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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}

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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).

View this table:
Table 1

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


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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  • 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.