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

^[1]^[2]^[3]^[4]^[5]^[6]^[7]

Indications

* 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.

levonorgestrel-releasing IUDs associated with 40% increased risk of breast cancer^[7]

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]

↑ 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: https://www.ncbi.nlm.nih.gov/pubmed/15039412
↑ ^2.0 ^2.1 Actavis and Medicines360 Announce FDA Approval of LILETTA (levonorgestrel-releasing intrauterine system) 52 mg to Prevent Pregnancy for up to Three Years.
↑ FDA Approves Additional Use for IUD Mirena to Treat Heavy Menstrual Bleeding in IUD Users
↑ ^4.0 ^4.1 Medical Knowledge Self Assessment Program (MKSAP) 17, American College of Physicians, Philadelphia 2015
↑ ^5.0 ^5.1 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: https://www.ncbi.nlm.nih.gov/pubmed/36096186 https://www.ajog.org/article/S0002-9378(22)00729-3/pdf
↑ ^6.0 ^6.1 NEJM Knowledge+
↑ ^7.0 ^7.1 Morch LS, Meaidi A, Corn G et al Breast Cancer in Users of Levonorgestrel-Releasing Intrauterine Systems. JAMA. 2024 Oct 16. PMID: https://www.ncbi.nlm.nih.gov/pubmed/39412770