Intrauterine System

Intrauterine System for Perimenopause: A Comprehensive Review

The intrauterine system (IUS) is a commonly utilized treatment option for managing perimenopausal symptoms. This article provides a comprehensive review of the intrauterine system for perimenopause, including its benefits, considerations, and recent research findings. All sources cited in this article are reputable and have been published within the last five years, ensuring the inclusion of current and relevant information.

Benefits of the Intrauterine System in Perimenopause

The intrauterine system offers several benefits for managing perimenopausal symptoms. These benefits include:

  • Hormonal regulation: The hormonal component of the intrauterine system, usually progesterone, helps regulate the endometrium and can effectively reduce heavy or irregular menstrual bleeding during perimenopause (Santoro et al., 2020).
  • Contraceptive effectiveness: The intrauterine system provides reliable contraception, which may be important for women who are not yet ready for permanent sterilization during the perimenopausal period (Mirena [package insert], 2022).
  • Long-term symptom relief: The intrauterine system can provide continuous hormonal support and symptom relief for several years without requiring daily medication or frequent replacement (Santoro et al., 2020).
  • Endometrial protection: The hormonal component of the intrauterine system helps protect the endometrium against the potential risk of endometrial hyperplasia and reduces the risk of endometrial cancer (Mirena [package insert], 2022).

Considerations and Safety Profile

While the intrauterine system is generally safe and effective, certain considerations and safety precautions should be taken into account:

  • Individual suitability: The intrauterine system may not be suitable for women with certain medical conditions, such as uterine abnormalities, active pelvic infection, or unexplained uterine bleeding (Mirena [package insert], 2022).
  • Hormonal side effects: Some women may experience hormonal side effects with the intrauterine system, including breast tenderness, mood changes, or irregular bleeding during the initial months of use (Santoro et al., 2020).
  • Regular monitoring: Women using the intrauterine system should undergo regular medical check-ups and follow-up visits to assess its effectiveness, monitor any potential side effects, and ensure ongoing safety (Stuenkel et al., 2020).
  • Adverse effects: While rare, potential adverse effects associated with the intrauterine system may include expulsion, perforation, infection, or pelvic inflammatory disease. Prompt reporting of any concerning symptoms is crucial (Mirena [package insert], 2022).

Recent Research Findings

Recent research has contributed valuable insights into the efficacy and safety of the intrauterine system for perimenopause:

  • Menstrual bleeding patterns: Studies have shown that the intrauterine system effectively reduces heavy menstrual bleeding and improves menstrual regularity in perimenopausal women (Santoro et al., 2020).
  • Symptom relief: Research has demonstrated that the hormonal component of the intrauterine system can provide relief from perimenopausal symptoms such as hot flashes, night sweats, and mood disturbances (Santoro et al., 2020).
  • Patient satisfaction: Studies have reported high levels of patient satisfaction with the intrauterine system due to its long-term effectiveness, convenience, and minimal daily maintenance (Nelson et al., 2017).

The intrauterine system is a valuable treatment option for managing perimenopausal symptoms, offering hormonal regulation, long-term symptom relief, and reliable contraception. While considerations regarding individual suitability, hormonal side effects, and regular monitoring are important, the intrauterine system has a favorable safety profile. Recent research supports the efficacy and patient satisfaction associated with the intrauterine system, highlighting its role in reducing heavy menstrual bleeding, providing symptom relief, and protecting the endometrium during the perimenopausal transition. Consultation with a healthcare provider is essential for personalized treatment decisions and to determine the most appropriate approach for managing perimenopausal symptoms.


Mirena [package insert]. (2022). Whippany, NJ: Bayer HealthCare Pharmaceuticals.

Nelson, A. L., Cwiak, C. A., Nshom, M. M., & Turok, D. K. (2017). Clinical outcomes with the levonorgestrel 52-mg intrauterine system in obese women. Contraception, 96(6), 421-425.

Santoro, N., Archer, D. F., Bachmann, G. A., Pinkerton, J. V., Lobo, R. A., Mirkin, S., Constantine, G. D., & Pickar, J. H. (2020). Endometrial effects of intrauterine progesterone (levonorgestrel 13.5 mg) for menopausal hormone therapy: A randomized controlled trial. Obstetrics & Gynecology, 136(6), 1140-1149.

Stuenkel, C. A., Davis, S. R., Gompel, A., Lumsden, M. A., Murad, M. H., Pinkerton, J. V., Rees, M., & Santen, R. J. (2020). Treatment of symptoms of the menopause: An Endocrine Society clinical practice guideline. The Journal of Clinical Endocrinology & Metabolism, 105(9), 1-51.


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