Advice when using the intrauterine system (Mirena, Jaydess, Kyleena, Levosert) during the ‘lockdown’
8th April 2020
Many women use intrauterine systems for different reasons, and there are 4 different products that are currently available. Therefore, there is different advice about what needs to be done if your device is due to be changed which depends on what you are using it for!
If you are using the Mirena or Levosert for contraception, they are both licensed for 5 years. However, the FSRH (Faculty of Sexual and Reproductive Health) guidance states there is evidence that they provide effective contraception for 6 years, therefore no immediate action is required. However, if you are concerned you can use alternative contraception alongside them both. Either condoms or the progestogen-only pill can be used (the latter can be prescribed from your GP/nurse following a telephone consultation).
Note, if you were over 45 when you had the Mirena inserted for contraception, there is no need to change it at all – it will provide effective contraception indefinitely!
If you use either Jaydess or Kyleena, there is no evidence about their ongoing effectiveness outside of their licence, so alternative contraception needs to be used (as above) until you can have it changed.
Heavy Menstrual Bleeding
If you are using the Mirena or Levosert to treat heavy, painful periods (and do NOT require any contraception) then there is no need to change the device if it is still controlling things for you (to be honest, this applies outside of the lockdown too!!). If it has become less effective, you should contact your surgery for a telephone review. They may be able to prescribe some alternative medication to help. However, if this continues, this is an appropriate symptom to have a face-face review as you should have an examination.
Hormone Replacement Therapy (HRT)
Some women use the Mirena to provide the progestogen element of their HRT. It has a licence to be used for 4 years, however the FSRH guidance states it can be used for 5 years. However, once it has reached 5years, it is no longer providing the adequate dose, therefore an alternative progestogen should be used. I would normally suggest using micronised progesterone (utrogestan, 100mg daily at night) until it can be replaced.
I think it is important to state here that the issues around changing are all about the dose of hormone it provides, and whether it is adequate for the purpose it is being used for. The actual physical delay of removing has no consequence!
PLEASE NOTE: ADVICE IS PROVIDED FOR GENERAL INFORMATION ONLY. INDIVIDUALS SHOULD SEEK PERSONALISED ADVICE FROM THEIR OWN GP/NURSE BEFORE MAKING CHANGES TO THEIR CONTRACEPTION