An update to Mirena
By Dr Shirley Shen, General Practitioner at Madison Medical Practice Berowra
Long-acting acting reversible contraception (LARC) levonorgestrel 52 mg (sold as Mirena) is one of the most popular long-acting hormonal contraceptives in Australia.
With an average efficacy rate of 99%, Mirena is considered one of the most effective methods of contraception that does not require further interventions such as daily dosing or monthly administration, with the option of removal at any time.
The recent TGA-approved updated label for Mirena extends the contraceptive lifespan of the hormonal intrauterine device (IUD) from five to eight years, with the duration of use for other indications remaining unchanged. This is based on the Phase III MIRENA Extension Trial, which evaluated the contraceptive efficacy and safety of the IUD between five and eight years. The study showed efficacy remains at more than 99% during years six to eight of use, while its safety profile remained the same, with no new or unexpected safety findings.
It is a very exciting news and should help increase uptake of the LARC where Australia still lags compared to many other countries.
Women now have the option of eight years of contraception and menstrual control, which may be a factor in someone choosing a LARC who may not have before. The extension also means increasing the cost efficacy of a highly effective contraception which significantly reduces period bleeding and pain. The upfront cost of the device and insertion is now spread over eight years for patients, and they do not need to return for replacement as quickly. But if bleeding returns the Mirena can be changed earlier. It is important to note that if Mirena is used as endometrial protection/progesterone component of menopausal hormone therapy the Mirena still needs to be changed every five years.
It is essential that women of reproductive age are informed of the pros and cons of the full range of contraceptive options, not just the various forms of the pill.
Click here to make an appointment to discuss your needs with Dr Shirley Shen.
Dr Shirley Shen is an independent contracted GP who operates her own medical business within the Madison Medical Practice Berowra.