In which clinical situations can the use of the 52-mg levonorgestrel-releasing IUD (Mirena) and the TCu380A copper-IUD (ParaGard) be extended?

OBG Management. 2016 September;28(9):8, 9, 13, 16

August 30, 2016|OBG Management

For women older than 35 years, the 52-mg levonorgestrel-intrauterine device (LNG-IUD) may be effective for up to 7 years and the TCu380A copper-IUD may be effective for up to 12 years

Emergency contraception with immediate placement of an IUD

For women who need emergency contraception and would like to initiate long-term contraception with an IUD, the copper device is an optimal choice. Recently, a novel use of combined oral levonorgestrel emergency contraception (1.5-mg dose) with immediate placement of a 52-mg LNG-IUD was reported to be an effective alternative to the placement of a copper-IUD for women who need both emergency and long-term contraception.¹

References

Turok DK, Sanders JN, Thompson IS, Royer PA, Eggebroten J, Gawron LM. Preference for and efficacy of oral levonorgestrel for emergency contraception with concomitant placement of a levonorgestrel IUD: a prospective cohort study. Contraception. 2016;93(6):526–532.

ParaGard and Mirena: Two highly effective contraceptives

For women with contraceptive needs and gynecologic issues such as heavy menstrual bleeding, dysmenorrhea, or endometriosis-related pelvic pain, the LNG-IUD may be an optimal choice. For women who desire to have monthly uterine bleeding and for women who prefer to avoid “hormones,” the copper-IUD may be the preferred option.

The IUD is one of the most effective forms of reversible contraception available. Yet IUDs are underutilized in the United States compared with Europe and Asia. Optimizing use of these devices is an important goal for ObGyns. The FDA does recommend that a single LNG-IUD (Mirena) or copper-IUD (ParaGard) not be used beyond 5 and 10 years, respectively. However, in certain clinical situations it may be appropriate to extend device use for a greater length of time.

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