The Role of Mirena (Intra-uterine progestogens), Other than Contraceptive benefits: Current Concepts and Practices

In: Journal of Bangladesh College of Physicians and Surgeons · 1970 · vol. 28(3) , pp. 174–182 · doi:10.3329/jbcps.v28i3.6511 · W1982953427
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This paper reviews Mirena's non-contraceptive benefits, including treatment for menorrhagia, endometrial protection during hormone replacement therapy, and potential effects on fibroids, endometriosis, adenomyosis, and endometrial hyperplasia.

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This paper reviews current concepts and practices for Mirena, a levonorgestrel-releasing intrauterine system (LNG-IUS), focusing on noncontraceptive benefits and related effects on the endometrium. It describes how LNG thins the endometrium, reduces endometrial gland activity, and may cause early unscheduled bleeding, with functional ovarian cysts noted as a common transient possibility; it also notes differing evidence for use in fibroid uterus, while reporting reductions in fibroid-related menstrual blood loss. It states that Mirena is licensed for menorrhagia with marked blood-loss reduction, provides endometrial protection during hormone replacement therapy, reduces endometrial hyperplasia, and may be used in some early endometrial cancer situations, with lower rates of ectopic pregnancy and pelvic inflammatory disease compared with IUCD users. The paper reports beneficial effects of LNG-IUS in endometriosis and adenomyosis by reducing pain and blood loss, making it directly relevant to those conditions.

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Abstract

Mirena is a long acting intrauterine hormone-releasing (LNG-IUS) contraceptive system with a flexible plastic T-shaped frame bearing a levonorgestrel(LNG)- containing cylinder which releases small doses levonorgestrel into the uterine cavity after insertion with maximum effect on the endometrium and minimum progestogenic side-effect. LNG causes thinning of the endometrium, atrophy of the endometrial glands and decidualisation of the endometrial stroma. The most common side-effect of LNG-IUS is unscheduled vaginal bleeding in the first 3 months, so proper counseling is needed. In some cases functional ovarian cysts may occur which are relatively small, symptomless and resolved spontaneously within a short time.Mirena is now licensed for the treatment of menorrhagia in UK because it reduces 97% of blood loss in 12 months uses. It is also an effective progestogenic endometrial protection in women with Hormone replacement therapy. There are conflicting evidence of LNG-IUS in the management of Fibroids uterus but it reduces fibroid related menstrual blood losses. It has also some beneficial effect in endometriosis and adenomyosis by reducing pain and blood loss. The LNG-IUS also reduces endometrial hyperplasia and may take place in the treatment of eartly endometrial cancer in some cases. The rate of ectopic pregnancy and pelvic inflammatory diseases are reduced in Mirena users compared with IUCD users.Keywords: Mirena; Intrauterine progestogens; Noncontraceptive; LNG-IUS DOI: 10.3329/jbcps.v28i3.6511J Bangladesh Coll Phys Surg 2010; 28: 167-173
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The Role of Mirena (Intra-uterine progestogens), Other than Contraceptive benefits: Current Concepts and Practices DOI: https://doi.org/10.3329/jbcps.v28i3.6511Keywords: Mirena, Intrauterine progestogens, Noncontraceptive, LNG-IUSAbstract Mirena is a long acting intrauterine hormone-releasing (LNG-IUS) contraceptive system with a flexible plastic T-shaped frame bearing a levonorgestrel(LNG)- containing cylinder which releases small doses levonorgestrel into the uterine cavity after insertion with maximum effect on the endometrium and minimum progestogenic side-effect. LNG causes thinning of the endometrium, atrophy of the endometrial glands and decidualisation of the endometrial stroma. The most common side-effect of LNG-IUS is unscheduled vaginal bleeding in the first 3 months, so proper counseling is needed. In some cases functional ovarian cysts may occur which are relatively small, symptomless and resolved spontaneously within a short time. Mirena is now licensed for the treatment of menorrhagia in UK because it reduces 97% of blood loss in 12 months uses. It is also an effective progestogenic endometrial protection in women with Hormone replacement therapy. There are conflicting evidence of LNG-IUS in the management of Fibroids uterus but it reduces fibroid related menstrual blood losses. It has also some beneficial effect in endometriosis and adenomyosis by reducing pain and blood loss. The LNG-IUS also reduces endometrial hyperplasia and may take place in the treatment of eartly endometrial cancer in some cases. The rate of ectopic pregnancy and pelvic inflammatory diseases are reduced in Mirena users compared with IUCD users. Keywords: Mirena; Intrauterine progestogens; Noncontraceptive; LNG-IUS DOI: 10.3329/jbcps.v28i3.6511 J Bangladesh Coll Phys Surg 2010; 28: 167-173 Downloads 478 207 Downloads How to Cite Issue Section License Submission of a manuscript for publication implies the transfer of the copyright from the author to the publisher upon acceptance. Accepted manuscripts become the permanent property of the Journal of Bangladesh College of Physicians and Surgeons and may not be reproduced by any means in whole or in part without the written consent of the publisher. No part of the materials published in this journal may be reproduced, stored in a retrieval system or transmitted in any form or by any means electronic, mechanical, photocopying, recording or otherwise without the prior written permission of the publisher. Reprints of any article in the Journal will be available from the publisher.

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endometriosisadenomyosis

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