Mirena is a recent long acting reversible contraceptive (LARC) which is producing 20 micrograms of levonorgestryl/day. It is indicated as a contraceptive and in management of different medical conditions. This study is designed to study the safety, effectiveness and tolerability of mirena as contraceptive. Also, study the effectiveness of merina in different other medical indications. The study was conducted on 490 cases who were followed for 5 years. The most common menstrual pattern in the 1st follow up visit was irregular spotting. After that in the next follow up visits, amenorrhea and hypomenorrhea were the commonest menstrual patterns in Mirena users in the different indications. The commonest cause of loop removal was heavy menstrual bleeding in non contraceptive group and desire for pregnancy in contraceptive group. There was no cases of uterine perforation and only one case of occurrence of pregnancy in the 4th year of IUDS use.