Extended use of the intrauterine device: a literature review and recommendations for clinical practice.
In response to a literature review assessing extended use of long-acting reversible contraceptives, this letter to the editor argues the conclusion that extended use of the 52 mg levonorgestrel (LNG) intrauterine system (IUS) - currently marketed as Mirena - to be premature. Deeming the authors’ summary of two product studies erroneous, the extremely small sample size in those two observational studies is not enough to support recommendation of prolonged use beyond five years. The author urges the medical community to understand that although it is eager to strongly believe that the 52-mg LNG IUS is effective beyond 5 years, there is a lack of sufficient data for such recommendations. Copyright © 2014 Elsevier Inc. All rights reserved.