Progestogen-releasing intrauterine system

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. 

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