer of cervix or womb. Infected abortion, endometritis after childbirth, women who have had heart valve surgery or who have lesions/anatomical abnormalities and who have had bacterial endocarditis (inflammation and infection of the endocardium of the heart) or serous pelvic infections. Also, leukaemia, other blood malignancies, trophoblastic disease, liver tumours, liver disorders, serious disease of the arteries, lowered immunity and increased susceptibilty to infections.

Possible Drug and Food Interactions

Drugs inducing liver enzymes.

Known Side Effects

Weight gain, pain in back and lower abdomen, disruption in pattern of menstruation, nausea, headaches, skin effects, greasy hair, breast pain, fluid retention, vaginal discharge, vaginitis, mood swings, hair loss, pelvic inflammatory disease, ovarian cysts. Monitor with ultrasound in event of delayed follicular artresia.