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Editorial
Intrauterine devices: a summary of new guidance
  1. Ashley Jefferies1,2,
  2. Katie Boog3,4
  1. 1 Blackpool and Lancashire Sexual Health Services, Blackpool Teaching Hospitals NHS Foundation Trust, Blackpool, UK
  2. 2 Obstetrics and Gynaecology, East Lancashire Hospitals NHS Trust, Burnley, UK
  3. 3 Chalmers Sexual Health, Lothian Sexual Health, Edinburgh, UK
  4. 4 Co-Director, Clinical Effectiveness Unit, Faculty of Sexual & Reproductive Healthcare, Edinburgh, UK
  1. Correspondence to Dr Ashley Jefferies, Sexual Health - Burnley, Blackpool Teaching Hospitals NHS Foundation Trust, Burnley, UK; ashley.jefferies2{at}nhs.net

https://doi.org/10.1136/bmjsrh-2023-201841

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    The Faculty of Sexual & Reproductive Healthcare (FSRH) Clinical Effectiveness Unit (CEU) has recently published an updated intrauterine device (IUD) guideline, incorporating new evidence-based recommendations alongside refreshed established guidance.1

    IUDs are effective and popular long-acting reversible contraception (LARC) used by approximately 159 million users worldwide2 and by approximately 21% of individuals seeking contraception at sexual health services in England.3

    Key changes

    Indications and duration of use of the levonorgestrel IUD

    With the addition of Benilexa® to the market in 2021, there are now three 52 mg levonorgestrel IUDs (LNG-IUDs) available in the UK. While the licensed durations and indications of use differ between the 52 mg LNG-IUDs, the FSRH Guideline Development Group advocate that the similarity between the devices and levonorgestrel (LNG) release rates is sufficient to extrapolate evidence from one device to another (table 1).

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    Table 1

    Comparison of the 52 mg levonorgestrel intrauterine devices available in the UK

    Indications

    Although Mirena® is the only LNG-IUD licensed for endometrial protection as part of hormone replacement therapy (HRT), this guideline recommends that any 52 mg LNG-IUD can be used as endometrial protection for 5 years .

    Duration of use

    Similarly, as Levosert® and Benilexa are licensed for use for 6 years for contraception (Mirena is licensed for 5 years), this guideline recommends that any 52 mg LNG-IUD inserted before age 45 years can be used for contraception for 6 years .

    In individuals aged …

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    Footnotes

    • Contributors AJ drafted the manuscript. KB reviewed and edited the manuscript.

      Both AJ and KB reviewed and edited following peer review for the revised version.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests KB led the Guideline Development Group for the FSRH updated Intrauterine Contraception guideline. KB is the Co-director of the Clinical Effectiveness Unit of the FSRH.

    • Provenance and peer review Not commissioned; internally peer reviewed.