Mirena

Mirena is inserted for up to 5 years, and Paragard T 380A is inserted for up to 10 years. Surveys have shown that IUDs have the highest satisfaction rate among patients using reversible contraceptives. 

Mirena releases levonorgestrel over 5 years. It causes a reduction in menstrual blood loss. 

Mirena is a relatively new intrauterine contraceptive device that releases levonorgestrel into the uterine cavity for 5 years. Use of this contraceptive device is associated with fewer systemic progestin side effects and is at least as effective as Norplant. 

Sweet s syndrome has been reported several times in women taking oral contraceptives, but a well-documented recent case concerned the use of the Mirena uterine system for the administration of menorrhagia, where the... 

A 54-year-old woman fitted with a Mirena system soon developed fever and progressive skin lesions. A skin biopsy confirmed Sweet s syndrome. She was treatment with topical and oral glucocorticoids, but the condition relapsed on reduction of the dose. Her symptoms finally resolved on removal of the intrauterine system and she remained symptom free after 9 months. 

Other complications (acne, alopecia, and pruritus) have been associated with Mirena, an intrauterine system containing levonorgestrel. 

Rosacea accompanied the use of Mirena in a 36-year-old woman for 2 years and disappeared within 6 months of removal (37). 

However, one is bound to wonder whether this was a direct reaction to levonorgestrel or a stress reaction to the absence of menstrual periods. Like many other users of Mirena, this woman had amenorrhea associated with facial flushing and pustules conditions such as urticaria, eczema, pompholyx, and erythema multiforme occur cyclically in some women in the second half of the menstrual cycle, irrespective of contraceptive use. 

A systematic review of Mirena, an intrauterine progestogen release system (56), has attracted correspondence (57,58). Like other devices, Mirena releases levonorgestrel, in this case 20 micrograms/day. Since it had no greater efficacy than the Copper T device and was very much more costly, the debate has turned on safety. Amenorrhea is common with this device, as with others like it, and correspondents have pointed out that this is regarded by many women as an unwelcome complication. 

In a study of the long-term acceptability of Mirena, 165 women were examined during and after 6 and 36 months of use. There were changes in menstrual bleeding pattern in 161 women (98%), with cessation or transient absence of menstruation in 75 (47%) and 14 (9%) women respectively. As in many other studies, amenorrhea was considered by most women (81%) as a welcome effect. The device had no disturbing effects on the women or their partners during sexual intercourse (59). 

Hamill M, Bowling J, Vega-Lopez F. Sweet syndrome and a Mirena intrauterine system. J Fam Planning Reprod Health Care 2004 30 115-6. 

Pereira A, Coker A. Hypersensitivity to Mirena—a rare complication. J Obstet Gynaecol 2003 23 81. 

Levonorgestrel-releasing (20 microgram/day) intrauterine systems (Mirena) compared with other methods of reversible contraceptives. BJOG 2000 107(10) 1218-25. 

Acceptability of the long-term contraceptive levonorgestrel-releasing intrauterine system Mirena a 3-year followup. Contraception 2003 67 87-91. 

McGavigan CJ, Metaxa-Mariatou V, Dockery P, Rodger MW, Cameron IT, Campbell S. Large, thin walled, superficial endometrial vessels the cause of breakthrough bleeding in women with Mirena Br J Fam Plann 2000 26 235-6. 

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