Levonorgestrel (Intrauterine)

Introduction

Levonorgestrel (lee-voe-nor-JES-trel)

This is an intrauterine device (IUD), which is a reversible form of birth control. This type of IUD slowly releases levonorgestrel, a hormone. It is used to prevent pregnancy for up to five years. It is also used to treat heavy menstrual bleeding. An IUD works best in women who have had at least one child.

Brand Name(s)

There may be other brand names for this medicine.

Mirena

When This Medicine Should Not Be Used

You should not receive this device if you have had an allergic reaction to levonorgestrel, polyethylene, silicone, or barium. You should not receive this device if you are pregnant, or if you think you might be. You should not receive this device if you have uterine fibroids, an abnormally-shaped uterus, or if you have liver disease or a liver tumor. You should not receive this device if you have had a baby, a miscarriage, or an abortion in the past three months that was followed by an infection of your female organs. You should not receive this device if you have a history of ectopic pregnancy (a pregnancy that grew outside of your uterus), or if you have a condition that increases your risk of having an ectopic pregnancy.You should not receive this device if you have neoplasia (abnormal or pre-cancerous cells) or cancer of the uterus or cervix, or if your last Pap smear was abnormal and the problem has not been fully treated. You should not receive this device if you already have an IUD that has not been removed, if you have breast cancer, or if you had breast cancer in the past. You should not receive this device if you have unusual bleeding from your vagina, or if you have any infection of the female organs or genitals (such as pelvic inflammatory disease or PID) that has not been fully treated. You should not use this type of birth control if you or your partner have sex with other people. You should not use this type of birth control if you are at increased risk of infections due to leukemia, HIV or AIDS, IV street drug use, or other health problems.

How to Use This Medicine

Device

  • Your IUD has a string or "tail" which is made of plastic thread. About one or two inches of this string hangs into your vagina. You cannot see this string, and it will not cause problems when you have sex. Check your IUD string every few days during the first few months that you have your IUD. After that, check the string after each monthly period. You may not be protected against pregnancy if you cannot feel the string or if you feel plastic. Do the following to check the placement of your IUD:
    • Wash your hands with soap and warm water. Dry them with a clean towel.
    • Bend your knees and squat low to the ground.
    • Gently put your index (pointing) finger high inside your vagina. The cervix is at the top of the vagina and feels like the tip of your nose. Find the IUD string coming from your cervix. Never pull on the string. You should not be able to feel the firm plastic of the IUD itself. Wash your hands after you are done checking your IUD string.
  • You will need to have your levonorgestrel-releasing IUD replaced every five years, or sooner if it comes out of your uterus.

Drugs and Foods to Avoid

Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

  • Make sure your doctor knows if you are also using a blood thinner, a steroid medicine, or insulin.

Warnings While Using This Medicine

  • Make sure your doctor knows if you are breastfeeding, or if you have had a baby, a miscarriage, or an abortion in the past three months. Tell your doctor if you have a history of diabetes, heart valve problems, heart disease that you were born with, or infective endocarditis (infection inside of the heart). Tell your doctor if you have had to take antibiotics before medical or dental procedures to prevent an infection inside of your heart. Make sure your doctor knows if you have blood clotting problems or bleeding problems. Tell your doctor if you have a history of a heart attack, stroke, blood clots, high blood pressure, or other heart problems.
  • The IUD is a very good form of birth control. There is a small chance that you could get pregnant when using an IUD. If this happens, your IUD may be removed to decrease the risk of miscarriage or other problems. You may have a higher risk of having a miscarriage if your IUD cannot be removed. You also have a higher risk of an ectopic pregnancy if you get pregnant while your IUD is in place. An ectopic pregnancy can be serious, even life threatening. An ectopic pregnancy can also cause problems that may make it harder for you to become pregnant in the future.
  • An IUD can slip partly or all of the way out of your uterus without you knowing it. If this happens, you will have no protection against getting pregnant or you may have an increased risk for serious problems. This is more likely during the first year that you have your IUD, but can happen at any time. Regularly checking the string of your IUD can tell you if your IUD is still in place.
  • You may have some blood spotting and cramping during the first weeks after the IUD has been inserted. These symptoms should go away within a few months. Rarely, the IUD may make a hole in the wall of your uterus when it is inserted. If this happens, it could cause serious problems.
  • An IUD increases your risk of a serious infection of the female organs called pelvic inflammatory disease (PID). PID can be serious, even life threatening. This infection could cause scarring of the female organs, which may make it hard for you to become pregnant in the future, and can increase your risk of ectopic pregnancy.
  • This device will not protect you from getting HIV/AIDS, herpes, or other sexually transmitted diseases. Tell your doctor if you or your partner begin to have sexual intercourse with other people, or you or your partner tests positive for a sexually transmitted disease. If this is a concern for you, talk with your doctor.
  • Your caregiver may want to do tests to make sure you do not have an infection before putting in an IUD. The IUD is usually inserted during your monthly period. Putting an IUD in during a period also helps to make sure that you are not pregnant. You will also need to see your doctor within four to twelve weeks of having your IUD placed and then once a year.
  • This medicine may raise or lower your blood sugar, or it may cover up symptoms of very low blood sugar (hypoglycemia).

Possible Side Effects While Using This Medicine

Call your doctor right away if you notice any of these side effects:

  • Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing.
  • Abdominal (belly) or pelvic pain, tenderness, or cramping that is sudden or severe, or that happens after a missed period or a period that is not normal.
  • Abdominal or pelvic pain, tenderness, or cramping that happens with fever or chills, or that happens with vaginal discharge that is green, yellow, has a bad smell, or has pus.
  • Any unexplained fever.
  • Chest pain, pressure, or tightness, or coughing up blood.
  • Dizziness, lightheadedness, or fainting.
  • Missed period, or vaginal bleeding after the first few weeks of IUD insertion that is heavy, irregular, or abnormal, and that lasts longer than a few weeks after your IUD was inserted.
  • New or worsening high blood pressure.
  • New or worsening migraine headaches, new severe headaches, or vision changes.
  • New problems with speech or walking, or pain in your lower leg.
  • Numbness or weakness in your arm or leg, or on one side of your body.
  • Painful intercourse (sex) for you or your partner, or if your partner feels the hard plastic of the IUD during intercourse.
  • Sores or bumps on your genitals.
  • The length of the thread hanging from your vagina has changed, or you cannot feel the thread.
  • Yellowing of your skin or the whites of your eyes.

If you notice these less serious side effects, talk with your doctor:

  • Acne, hair loss, or other skin changes.
  • Back pain or breast pain.
  • Decrease in your desire to have sex.
  • Depression or nervousness.
  • Itching or swelling of the vagina or genital area.
  • Nausea or vomiting.
  • Painful menstrual periods.
  • Weight gain.

If you notice other side effects that you think are caused by this medicine, tell your doctor

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088

Review Date: 2011-02-04 Reviewed By: Keywords: ,
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