Aspectos éticos del uso del "DIU Mirena®" en el tratamiento de la hemorragia menstrual severa

  1. Miriam Turiel Miranda 1
  2. Pau Agulles Simó 2
  1. 1 Hospital de La Paz
  2. 2 Universidad Pontificia de la Santa Cruz (Italia)
Journal:
Cuadernos de bioética

ISSN: 1132-1989,  2386-3773

Year of publication: 2018

Volume: 29

Issue: 96

Pages: 159-176

Type: Article

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More publications in: Cuadernos de bioética

Abstract

The levonorgestrel-releasing intrauterine device known as Mirena IUD® (20mcg/24h) is nowadays considered among the leading resources in the treatment of heavy menstrual bleeding. Nonetheless, due to either its effect of prevention of conception and especially to the possibility that it may also have an anti-implantation effect, there is a founded concern on whether its therapeutic use may be ethically licit. This article engages in an exhaustive literature review in order to ascertain the mechanism of action of Mirena® IUD, in view of an ethical evaluation of its therapeutic use, keeping in mind those two unwanted effects. According to the most recent bibliography, the modification of the cervical mucus in patients carrying Mirena® IUD seems to consistently impede the spermatozoa penetration through the cervix, thus keeping down the probability of conception. Therefore, the likelihood of inducing an embryonic loss that can be ascribed to the device seems to be virtually nil. Given that there are no therapeutic alternatives that respect fertility as they address the pathology once the first-line treatments have failed, the prevention of fertilization effect of Mirena® IUD may be judged as ethically acceptable. Moreover one cannot conclude that the embryonic loss that might aggravate the moral evaluation of its use actually takes place.

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