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Does research show that Mirena is effective longer than the 5-year approved time? #436/9
At the Contraceptive Technology conference in San Francisco, you gave us the pages on the advantages of Mirena vs, oral contraceptives over a 7 year period. Does research show that Mirena is effective longer than the 5 year approved time?

I have a client whose Mirena passed 5 years 1 week ago. She is a partial pay client who needs to collect funds over a few months in order to pay her portion. She has a BMI of 37. Can she safely use just the Mirena longer than 5 years?

Thanks so much for your help through all the 32 years I have been in this business in Texas.

RNC, CNS

Both Grimes in Contraceptive Technology and Speroff and Darney even more clearly in A Clinical Guide for Contraceptionsuggest that Mirena is effective for more than 5 years.

 

However, your patient is definitely overweight and it was in overweight women using Norplant implants that failures occurred if women used Norplant for more than 5 years. Therefore, I would suggest caution even though I would imagine that Mirena remains effective beyond 5 years.  Would your patient consider using condoms or foam as a backup?

  

Thanks for your work in Texas for the past 32 years. It has been almost exactly the same for me, 33 years, but I took one year off for a masters in public health. So we are in the 32 year club!!

 

I feel we need to wrestle this question of the duration of Mirena effectiveness to the ground. 

 

There are undoubtedly women having their Mirena IUDs removed who do not have the money to buy a new one and subsequently pregnancies may result from a mentality that suggests that Mirena IUDs be removed at exactly 5 years.

 

 

Perhaps the best advice for all women wanting to continue Mirena for more than 5 years is: 

 

"If you want to continue using your Mirena IUD for another 2 years, we suggest that you use condoms as a backup."

 

Does this make sense?

 

I am sending this to Drs. Phil Darney and Mimi Zieman for their wisdom.

 

Here is where the next 3 Contraceptive Technology Update conferences will be held:

 

Atlanta             October 29-31, 2009

San Francisco  March 24-27, 2010

Boston             April 14-17, 2010

 

Please join us!! Also please tell others.  For more information click on:

http://www.contemporaryforums.com/brochure.asp?cid=731

 

 

Key Words:  Mirena IUD, effectiveness, partial pay client, BMI, overweight, Contraceptive Technology, A Clinical Guide for Contraception, Speroff, Darney, Grimes, failures, condoms, backup contraceptive, pregnancies

Updated 8=7=2014

 

Robert A. Hatcher MD, MPH
Emeritus Professor of Gynecology and Obstetrics
Emory University School of Medicine
Atlanta, GA
---2014-08-7

The directors and owners of this website and any publications and information concerning health matters offered here advise a person with a particular problem to consult a primary-care clinician or a specialist in obstetrics, gynecology, or urology (depending on the problem or the contraceptive) as well as the product package insert and other references before diagnosing, managing, or treating the problem.
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