The Mannix Ring refers to the Levonorgestrel IUD system, where three shots means three injections of GnRH-a agonist. It is not mandatory to take three injections to get on the levonorgestrel IUD system, it depends on the patient’s specific condition. The levonorgestrel IUD system is indicated for those who have a need for contraception, and can also be used to treat dysmenorrhea, heavy menstrual periods, endometrial hyperplasia, and endometriosis. For patients with endometriosis or large uterine volume, three injections of GnRH-a agonists, such as treprostinil and leuprolide, can be given before going on the levonorgestrel IUD system. If it is for contraception, treatment of excessive menstruation, endometrial hyperplasia, etc., and the patient’s uterine cavity depth is within the normal range, there is no need for other injections prior to putting on the levonorgestrel IUD system. It is important to exclude a woman from pregnancy, reproductive tract infections, reproductive tract tumors, unexplained uterine bleeding, and serious liver problems before putting on the levonorgestrel IUD system. It is also forbidden to use the levonorgestrel IUD system if a woman is allergic to it. Levonorgestrel IUD system is a medicated ring and needs to be used under medical supervision.