I would like to comment in the diverse use of the progesterone/based IUD- Mirena. It is Levonorgestrel releasing that primarily confines itself to the uterus with systemic release. It is beginning to be more than a contraceptive. In our recent “green” journal there were articles addressing some other indications. The key topics that were brought up were- it is safe to use in the teen population, it is safe to use in women that have not had children, it is used to manage very heavy periods, it might be effective in preventing uterine cancer or polyps in high risk patients and the risks are minimal. It’s use has increased from 1.3% in 2002 to close to 9% in 2009 of all contraceptive users. I believe that number will increase as it has become more affordable. Women of all ages are using it and once they experience the freedom of little or no bleeding, they want to do it again. The insertion is done in the office, by a trained provider, and should take less then 10 minutes.
It is an option that I believe more providers need to talk about. Not only for contraception but for other gyn disorders as well. Dr N