What is the risk of heavy menstrual periods with Mirena (levonorgestrel) intrauterine system (IUS)?

From the Guidelines

The MonaLisa Mini IUD may increase the risk of heavy periods, especially in the first few months after insertion, with most women experiencing a 20-50% increase in menstrual blood loss with copper IUDs, as noted in studies such as 1.

Key Points to Consider

• The MonaLisa Mini is a copper IUD, which works by creating a local inflammatory response in the uterus to prevent pregnancy, but this can lead to heavier, longer periods and increased cramping for some users.
• According to the most recent guidelines, such as those outlined in 1, management of bleeding irregularities while using contraception, including copper IUDs like the MonaLisa Mini, may involve exploring patient goals, providing reassurance, and considering treatment options like NSAIDs for spotting, light bleeding, or heavy/prolonged bleeding.
• It's essential to weigh the benefits of using the MonaLisa Mini IUD against potential risks, including the risk of heavy periods, and to discuss these with a healthcare provider, especially if heavy bleeding persists or significantly impacts quality of life.

Management and Treatment Options

• For women experiencing heavy or prolonged bleeding with the MonaLisa Mini IUD, treatment options may include NSAIDs, such as ibuprofen (400-600mg every 6-8 hours during the period), as suggested in 1.
• If heavy bleeding continues to be problematic after 6 months or significantly impacts quality of life, consulting a healthcare provider about alternative contraceptive options, such as hormonal methods that often reduce menstrual bleeding, is recommended.
• The decision to continue or discontinue the use of the MonaLisa Mini IUD should be based on individual patient goals and preferences, with consideration of the potential risks and benefits, as outlined in guidelines like 1.

From the Research

Risk of Heavy Periods with Mono Lisa Mini

• The Mono Lisa Mini is a type of intrauterine device (IUD) used for contraception.
• There is limited information available on the Mono Lisa Mini specifically, but studies on other IUDs can provide some insights into the risk of heavy periods associated with IUD use 2, 3, 4.
• Copper IUDs, such as the Mono Lisa Mini, tend to increase menstrual bleeding, while levonorgestrel IUDs tend to reduce menstrual bleeding 2.
• A study on interventions to prevent or treat heavy menstrual bleeding or pain associated with IUD use found that vitamin B1 and mefenamic acid may be effective in reducing heavy menstrual bleeding in women using copper IUDs 2.
• Non-steroidal anti-inflammatory drugs (NSAIDs) have been shown to reduce menstrual blood loss and pain associated with IUD use 3, 5.
• The levonorgestrel-releasing intrauterine system (LNG IUS) has been found to be more effective than NSAIDs in reducing heavy menstrual bleeding 5, 6.

Factors Influencing Heavy Periods with IUD Use

• The type of IUD used can influence the risk of heavy periods, with copper IUDs tend to increase menstrual bleeding and levonorgestrel IUDs tend to reduce menstrual bleeding 2, 4.
• Individual factors, such as age and medical history, can also influence the risk of heavy periods with IUD use 4.
• The use of NSAIDs or other medical therapies may be effective in reducing heavy menstrual bleeding and pain associated with IUD use 2, 3, 5.

Management of Heavy Periods with IUD Use

• Treatment options for heavy periods associated with IUD use include NSAIDs, anti-fibrinolytics, and paracetamol 2.
• The use of vitamin B1 and mefenamic acid may be effective in reducing heavy menstrual bleeding in women using copper IUDs 2.
• The levonorgestrel-releasing intrauterine system (LNG IUS) may be a effective option for women experiencing heavy menstrual bleeding with IUD use 5, 6.