Continuation rates of levonorgestrel intrauterine device (Mirena) inserted for non-contraceptive reasons after 6 months use

A.K. Abraham, S Radhakrishnan 

Royal Free Hospital, London,, United Kingdom

Objective To determine the continuation rates of Levonorgestrel intrauterine device inserted for non contraceptive reasons and evaluate tolerability and efficacy of this device in the long term management of gynaecological problems such as menorrhagia, dysmenorrhoea and as progesterone arm of HRT

Methods Study was conducted on patients referred to tertiary hospital, family planning clinic. This was a retrospective study conducted between January 2004 and December 2005. 46 case notes were reviewed at 6 weeks and 6 months follow up. The inclusion criteria were patients with menstrual problems related to 1) DUB and other pathologies like fibroids, endometriosis 2) Simple/cystic hyperplasia 3) Pelvic pain 4) progesterone arm of HRT.

Results At 6 weeks follow up10 out of 46(24%) did not attend and at 6 months 22 out of 44(50%) were lost to follow up. 48% of those that retained the coil were in the age group 41-50 at 6 weeks and 18%at 6 months, compared to age group 21-30 of which 7% retained their coil at 6 weeks and none at 6 months. Reasons for removal at 6 months were unacceptable bleeding in 25%, opting out for alternate treatment in12%, expulsion or near expulsion in 25%, lower limb oedema and puffiness in12%.

Discussion While a good option for management of menorrhagia, and as progesterone component of HRT, removal rates(including expulsion) of 22% suggest that more needs to be done before offering the Mirena coil as an alternative.