Contains: progestin — levonorgestrel (intrauterine device)
The Mirena is an IUD that releases a small amount (20 mcg.) of progestin daily. While primarily designed for use as a contraceptive, it is also sometimes used as the progestin component in HRT.
The amount released daily is such a low dose it tends to cause few side effects. In addition, since it is released in your uterus, it doesn’t have what’s called the “first pass” effect — in which the medication is first broken down by your liver and stomach. This is a big plus for women who are concerned about overtaxing their liver or who’ve had a history of liver problems.
The Mirena can cause spotting and breakthrough bleeding, but this typically lasts only about three months after insertion. Typically after five months, bleeding is infrequent — and a year after insertion, most women stop getting periods entirely.
- Standard dosage: One of the easiest forms of HRT; once inserted, the Mirena doesn’t need to be replaced for 5 years
- Pros: Delivered directly to your uterus; very few side effects;
- Cons: Often causes some pain when first inserted; not recommended for women who have a history of pelvic inflammatory disease, uterine abnormalities, uterine, cervical or endometrial cancer, or for those who’ve never had a pregnancy. Sometimes is partially or completely pushed out of the uterus (but this is most common in young women and those who’ve never had children). Can cause uterine perforation (but this is a very rare occurrence).
Please see “The Premature Menopause Book” by Kathryn Petras for sources.