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Levonorgestrel intrauterine system is a long-acting reversible contraceptive device placed in the uterus that slowly releases the hormone levonorgestrel. It is primarily used for contraception and can also be indicated for the treatment of heavy menstrual bleeding. The device works by thickening cervical mucus to inhibit sperm passage, thinning the endometrial lining to prevent implantation, and in some cases suppressing ovulation. Its effectiveness lasts from 3 to 8 years depending on the brand (Skyla up to 3 years; Kyleena up to 5 years; Liletta and Mirena up to 8 years). Levonorgestrel is a synthetic progestogen (progestin) that mimics natural progesterone activity[1][2][3][4][5][6][8].
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