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LNG‐IUD (52/5) “Mirena”
• 2015 meta‐analysis of 7 randomized trials
• 4 trials:
• higher RR at 6 months for LNG 52/5 (88% vs. 69%)
• lower hysterectomy rate (OR 0.26, CI 0.15‐0.45)
• LNG‐IUD is more effective than oral progestins
Follow‐up
• Menstrual pattern normalizes:
1. repeat endometrial biopsy is not required 2. surveillance
• Abnormal bleeding pattern:
1. repeat endometrial biopsy every 6 months
2. continue progestin therapy
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