Conservative Gynaecology
Mirena
The Mirena is a delivery system for putting a tiny amount of a progesterone hormone directly onto the uterine lining. The hormone is LEVONORGESTROL, a well tollerated hormone used as the "breast feeding pill" and a common component of most pills. Unlike the pill, the hormone in the Mirena does not have to go to the target organ (womb) through the bloodstream, thus minimising any potential for side effects.
Although produced initially as a contraceptive (and a very effective one at that!) its other use in conservative gynaecology is as a period control agent.
Prior to the introduction of the Mirena, women in the 5 to 10 years prior to the menopause, who complained enough about their heavy, irregular, painful periods only had two choices. They could try a few hormone treatments which didnt work well, then have a hysterectomy, or they could put up with the horrible periods until the menopause
The Mirena has changed this and has become the most useful treatment for perimenopausal abnormal periods. It reduces the uterine lining overgrowth, leads to a thinner lining, and thus reduces the shedding at period time. The amount of flow reduction varies, but is usually quite marked. Many reduce the flow to the stage that they don't actually have a period. In reducing the volume of loss, the period associated symptoms (bloating, backache, leg pains and even PMT) usually settle to a degree.
The mirena will not significantly alter the hormone pattern, and therefore won't stop direct hormone symptoms(ovulation pain, menstrual migraine) but this means that the hormonal diagnosis of the menopause can be made. This can be of use if the mirena stops the period. Be warned, however, that the Mirena has a 3 month settling in time, during which the uterine lining is unstable. Any degree of bleeding, spotting, discharge etc. IS NORMAL for the first 3 months. The actual period volume, however, usually begins to settle quickly.
