An update has been made to the Mirena contraceptive. Known as the long-acting reversible contraception levonorgestrel 52 mg (LARC), the lifespan of usage has been bumped up three years. This effectively makes the Mirena the longest-acting hormonal contraceptive in Australia.

With a median efficacy rate of 99%, Mirena is one of the most sought after methods of contraception. It does not require further interventions such as daily consumption or monthly administration. The option of removal also exists at any time.

Now, the TGA has updated the label for Mirena, extending the contraceptive lifespan of the hormonal device (IUD) from five to eight years. The duration and condition of use for other indications remaining unchanged. The updated span of time also increases cost efficacy. Pain threshold is also drastically reduced, as the period of bleeding and pain has been halved.

‘Increasing funding for training and supervising training in LARC as well as rebates for insertion and removal would assist by decreasing costs to users and to offsetting costs of providing LARCs.’

The decision to increase Mirena’s duration of use was made after the Phase III MIRENA Extension Trial, which weighed the differences in contraceptive efficacy and safety of the IUD between five and eight years. Results of the study showed efficacy remains unchanged. Stabilising at more than 99% during years six to eight of use, there were also no deviations in the safety profile over the extended period.

 

What is the benefit of the extended lifespan?

University of Sydney Professor Deborah Bateson and former Medical Director at Family Planning NSW believes that contraceptive lifespan will accelerate the usage of LARCs in Australia. She says, ‘The longer a contraceptive works, the more appealing an option it may become for many women... an extra three years of protection with Mirena means not only peace of mind for longer, but it also further increases the convenience and affordability of this highly effective contraceptive.’
The upfront cost of the procedure and device has now increased to over eight years for returning patients. This lengthens the period between re-insertions. PBS has reported from 2008–12, use of the Mirena and other IUDs for contraception was between 3.2–6.1% of women. Another online survey estimated that just 10.8% of women aged 15–44 years were using a LARC in 2018.

While uptake of LARC has been on the rise in Australia, patient services remains low. According to Medicare statistics, from July 2023 to April 2024, 74,111 women and non-conforming individuals processed for the procedure to insert an IUD (Medicare item 35503). This has dropped significantly from the 92,789 processed between July 2022 to June 2023.

Bateson says,  "It is essential that women of reproductive age are informed of the pros and cons of the full range of contraceptive options; not just the various forms of the pill. It is essential that women of reproductive age are informed of the pros and cons of the full range of contraceptive options; not just the various forms of the pill."

On that note, we are inclined to agree.