Abstract

PIP: There are 2 progestin-releasing IUDs commercially available: Progestasert and the levonorgestrel-releasing device Mirena. This article reviews state-of-the-art information on the therapeutic use of these devices. Unlike inert or copper-releasing IUDs, progestin-releasing devices are not associated with increased menstrual blood loss. Special indications for inserting a levonorgestrel-releasing IUD include a desire for long-acting contraception other than sterilization, heavy menstrual bleeding and/or dysmenorrhea, risk of iron deficiency anemia, heavy bleeding during use of a copper IUD, and a previous intrauterine pregnancy during use of a copper-releasing IUD. Special attention must be placed on the selection of users and counseling, however. The main problem with the progesterone-releasing IUD is its short effective life span, which makes annual replacement necessary.