This new guideline from the FSRH is about 'Jaydess', which is a new Levonorgestrel releasing intrauterine system, so very similar to Mirena.
How is Jaydess different to Mirena?
- Licensed for 3 yrs vs 5 yrs
- It is smaller in size and has a lower dose of levonorgestrel (13.5mg vs 52mg)
- Costs £69.22 vs £88
- Only licensed for contraception (ie not for menorrhagia or for HRT progesterone use).
What is the adverse event profile?
- Overall it there hasn't been shown to be any different to Mirena.
- Some studies suggest a higher failure rate and a higher ectopic rate than with Mirena, but the numbers in the studies were too small to know whether this is a significant difference or not. After 3 years there were about 0.33 pregnancies per 100 women.
- Amenorrhoea - there is a lower rate than with Mirena (12.7% after 3 yrs), though this may appeal to some women.
Who can it be used in?
- Safety and efficacy hasn't been studied in the under 18s, but the FSRH advises that it can be used from menarche up.
- Nullips - The SPC states that it isn't the first choice IUS for nullips due to limited clinical experience, but again the FSRH says it can be used in nullips.
Same method as Mirena. In theory insertion may be easier due to it's smaller size, but this hasn't been looked at in the clinical trials.
There aren't specific ones for Jaydess yet, so you should use the Mirena ones.
Can it be distinguished from Mirena after insertion?
It has a silver ring which will distinguish it on USS or xray.