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LNG‐IUD “Mirena”
• First‐line therapy
• 52 mg with a release rate of 20 mcg/day over five year
• More effective than oral progestins
• Does not require daily administration
• Better tolerated than oral
Vereide AB, et al, Gynecol Oncol 2003; 91:526 Abu Hashim H, et al, Am J Obstet Gynecol 2015; 213:469.
Oral Progestins
• Preferred when:
1. IUD is not tolerated or declined from women due to side effects (e.g.
dysmenorrhea)
2. Uterine factors make the placement of IUD difficult (e.g. congenital anomaly, large fibroids)
• Usual treatment6 months with continuous dosing (not cyclic)
• MA (40 – 60 mg/day)for atypical EH
• MPA (10 – 20 mg/day)for non‐atypical EH
Cholakian D, et al, Gynecol Oncol 2016; 140:234
Orbo A, et al, BJOG 2014; 121:477
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