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There is significant discrepancy between licensed durations for contraceptive efficacy of 52 mg levonorgestrel intrauterine devices (LNG-IUDs) across different countries and between UK licences and national recommendations (table 1). This is confusing and unhelpful for both clinicians and users.
What is the discrepancy?
The 52 mg LNG-IUD is a highly effective, long-acting reversible method of contraception (LARC) offering additional therapeutic benefits to those with heavy menstrual bleeding or requiring endometrial protection as part of a hormone replacement therapy (HRT) regimen. Since the introduction of the Mirena® LNG-IUD 30 years ago,1 LNG-IUDs are now available in a variety of forms with different inserters, frame sizes, levonorgestrel (LNG) content and release rates.2
The Faculty of Sexual & Reproductive Healthcare (FSRH) intrauterine contraception guideline, published in March 2023, highlights that 52 mg LNG-IUDs are currently licensed in the UK for contraception for 5 years, Mirena®, or 6 years, Levosert®, two-handed device, and Benilexa®, one-handed device (marketed as Liletta® in the USA and Levosert® in some European countries) in women under the age of 45 years.2 During the COVID-19 pandemic, the FSRH temporarily recommended extended Mirena® contraceptive use to 6 years,3 4 and this change has been made …
Contributors ZN and AT contributed equally to the conception and writing of this article.
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 None declared.
Provenance and peer review Not commissioned; externally peer reviewed.