Examples and Duration of Use:
Jaydess (3 years)
Mirena (5 years)
Kyleena (5 years)
All intrauterine devices contain levonorgestrel (progestin).
Indications:
-contraception
-endometriosis
-dysmenorrhea
Insertion:
-inserted by a doctor
-doctors may prescribe misoprostol (oral or vaginal) to dilate the cervix and allow for easier insertion. Patients may need to take anti-inflammatories for insertion pain.
Contraindications:
-pregnancy
-pelvic inflammatory disease
-active sexually transmitted infection
-abnormal uterine bleeding
-cancers of breast or uterine
Adverse Effects:
-foreign body sensation
-unpredictable bleeding (usually during first year)
-amenorrhea: some patients may not get a period at all afterwards
-cramping
-rare: uterine perforation
-pelvic inflammatory disease
Benefits:
-IUD is good for compliance with low failure rate
-large upfront cost, but worth it over time
-choose progestin only option if there are contraindications to combined estrogen/progestin option
-IUD efficacy not affected for patients on enzyme inducers (especially antiepileptic ones like phenytoin, carbamazepine)