Abnormal uterine bleeding (AUB) affects up to 30% of women at any point in their life(1). It affects women’s physical social andpsychological aspects of life. A wide variety of medications, hormonal and non-hormonal are available for the treatment of abnormal uterine bleeding. LNG IUS(Mirena) was approved for use in abnormal uterine bleeding by US food and drug administration since 2009(2). The device is a polyethylene T frame with a drug reservoir which releases levonorgestrel at 20 micrograms/ day for the intial 5 years. The local release of Progesterone causes suppression of the endometrial gland and decidualisation of the stroma thus bringing a significant reduction in the mean menstrual blood loss(3). There is a local foreign body reaction characterised by increase in neutrophils, lymphocytes plasma cells and macrophages. These histological changes are established by 3 months after insertion.(4) Mirena being a safer and cost effective treatment option for heavy menstrual bleeding, is often opted by both patient and the gynaecologist. Desire for preserving fertility and the severe high risk comorbid conditions also make mirena the preferred treatment option among patients(5). Mirena can be inserted as an OP procedure, a less invasive procedure and is marketed for use for 5 years. All women opting for mirena must have a bimanual pelvic examination, papsmear and ultrasonography. Any contraindications for mirena insertion is screened. Endometrial sampling is done prior to insertion to screen for atypia.