What symptom does NOT require immediate reporting after the implantation of levonorgestrel (Mirena)?

• A. Amenorrhea
• B. Painful intercourse
• C. Fever with vaginal discharge
• D. String disappearance

Answer: (A)

Amenorrhea, which is the absence of menstruation, is a common and expected outcome after the implantation of levonorgestrel (Mirena). In many cases, this medication is used for its contraceptive properties, and one of its effects can be reduced menstrual bleeding or amenorrhea itself. This symptom does not require immediate reporting because it often indicates that the system is working as intended, reducing menstrual flow and providing effective contraception.

On the other hand, the symptoms related to painful intercourse, fever with vaginal discharge, or disappearance of the strings of the intrauterine device can indicate complications that require prompt attention. Painful intercourse may suggest issues such as placement problems or even pelvic inflammatory disease. The presence of fever along with vaginal discharge could signal an infection, which is a serious concern that should be evaluated immediately. Lastly, the disappearance of the strings might indicate that the device has been expelled or displaced, and this also requires a timely assessment. Thus, among the options presented, amenorrhea is the symptom least likely to indicate an urgent problem post-implantation.