Is there a place for the Mirena (LNG-IUS) in the management of the menopause?

In 1995 for contraception (Mirena). For women approaching the menopause it provides excellent birth control. It provides progestogen protection of the lining of the uterus to be used in conjunction with any form of oestrogen replacement therapy (HRT and progestogen;Figure 28.1B) whether this be by tablet, patch, gel or subcutaneous implant. Before the menopause periods, would usually be absent or light and after the menopause a Mirena would provide one option for HRT without withdrawal bleeds.

Q 28. 2 How can atrophic vaginitis - dry vagina at menopause - painful sex - be treated? - Topical Estrogen
Q 28. 3 How will we decide which is the most appropriate HRT preparation for me?
Q 28. 4 What problems might occur when I start HRT?
Q 28. 5 What is the choice of oestrogen-only preparations?
Q 28. 6 How are oestradiol implants introduced?
Q 28. 7 Is it possible for me to be given too much oestrogen?
Q 28. 8 How long will my oestradiol implant last?
Q 28. 9 Why might I require progestogen in addition to oestrogen?
Q 28. 10 Do all women taking se quential (cyclical progestogen) HRT have withdrawal bleeds?
Q 28. 11 Could we adjust the timing of the withdrawal bleed associated with se quential (cyclical progestogen) HRT preparations for my social convenience?
Q 28. 12 I have gone through the menopause. Does HRT mean that I must have 'periods' again?
Q 28. 13 What is Tibolone (Livial Organon)
Q 28. 14 I have had a premature menopause. What forms of HRT are available.?
Q 28. 15 Is there an indication for the levonorgestrel intrauterine system (Mirena) in the management of the menopause?
Q 28. 16 Is there a place for progesterone replacement therapy?
Q 28. 17 Is there a place for testosterone replacement therapy?
Q 28. 18 My sex drive (libido) is rather low. Is there anything that might improve it?
Q 28. 18 a What is the place of Viagra (sildenafil citrate) in sexual dysfunction in women?
Q 28. 19 How would the possible advantages and disadvantages of HRT compare for me?
Q 28. 20 What side effects could I have with HRT?
Q 28. 21 What can be done if I develop irregular bleeding on HRT?
Q 28. 22 If I start HRT, will I gain weight?
Q 28. 23 If I have menopausal symptoms but I cannot take HRT what other options are available for me?
Q 28. 24 How will I be monitored once I start HRT?
Q 28. 25 How long can I take HRT?
Q 28. 26 Do most women continue with HRT?
Q 28. 27 How can doctors encourage their patients to continue with our HRT?
Q 28. 28 Are women who have had higher education more likely to take HRT?
Q 28. 29 Are there any new developments with HRT?
Q 28. 30 What are your conclusions with regard to the risks and benefits of HRT?
Q 28. 31 Support Groups.

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This is the personal website of David A Viniker MD FRCOG, Consultant Obstetrician and Gynaecologist at Whipps Cross University Hospital, London.

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DISCLAIMER

The aim of this web site is to provide a general guide and it is not intended as a substitute for a consultation with an appropriate specialist in respect of individual care and treatment.