MIRENA (LNG IUS) in heavy periods

Menorrhagia is the medical term for menstrual periods with abnormally heavy or prolonged bleeding.

  • In a normal menstrual cycle , a balance between the hormones estrogen and progesterone regulates the build up of the lining of the uterus (endometrium) , which is shed during menstruation.
  • But If a hormone imbalance occurs, the endometrium develops in excess and eventually sheds in form of heavy menstrual bleeding. So hormone imbalance is one of the important cause for HMB.

  • MIRENA is an Intrauterine System ( IUS ) - ’ T ‘- Shaped device placed inside the uterus.
  • The vertical arm , which acts as a reservoir contains 52 mg levonorgestrel and releases a small amount of hormone everyday for 5yrs.
    MIRENA

    MIRENA

    MIRENA

    MIRENA

The hormone in MIRENA reduces menstrual bleeding by controlling the monthly development of the womb lining , making it thinner , so that there is less bleeding every month.

MIRENA

MIRENA

MIRENA is inserted under short general anaesthesia as a day care procedure after dilatation and curettage for heavy menstrual bleeding.

  • MIRENA is effective for 5 years, after which it is removed as an OPD procedure.

  • It can be removed any time in-between if required.

  • MIRENA usually achieves a significant reduction in menstrual blood loss within 3 to 6 months of treatment. You may have irregular bleeding, usually in the first 2 to 3 months, before a reduction in blood loss is achieved.
  • After insertion of MIRENA, approximately 60% women develop oligo-menorrhoea (Lighter Periods) and 16% women develop amenorrhoea (No Periods) during 1st year of use and it may last as long as MIRENA is present.
  • Irregular bleeding & spotting are common side effects during initial few months.

  • Spontaneous expulsion :
    • The muscular contractions of the womb ( uterus ) during menstrual cycle may sometimes push MIRENA out of place or expel it.
  • Ovarian Cyst :
    • Simple ovarian cysts have been reported in approximately 7% of women using MIRENA .
    • Most of these cysts are asymptomatic.
    • In most cases, the ovarian cysts disappear spontaneously over 2-3 months time.

It prevents pregnancy and acts as a birth control device.

  • You should have it checked 6 weeks after the insertion, again at 12 months and then once a yearuntil it is removed.
  • Ultrasound examination can help us in assessing the location of MIRENA, which is done routinely at our SAAVI Women’s Hospital.

  • MIRENA releases very small amount of hormone levonorgestrel everyday for 5 years.
  • This hormone will not cause major significant adverse effect as the amount released is very minimal.

As less flow is because of thinning of inner lining of uterus , there will not be any side effects.

MIRENA may decrease HMB associated with fibroids .

MIRENA alleviates adenomyosis related HMB and pain during periods.

MIRENA appears equally effective as hysterectomy in improving quality of life in patients of heavy periods, it can serve to lower the incidence of hysterectomies.