Glossary · Treatments

Levonorgestrel IUD (Mirena)

Also called: Mirena, Liletta, LNG-IUS.

Definition: The 52-mg levonorgestrel-releasing intrauterine device (Mirena, Liletta) provides excellent endometrial protection in women on systemic estrogen and is FDA-approved for this off-label use in some markets. It is particularly useful for women who do not want a daily oral progestogen or who have heavy bleeding in perimenopause.

Detailed definition

The 52-mg levonorgestrel-releasing IUD delivers ~20 mcg/day of levonorgestrel locally to the endometrium for 5–8 years, depending on the product and indication. Brands include Mirena (FDA-approved 8 years for contraception), Liletta (FDA-approved 8 years), and Skyla and Kyleena (lower-dose, shorter duration). The 52-mg device produces marked endometrial atrophy and amenorrhea in many users, which is also why it is highly effective at endometrial protection in women on systemic estrogen — the indication is approved in some European markets and is widely used off-label in the US for this purpose. Serum levonorgestrel levels are very low compared to oral or implanted progestins. The IUD is also approved for treatment of heavy menstrual bleeding, making it a particularly useful option for late-perimenopausal women still cycling who need both bleeding control and endometrial protection.

Why it matters in menopause

For women in late perimenopause or early postmenopause who don't want a daily progestogen — or who are bothered by oral progesterone side effects, or who have heavy bleeding — a 52-mg LNG-IUD is one of the most elegant solutions. Insertion is a one-time office procedure, and protection lasts 5–8 years.

Sources

External references: Wikipedia.

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