Mirena is the only IUS (intrauterine device) approved for marketing in China. The Mirena IUD System (IUS) is a new, long-lasting method of contraception. It has been widely used in European countries for 10 years and is considered to be the ideal method for mothers seeking contraception based on its high effectiveness, safety and convenience and its ability to reduce the amount of menstrual blood. From the first day of use, it offers a highly reliable contraceptive guarantee for up to 5 years, with a safe contraceptive efficiency of almost 100%, it is even more effective than female sterilization, and fertility is restored immediately after removal. As a result, at the 16th World Congress of Obstetrics and Gynecology in 2000, Manuel was considered “the most significant advance in reversible contraception since the invention of the oral contraceptive pill”. About 12 million women are currently using Mannorrhea, mainly in Europe. The Manuel IUD was launched in Singapore in 1995, in Hong Kong, China in 1998, in Korea, Malaysia and Taiwan in 1999 and in China in 2000. The Mandelor IUD System The Mandelor is placed in the uterus and consists of a small, flexible T-shaped plastic frame that surrounds the main stem with a hormone reservoir that releases a steady dose of very low dose levonorgestrel. The drug acts directly on the endometrium and myometrium and is a local drug effect, so there are no systemic side effects. Mannitol releases a very low dose of levonorgestrel into the uterine cavity daily. Its contraceptive effect is achieved through the local action of progesterone in the uterus – it inhibits the proliferation of the monthly endometrium, which prevents the fertilized egg from being laid; it thickens the cervical mucus, making it difficult for the sperm to pass through and unite with the egg; and it inhibits the movement of sperm in the uterus and fallopian tubes. The biggest advantage of MANETIC is that it completely relieves women of the trouble of increased menstrual blood, altered cycles, etc. Instead, it can reduce menstrual flow, relieve menstrual pain, reduce the incidence of pelvic inflammatory disease and ectopic pregnancy, and has a low rate of IUD removal. Compared to traditional IUDs, the biggest advantage of Mannorrhea is its reliable contraceptive effect, and secondly, it completely relieves women from the problems of increased menstrual blood flow and cycle changes. Because of the local action of the drugs contained in Mannorrhea on the uterine cavity, it can instead reduce menstrual flow, relieve menstrual pain, reduce the incidence of pelvic inflammatory disease and ectopic pregnancy, and have a low rate of IUD removal. Why does it instead reduce the blood volume? Every month, the endometrium, which consists of cells and glands, proliferates. This proliferation is a regular change caused by hormones. At the beginning of each menstrual cycle, the endometrium thickens in preparation to receive a fertilized egg. If fertilization does not occur, the endometrium will peel off at the end of the menstrual cycle and flow out of the vagina, creating menstrual bleeding. Menstrual bleeding releases small daily doses of levonorgestrel into the uterine cavity. This high local concentration of progesterone in the uterus inhibits the proliferation of the endometrium. As a result, the endometrium at the time of exfoliation is very thin, allowing little bleeding at the end of the menstrual cycle. After one year of using Mannitol, women have an average of only two days of light menstrual bleeding per month. This is a local effect only, the normal physiological functions of the ovaries are not affected, their own hormones remain at normal levels and this reduction in menstrual flow gives women more freedom and brings a better quality of life. Once removed, menstruation will quickly return to normal within a month. Of course it has its side effects: mainly some women experience slight bleeding outside of their periods for the first 3 months after placement, which is harmless and passes quickly. The reasoning is the same as for other IUDs. The Mannorrhea follow-up is also surprisingly effective. Its little baton seems to detect that the uterus does not want to accept the “seed” – the fertilized egg – and does not want to tolerate the resulting menstruation, so that after one year of using Mannorrhea, an average of 10 – 20 % of women experience Suspension of menstruation. Do women have any concerns about having almost no periods after one year? This is still a controversial matter: some women are older and are worried about early menopause; some women are not worried, but based on this reality, they inevitably consider: does this mean pregnancy? Does it have a bad effect on the female endocrine system? The answer, of course, is reassuring: the small daily dose of levonorgestrel released into the uterine cavity by Mannorrhea causes the monthly thickening of the uterine wall to cease completely in these women, so that there is no menstrual bleeding. This pause in menstruation that occurs with the use of Mannorrhea is temporary and should not be of any concern. Menstruation will return to normal after the removal of Mannorrhea. Clinical tests and market feedback so far have shown the effectiveness of Mannorrhea to be nearly 100%. Therefore, the chance of pregnancy after the placement of Mannorrhea is minimal. During the first month of menstrual suspension, you may want to have a pregnancy test for peace of mind. However, it is not necessary to repeat the test later. Some women also suspect that their endocrine system is greatly damaged as a result. In fact, because Mannorrhea only works locally on the uterus, the ovaries still produce hormones and ovulate as they did before Mannorrhea was placed. The fact that a woman experiences a pause in menstruation with Mannorrhea does not mean that she has entered menopause, because her ovarian function is not affected and hormone production is still normal. Some of the changes that occur during menopause, like hot flashes and night sweats are unrelated to menstrual bleeding. If a woman experiences any of these changes, she should consult her doctor promptly. Warning: Who should not use Manometrium? A woman should not use the Mannorrhea IUD if she has any of the following conditions: 1. known or suspected pregnancy; 2. current or recurrent pelvic inflammatory disease; 3. infection of the lower genital tract; 4. postpartum endometritis; 5. infected abortion within the past 3 months; 6. atypical hyperplasia of the cervix; 7. malignant lesions of the uterus or cervix; 8. congenital or acquired uterine anomalies, including myomas that distort the uterine cavity of the uterus; 9. acute liver disease or liver tumors; 10. increased susceptibility to infection.