Comment & Controversy

Mirena-related spotting
is a challenge in some patients

“UPDATE ON CONTRACEPTION” AILEEN GARIEPY, MD, AND MITCHELL D. CREININ, MD (AUGUST 2009)

I found this article to be pertinent to the clinician in the trenches. I am very much concerned about breakthrough bleeding in my patients who are using the levonorgestrel-releasing intrauterine system (Mirena). I believe that most patients who have persistent brown spotting following the insertion of Mirena have some degree of adenomyosis and would benefit from continuation of this contraceptive method.