PEBC: What You Need to Know: Progestin Only IUDs

Examples and Duration of Use:

Jaydess (3 years)

Mirena (5 years)

Kyleena (5 years)

All intrauterine devices contain levonorgestrel (progestin).

Indications:

-contraception

-endometriosis

-dysmenorrhea

Insertion:

-inserted by a doctor

-doctors may prescribe misoprostol (oral or vaginal) to dilate the cervix and allow for easier insertion. Patients may need to take anti-inflammatories for insertion pain.

Contraindications:

-pregnancy

-pelvic inflammatory disease

-active sexually transmitted infection

-abnormal uterine bleeding

-cancers of breast or uterine

Adverse Effects:

-foreign body sensation

-unpredictable bleeding (usually during first year)

-amenorrhea: some patients may not get a period at all afterwards

-cramping

-rare: uterine perforation

-pelvic inflammatory disease

Benefits:

-IUD is good for compliance with low failure rate

-large upfront cost, but worth it over time

-choose progestin only option if there are contraindications to combined estrogen/progestin option

-IUD efficacy not affected for patients on enzyme inducers (especially antiepileptic ones like phenytoin, carbamazepine)