Endometrial adenocarcinoma in association with a levonorgestrel-releasing intrauterine system (Mirena).

The levonorgestrel-releasing intrauterine system (LNGIUS), Mirena®, has been licensed as a contraceptive in the UK since 1995. In 2002, Mirena became licensed also for the management of idiopathic menorrhagia and in 2004 the product licence was extended further to use for “endometrial protection” to prevent endometrial hyperplasia in women receiving oestrogen replacement therapy. We report a case of primary endometrioid endometrial carcinoma diagnosed in a postmenopausal woman who had a LNG-IUS inserted 4 years previously for treatment of perimenopausal menorrhagia, and we discuss the implications for management of women presenting with perimenopausal menorrhagia.