Further reading

Practice-oriented recommendations for physicians:

Mirena®: painless handling, effect and safety

Jaydess®: a new, small and low-dose levonorgestrel IUS

Kyleena®: Latest LNG-IUS

Sources (where not already indicated, and in alphabetical order):






Gynmed Ambulatorium: Long-term Contraception with the Hormone IUD. Brochure, Vienna 2009

Ludwig, M.: Hormonal Contraception – A Handbook for Practice, 2009


Mirena –endometrial protection during ERT; Frequently Asked Questions, Schering 2004

Mirena after abortion – reversible long-term protection against further unplanned pregnancies, Schering



Scientific literature:

Acceptability of the long-term contraceptive levonorgestrel-releasing intrauterine system (Mirena): a 3-year follow-up study.Baldaszti E, Wimmer-Puchinger B, Löschke K., Contraception. 2003 Feb;67(2):87-91

Use of the levonorgestrel-releasing intrauterine system: an Austrian perspective. Concin H, Bösch H, Hintermüller P, Hohlweg T, Mursch-Edlmayr G, Pinnisch B, Schmidl-Amann S, Schulz-Greinwald G, Unterlerchner D, Wagner T, Mattle V, Wildt L, Fiala C.Curr Opin Obstet Gynecol. 2009 Nov;21 Suppl 1:S1-9.

A comparative study of the levonorgestrel-releasing intrauterine system Mirena versus the Copper T380A intrauterine device during lactation: breast-feeding performance, infant growth and infant development. Shaamash AH, Sayed GH, Hussien MM, Shaaban MM. Contraception. 2005 Nov;72(5):346-51.

Safety, efficacy and patient acceptability of the contraceptive and non-contraceptive uses of the LNG-IUS, Paula H Bednarek and Jeffrey T Jensen, Int J Women Health. 2009; 1: 45–58

Return to fertility after removal of a levonorgestrel-releasing IUD and Nova-T, Andersson, Batar, Rybo, Contracpetion 1992, 46:575-84

Health effects of long-term use of the intrauterine levonorgestrel-releasing system. A follow-up study over 12 years of continuous use. Rönnerdag M, Odlind V. Acta Obstet Gynecol Scand 1999 Sep;78(8):716–21.

Bleeding pattern and safety of consecutive use of the levonorgestrel-releasing intrauterine system (LNG-IUS)–a multicentre prospective study. Gemzell-Danielsson K, Inki P, Boubli L, et al. Hum Reprod 2010 Feb;25(2):354–9.

Predictors of bleeding and user satisfaction during consecutive use of the levonorgestrel-releasing intrauterine system. Heikinheimo O, Inki P, Kunz M, et al. Hum Reprod 2010 Jun;25(6):1423–7.

Noncontraceptive uses of the levonorgestrel intrauterine system. ACOG committee opinion. No. 337: Obstet Gynecol 2006 Jun;107(6):1479–82.

Progesterone or progestogen-releasing intrauterine systems for heavy menstrual bleeding. Lethaby AE, Cooke I, Rees M. Cochrane Database Syst Rev 2005(4):CD002126.

Modern management of abnormal uterine bleeding: the levonorgestrel intra-uterine system. Mansour D. Best Pract Res Clin Obstet Gynaecol 2007 Dec;21(6):1007–21.

Non-contraceptive uses of levonorgestrel-releasing hormone system (LNG-IUS)–a systematic enquiry and overview. Varma R, Sinha D, Gupta JK. Eur J Obstet Gynecol Reprod Biol 2006 Mar 1;125(1):9–28.

The levonorgestrel-releasing intrauterine system (LNG-IUS) in contraception and reproductive health. Faculty of Family Planning and Reproductive Health Care Clinical Effectiveness Unit. FFPRHC Guidance (April 2004). J Fam Plann Reprod Health Care 2004 Apr;30(2):99–108; quiz 9.

Benefits and risks of pharmacological agents used for the treatment of menorrhagia. Roy SN, Bhattacharya S. Drug Saf 2004;27(2):75-90.

A randomised trial comparing the levonorgestrel intrauterine system and thermal balloon ablation for heavy menstrual bleeding. Busfield RA, Farquhar CM, Sowter MC, et al. BJOG 2006 Mar;113(3):257–63.

Randomised comparative trial of thermal balloon ablation and levonorgestrel intrauterine system in patients with idiopathic menorrhagia. Shaw RW, Symonds IM, Tamizian O, et al. Aust N Z J Obstet Gynaecol 2007 Aug;47(4):335–40.

Levonorgestrel-releasing intrauterine device versus hysteroscopic endometrial resection in the treatment of dysfunctional uterine bleeding. Crosignani PG, Vercellini P, Mosconi P, et al. Obstet Gynecol 1997 Aug;90(2):257–63.

A randomized controlled trial of levonorgestrel releasing IUD and thermal balloon ablation in the treatment of menorrhagia. Soysal M, Soysal S, Ozer S. Zentralbl Gynakol 2002 Apr;124(4):213–9.

Health status function after treatment with thermal balloon endometrial ablation and levonorgestrel intrauterine system for idiopathic menorrhagia: a randomized study. Tam WH, Yuen PM, Shan Ng DP, et al. Gynecol Obstet Invest 2006;62(2):84–8.

Comparison between the levonorgestrel intrauterine system (LNG-IUS) and thermal balloon ablation in the treatment of menorrhagia. Barrington JW, Arunkalaivanan AS, Abdel-Fattah M. Eur J Obstet Gynecol Reprod Biol 2003 May 1;108(1):72–4.

Levonorgestrel-releasing intrauterine system vs. transcervical endometrial resection for dysfunctional uterine bleeding. Gupta B, Mittal S, Misra R, et al. Int J Gynaecol Obstet 2006 Dec;95(3):261–6.

Management of menorrhagia with the levonorgestrel intrauterine system versus endometrial resection. Malak KA, Shawki O. Gynecol Surg 2006;3:275–80.

Prospective comparison study of levonorgestrel IUD versus Roller-Ball endometrial ablation in the management of refractory recurrent hypermenorrhea. Romer T. Eur J Obstet Gynecol Reprod Biol 2000 May;90(1):27–9.

The efficacy of levonorgestrel-releasing intrauterine device in selected cases of myoma-related menorrhagia: a prospective controlled trial. Soysal S, Soysal ME. Gynecol Obstet Invest 2005;59(1):29–35.

Levonorgestrel-releasing intrauterine system and endometrial ablation in heavy menstrual bleeding: a systematic review and meta-analysis. Kaunitz AM, Meredith S, Inki P, et al. Obstet Gynecol 2009 May;113(5):1104–16.

Ahmad A, Khan AU. Prevalence of Candida species and potential risk factors for vulvovaginal candidiasis in Aligarh, India. Eur J Obstet Gynecol Reprod Biol 2009 May;144(1):68–71.

Self-elimination of risk factors for recurrent vaginal candidosis. Donders GG, Mertens I, Bellen G, et al. Mycoses 2009 Sep 22.

Candidiasis in women fitted with an intrauterine contraceptive device. Parewijck W, Claeys G, Thiery M, et al. Br J Obstet Gynaecol 1988 Apr;95(4):408–10.

The association between copper containing IUCD and bacterial vaginosis. Demirezen S, Kucuk A, Beksac MS. Cent Eur J Public Health 2006 Sep;14(3):138–40.

Microflora of cervical and vaginal secretion in women using copper- and norgestrel-releasing IUCDs. Ulstein M, Steier AJ, Hofstad T, et al. Acta Obstet Gynecol Scand 1987;66(4):321–2.

Do users of the intrauterine system (Mirena) have different genital symptoms and vaginal flora than users of the intrauterine contraceptive device? Neale R, Knight I, Keane F. Int J STD AIDS 2009 Jun;20(6):423–4.

Vaginal flora changes on Pap smears after insertion of levonorgestrel-releasing intrauterine device. Gilbert G.G., Donders ABD, Bergerb J,  Heuninck H, Bellena G, Cornelisc A. Contraception, 2011;

Microscopy of the bacterial flora on fresh vaginal smears. Donders GG. Infect Dis Obstet Gynecol 1999;7(4):177–9.

Definition and classification of abnormal vaginal flora. Donders GG. Best Pract Res Clin Obstet Gynaecol 2007 Jun;21(3):355–73.

Definition of a type of abnormal vaginal flora that is distinct from bacterial vaginosis: aerobic vaginitis. Donders GG, Vereecken A, Bosmans E, et al. BJOG 2002 Jan;109(1):34–43.

Statistik Austria, Statistik der natürlichen Bevölkerungsbewegung 2007

Pain from copper intrauterine device insertion. Hubacher et al. Am J Ob Gyn 2006

Use of copper intrauterine devices and the risk of tubal infertility among nulligravid women. Hubacher et al.N Engl J Med 345:561-7

Experience of IUD/IUS insertions and clinical performance in nulliparous women-a pilot study. The European Journal of Contraception and Reproductive Health Brockmeyer et al. Care September 2008;13(3):248–254

Clinical performance of a levonorgestrel-releasing intrauterine system and oral contraceptives in young nulliparous women: a comparative study. Suhonen et al. Contraception. 2004 May;69(5):407-12.

2004; RCOG, www.rcog.org.uk/womens-health/clinical-guidance/care-women-requesting-induced-abortion

UK Medical eligibility criteria for contraceptive use, 2006

WHO Medical Eligibility Criteria for Contraceptive Use. 3rd ed. 2004

FFPRHC Guidance (April 2004). J Fam Plann Reprod Health Care. 2004;30:99-108

FFPRHC Guidance (January 2004). J Fam Plann Reprod Health Care. 2004;30:29-41

Assessment of compliance with a weekly contraceptive patch (Ortho Evra/Evra) among North American women. Archer et al. Fertil Steril. 2002 Feb;77(2 Suppl 2):S27-31

Levonorgestrel-releasing and copper-releasing (Nova T) IUDs during five years of use: a randomized comparative trial. Andersson et al. Contraception 49: 56-72,1994

Cervical priming with misoprostol prior to transcervical procedures.Fiala C, Gemzell-Danielsson K, Tang OS, von Hertzen H.Int J Gynaecol Obstet. 2007 Dec;99 Suppl 2:S168-71. Epub 2007 Oct 24.

Mifepristone versus vaginally administered misoprostol for cervical priming before first-trimester termination of pregnancy: a randomized, controlled study. Ashok PW, Flett GM, Templeton A. Am J Obstet Gynecol. 2000 Oct;183(4):998-1002

Hulka et al. Am.J. Obstet. Gynecol, 1974