### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
I have coproporphyria and endometriosis. My surgeon is wanting to place Mirena after ablation since Lupron and other hormone alternatives are contraindicated, but neither of us can find much information about it and porphyria. Is there any benefit to placement of Mirena in thwarting endometriosis re-growth, and how well has the levonorgestrel been tolerated in porphyria patients? I know only a little is supposed to get into the bloodstream, but sometimes just "a little" bit of medications can cause big issues. Thank you in advance for any information you can provide.

### output:

It makes sense that IRENA might help a little but to prevent some symptoms of endometriosis such a heavy and painful periods, even after ablation.  However, it is not well studied, and it is not known for sure if it will work, so the manufacturer does not currently recommend the use of IRENA after an ablation.  This doesn't mean that your doctor can't use it, it just means that he/she can't be sure if it will work, or maybe even there may be problems with it such as infection.  I am but aware I any studies of IRENA use in women with a history of porphyria.  In general though, progesterone are used with caution if it is really necessary.  I would assume then that IRENA should be safe.  Personally, I don't use IRENA in women with an ablation.  That doesn't mean it can't be done, I just think that you should give the ablation a chance to work on its own, and because it is unknown what the effects would be.  That doesn't mean though that your doctor doesn't feel differently.  I hope this is helpful, please let me know if I can be of further assistance.