Hysterectomy Alternatives Program (HAlt)
Mirena® Intrauterine Progestin Device
This intrauterine device releases a small amount of levonorgestrel (a progestin) in the uterus. This prevents pregnancy but also significantly reduces menstrual flow. As with other progestins, it works by thinning the endometrial lining over time. It is easily inserted in the doctor’s office and may stay for 5 years. It has shown good results in the treatment of adenomyosis. Side effects include breakthrough bleeding, weight gain, increased appetite and headache. The most common side effect and often the most bothersome is breakthrough bleeding. Some women report spotting on most days for up to three months. It is important to accept this as a temporary side effect and after 6 months, many women report no bleeding at all. This may be a good alternative for women who are wishing to conserve their fertility since ovulation returns within about 3 months after the removal of the device.