7.3.2.3. Intra-uterine progestogen-only device

ChoiceDrugDosage
1st choiceKyleena® 19.5mg intrauterine deviceDose:
Insert into uterine cavity within 7 days of the onset of menstruation (anytime if replacement); effective for 5 years
Or
Mirena® 20 micrograms/24 hours intrauterine delivery system Dose:
Insert tube into uterine cavity within 7 days of the onset of menstruation (anytime if replacement); effective for 5 years

Prescribing Notes

  • Refer to NICE Guidance CG 30 Long Acting Reversible Contraception and FSRH guidance.
  • Levonorgestrel-releasing intrauterine systems should always be prescribed by brand name, see MHRA guidance.
  • IUS insertions should be performed by trained healthcare staff who are regularly updated and who perform frequent insertions (recommendation is 12 or more per year).
  • Levonorgestrel intrauterine system products are highly effective methods of contraception.
  • Kyleena® has a lower levonorgestrel content. Unlike Mirena®, it is not licensed for the management of heavy menstrual bleeding or to provide endometrial protection as part of HRT. It has been suggested that a narrower introducer and smaller device could make Kyleena® more suitable for nulliparous or young women.
  • Many women experience quite frequent and prolonged spotting for the first 3–6 months, thereafter amenorrhoea is common. Patients should be counselled accordingly.
  • Mirena® has a beneficial effect on dysmenorrhoea and menorrhagia.