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Genetic and Rare Diseases Information Center (GARD)

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Factor V Leiden thrombophilia


* Not a rare disease
Other Names for this Disease
  • APC resistance, Leiden type
  • Hereditary resistance to activated protein C
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Your Question

I am heterozygous for a factor V Leiden mutation. I was on oral contraceptives for 10 years before trying to get pregnant. After two miscarriages, I was tested and I found out that I had this condition. I saw where you discuss oral contraceptives; but I didn't know if an IUD such as Mirena may be safer to use than an oral contraceptives?

Our Answer

We have identified the following information that we hope you find helpful. If you still have questions, please contact us.

Is the Mirena IUD safe to use for people with factor V Leiden thrombophilia?

It is well known that combination contraceptives (containing estrogens and progestins) increase the risk for deep venous thromboembolism and pulmonary embolism in those with factor V Leiden thrombophilia. The Mirena IUD (also called the levonorgestrel-releasing intrauterine system) only releases progestins and only low levels of progestins are absorbed into the blood stream. It may, therefore, be a particularly safe contraceptive method in individuals with a history of thrombosis or thrombophilia.[1]
Last updated: 9/22/2011

Has there been any research on use of the Mirena IUD in individuals with factor V Leiden thrombophilia?

We found two research studies on the use of the Mirena IUD (levonorgestrel-releasing intrauterine system or LNG-IUS) in women with hemostatic disorders, which includes factor V Leiden thrombophilia. Both studies evaluated the use of the LNG-IUS in women with known hemostatic disorders and abnormal uterine bleeding. The first study concluded that the LNG-IUS should be considered when managing abnormal uterine bleeding.[2] The second study concluded that the LNG-IUS seems to be an effective treatment for heavy menses in women with hemostatic disorders. They also stated that providers should consider this option for women with hemostatic disorders because it is safe and simple to use.[3]

A more recent study assessed the risk of venous thrombosis associated with non-oral contraceptives, including the depot-medroxyprogesterone injection (also called Depo-Provera) and the levonorgestrel-releasing intrauterine system. This study found a statistically significant 3-4 fold increased risk of venous thrombosis with injectable progestin-only contraceptives, but no increased risk with progestin-releasing IUD.[4]
Last updated: 9/22/2011