Contents

Search

levonorgestrel-releasing intrauterine system (Mirena, LNG-IUS, LILETTA, Skyla)

Indications: 1) contraception* 2) abnormal uterine bleeding# * appropriate contraceptive option for women at increased risk for venous thromboemboembolism [4] * appropriate contraceptive option for women with uncontrolled hypertension [6] # FDA approved in US only for contraception; however, it is the most effective hormonal treatment for abnormal uterine bleeding. Procedure: - see intrauterine device procedure Complications: - levonorgestrel-releasing IUDs associated with 40% increased risk of breast cancer [7] Notes: - LILETTA FDA-approved for use by women to prevent pregnancy for up to three years [2] - Mirena IUS is now U.S. FDA approved for preventing pregnancy for 8 years [5]

General

intrauterine contraceptive or device (IUD)

References

  1. Journal Watch 24(9):69, 2004 Hurskainen R, Teperi J, Rissanen P, Aalto AM, Grenman S, Kivela A, Kujansuu E, Vuorma S, Yliskoski M, Paavonen J. Clinical outcomes and costs with the levonorgestrel-releasing intrauterine system or hysterectomy for treatment of menorrhagia: randomized trial 5-year follow-up. JAMA. 2004 Mar 24;291(12):1456-63. PMID: 15039412
  2. Actavis and Medicines360 Announce FDA Approval of LILETTA (levonorgestrel-releasing intrauterine system) 52 mg to Prevent Pregnancy for up to Three Years.
  3. FDA Approves Additional Use for IUD Mirena to Treat Heavy Menstrual Bleeding in IUD Users
  4. Medical Knowledge Self Assessment Program (MKSAP) 17, American College of Physicians, Philadelphia 2015
  5. Jensen JT et al. Contraceptive efficacy and safety of 52mg LNG-IUS for up to 8 years: Findings from the Mirena Extension Trial. Am J Obstet Gynecol 2022 Sep 9; [e-pub]. PMID: 36096186 https://www.ajog.org/article/S0002-9378(22)00729-3/pdf
  6. NEJM Knowledge+
  7. Morch LS, Meaidi A, Corn G et al Breast Cancer in Users of Levonorgestrel-Releasing Intrauterine Systems. JAMA. 2024 Oct 16. PMID: 39412770