Each Mirena intrauterine system now provides conception control for up to 8 years

Bayer’s Mirena (levonorgestrel-releasing intrauterine system 52 mg) can now be left in place to provide conception control for up to eight years,1 rather than five years.2 Health Canada has approved the extended time period, allowing patients to keep each intrauterine system in place for up to eight years for conception control. If a patient wishes to continue to use Mirena for conception control after eight years, a new Mirena system should be inserted immediately after the old one is removed.1The contraceptive efficacy of Mirena during extended use beyond five years was examined in the Mirena Extension Trial, a multicentre, open-label, uncontrolled study involving 362 women. At the end of the three-year period of extended use (years 6, 7 and 8), the cumulative three-year pregnancy rate was 0.68%. During extended use beyond five years and for up to eight years, women reported a decrease in the mean number of bleeding or spotting days, with approximately half experiencing amenorrhea or infrequent bleeding. At the end of year 8, most of the women (98.7%) who completed the study remained satisfied with the continued use of the 52-mg levonorgestrel-releasing intrauterine system.3The Society of Obstetricians and Gynaecologists of Canada recommends that healthcare professionals offer intrauterine contraceptives (levonorgestrel-releasing intrauterine system or a copper intrauterine device) as first-line methods of contraception to both nulliparous and multiparous women.4 They are as effective as permanent contraception methods, can be used by women of all ages and their effectiveness does not depend on the user. Intrauterine contraceptives may be particularly well-suited for women who want longer-term contraception, a method that is “forgettable” and less adherence-demanding, or who wish to have an “invisible” method of contraception. Other good candidates are women who do not wish to take hormones, have contraindications and/or sensitivities to estrogen, or are breastfeeding.4Mirena is also indicated for the treatment of idiopathic menorrhagia, following appropriate diagnostic investigation, in women accepting the contraceptive effect of Mirena.1,2 Previously, no time period was specified for the use of a single Mirena system for this therapeutic indication.2 Health Canada has now approved Mirena use for a period of up to five years for this indication.1 If after five years, continued use of Mirena is desired to treat idiopathic menorrhagia, a new Mirena system should be inserted immediately after the old one is removed. However, data are limited regarding the use of Mirena for idiopathic menorrhagia beyond five years.1 References:Bayer Inc. Mirena (levonorgestrel-releasing intrauterine system) product monograph. Mississauga, ON; February 16, 2024. (accessed March 28, 2024).Bayer Inc. Mirena (levonorgestrel-releasing intrauterine system) product monograph. Mississauga, ON; October 9, 2014.Jensen JT, Lukkari-Lax E, Schulze A, et al. Contraceptive efficacy and safety of the 52-mg levonorgestrel intrauterine system for up to 8 years: findings from the Mirena Extension Trial. Am J Obstet Gynecol 2022;227:873.e1-873.e12. (accessed March 28, 2024).Society of Obstetricians and Gynaecologists of Canada. Canadian Contraception Consensus (Part 3 of 4): Chapter 7 – Intrauterine contraception. J Obstet Gynaecol Can 2016;38(2):182-222.

Each Mirena intrauterine system now provides conception control for up to 8 years

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