Contraceptive efficacy and global licensing of 52 mg levonorgestrel intrauterine devices: does a Mirena last longer in New York than York?

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…

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