Notes for: ContraceptivesLast edited [26/03/2014 14:38:37]Drug Safety Update Feb'14 advice
Notes for: IUD Progestogen-only DeviceLast edited [21/08/2013 15:12:45]
1. Mirena® is a T-shaped device which releases levonorgestrel directly into the uterine cavity. It is licensed for 5 years use. Its main contraceptive effects are by endometrial suppression and changes to cervical mucus and utero-tubal fluid. Most women continue to ovulate and in the remainder sufficient oestrogen is produced from the ovary even if they become amenorrheic (primarily a local end organ effect). Return of fertility after removal is rapid and appears to be complete. Advantages over copper IUCDs are that there may there be an improvement in any dysmenorrhoea and a reduction in blood loss. Risk of pelvic inflammatory disease is less than 1% for women at low risk of sexually transmitted infection.
2. As the responsibility for prescribing lies with the doctor who signs the prescription the doctor fitting Mirena® should also prescribe it.
3. Counselling should cover:-
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Likely bleeding pattern over the first 3 to 6 months
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Abdominal discomfort
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Possible progestogenic side-effects
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Risks associated with intra-uterine device and its fitting
4. The PPD has classified Mirena® as an intra-uterine device. Therefore, it will be reimbursed as a personally administered item.
5. Mirena® is also licensed for primary menorrhagia and prevention of endometrial hyperplasia during oestrogen replacement therapy.