What is the Mirena (levonorgestrel) intrauterine device (IUD) composed of?

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Mirena IUD Composition

The Mirena IUD consists of a T-shaped polyethylene frame with a cylindrical reservoir on the vertical stem containing 52 mg of levonorgestrel mixed with polydimethylsiloxane, covered by a rate-limiting silastic membrane that releases 20 micrograms of levonorgestrel per 24 hours into the uterine cavity. 1, 2

Physical Structure

  • The device is built on a plain Nova-T frame design with a silastic (polydimethylsiloxane) reservoir attached to the vertical arm 3
  • The reservoir is impregnated with levonorgestrel and covered with a rate-limiting silastic membrane to control hormone release 3
  • The plastic frame measures 32 mm in length and is T-shaped to conform to the uterine cavity 2

Hormonal Component

  • The device contains 52 mg of levonorgestrel total, which is a progestin-only hormone with no estrogen component 1, 4
  • The release rate is approximately 20 micrograms of levonorgestrel per 24 hours, maintained for at least 5 years (and effective up to 7 years) 1, 3
  • This local delivery system maintains very low circulating levels of levonorgestrel while achieving high concentrations directly in the uterine cavity 5

Clinical Significance of Composition

  • The progestin-only formulation avoids all estrogen-associated risks, making it suitable for women with contraindications to estrogen including cardiovascular risk factors, history of thromboembolism, or migraine with aura 1, 4
  • The silastic membrane technology allows for steady, controlled hormone release that provides both contraceptive efficacy (failure rate <1%) and therapeutic benefits for heavy menstrual bleeding 1, 3

References

Guideline

Levonorgestrel Intrauterine Device (IUD) Contraception and Therapeutic Benefits

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2026

Research

Endometrial adenocarcinoma following insertion of the levonorgestrel-releasing intrauterine system (mirena) in a 36-year-old woman.

International journal of gynecological cancer : official journal of the International Gynecological Cancer Society, 2006

Research

The levonorgestrel intrauterine system: more than a contraceptive.

The European journal of contraception & reproductive health care : the official journal of the European Society of Contraception, 2001

Guideline

Mirena IUD and Menstrual Migraine Management

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2026

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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