Depo-Provera vs. Kyleena

See how Depo-Provera and Kyleena compare on approved uses, dosing, side effects, and cost.

Key Takeaways

  • Depo-Provera requires a new injection every 3 months, while Kyleena is placed once by a clinician and works for up to 5 years.

  • Depo-Provera carries a boxed warning for bone density loss with prolonged use; Kyleena has no such warning but carries insertion-related risks.

  • Depo-Provera works systemically throughout the body, while Kyleena releases hormone mainly within the uterus.

Depo-Provera vs. Kyleena Drug Summary

Depo-Provera

Depo-Provera is a progestin injection that prevents pregnancy for three months at a time. It's given by a healthcare provider in the arm or buttock, so there's no daily or weekly routine to manage.

Kyleena

Kyleena is a hormonal IUD placed inside the uterus by a clinician, preventing pregnancy for up to five years from a single insertion. It releases a low, steady dose of levonorgestrel that acts mostly locally.

Depo-Provera vs. Kyleena Side Effects

Depo-Provera

Most common
headache (up to 17%)
abdominal pain/discomfort (up to 11%)
nervousness (up to 11%)
dizziness (up to 6%)

Kyleena

Most common
vulvovaginitis (up to 24%)
ovarian cysts (up to 22%)
abdominal/pelvic pain (up to 21%)
headache/migraine (up to 15%)

Depo-Provera vs. Kyleena Dosage

Depo-Provera

Dosage
Dosage Table
STAGE DOSE WHEN
Starting dose 150 mg every 3 months At the start
Maximum dose 150 mg every 3 months Same as starting
Dose changes None Fixed dose

Kyleena

Dosage
Dosage Table
STAGE DOSE WHEN
Starting dose 19.5 mg IUS, one device At the start
Maximum dose 19.5 mg IUS, one device Same as starting
Dose changes None Fixed dose

Depo-Provera vs. Kyleena Indications

Depo-Provera

Depo-Provera is FDA-approved solely to prevent pregnancy, given as an injection every three months. It isn't recommended as a continuous method beyond two years unless other contraceptive options aren't suitable, due to its bone density warning.

  • Approved solely for pregnancy prevention

  • Given by injection every 3 months at a clinic

  • Not recommended for continuous use beyond 2 years without other options

  • Can be used while breastfeeding

Kyleena

Kyleena is FDA-approved to prevent pregnancy for up to five years after a single insertion by a clinician. It isn't approved for emergency contraception or for use before a person's first period.

  • Approved for pregnancy prevention for up to 5 years

  • Placed once by a clinician, no repeat dosing needed

  • Not approved for emergency contraception

  • Not intended for use before first menstrual period

Depo-Provera vs. Kyleena Pros and Cons

Depo-Provera

Depo-Provera works systemically as an injectable progestin, offering effective contraception without a device or daily routine. It's affordable per dose but requires a clinic visit every three months and carries a boxed warning for bone loss with extended use.

Pros

  • No daily or weekly routine to remember

  • Fully reversible with no procedure needed to start

  • Can be stopped anytime without a removal visit

  • Longstanding track record since 1992 approval

Cons

  • Requires a new injection every 3 months

  • Boxed warning for bone density loss with prolonged use

  • Weight gain reported in over a third of long-term users

  • Return to fertility can take several months after stopping

Kyleena

Kyleena works locally within the uterus as a low-dose hormonal IUD, offering years of contraception from a single procedure. It avoids the systemic bone-density warning tied to Depo-Provera but requires an insertion procedure with its own risks.

Pros

  • Single insertion lasts up to 5 years

  • Hormone acts mainly locally, lower systemic exposure

  • No boxed warning for bone density loss

  • No need for repeat clinic visits once placed

Cons

  • Requires an in-office insertion procedure

  • Small risk of uterine perforation during placement

  • Risk of pelvic inflammatory disease soon after insertion

  • Ectopic pregnancy risk increases if pregnancy occurs with device in place

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