Depo-Provera vs. Skyla
See how Depo-Provera and Skyla compare on approved uses, dosing, side effects, and cost.
Key Takeaways
Depo-Provera is a progestin injection given every 3 months, while Skyla is a small hormonal IUD placed once and left in place for up to 3 years.
Depo-Provera carries a boxed warning for bone density loss with prolonged use, a risk that Skyla does not share.
Skyla requires a clinician insertion and removal procedure, while Depo-Provera only needs a quick injection at each visit.
Depo-Provera vs. Skyla Drug Summary
Depo-Provera
Depo-Provera is a progestin injection that prevents pregnancy by suppressing ovulation. It is given by a healthcare provider once every 3 months, either into a muscle or under the skin. It has been available since 1992 and is one of the longest-used hormonal contraceptives on the market.
Skyla
Skyla is a small, T-shaped intrauterine device that releases a low, steady dose of the progestin levonorgestrel directly into the uterus. It is placed once by a clinician and can prevent pregnancy for up to 3 years. Skyla was approved in 2013 and delivers the lowest hormone dose among currently marketed levonorgestrel IUDs.
Depo-Provera vs. Skyla Side Effects
Depo-Provera
Skyla
Depo-Provera vs. Skyla Dosage
Depo-Provera
Skyla
| 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 |
| STAGE | DOSE | WHEN |
| Starting dose | 13.5 mg IUS, one insertion | At the start |
| Maximum dose | 13.5 mg IUS, one insertion | Same as starting |
| Dose changes | None | Fixed dose |
Depo-Provera
| 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 |
Skyla
| STAGE | DOSE | WHEN |
| Starting dose | 13.5 mg IUS, one insertion | At the start |
| Maximum dose | 13.5 mg IUS, one insertion | Same as starting |
| Dose changes | None | Fixed dose |
Depo-Provera vs. Skyla Indications
Depo-Provera
Depo-Provera is FDA-approved solely to prevent pregnancy. It works by delivering a steady dose of progestin every 3 months, which suits people who want effective birth control without a daily routine. It is not intended for continuous use beyond 2 years unless other methods are inadequate, due to bone density concerns.
Prevents pregnancy with an injection every 3 months
No daily pill or ongoing device to manage
Not recommended for continuous use over 2 years without reassessment
Not approved for use before the first menstrual period
Skyla
Skyla is FDA-approved to prevent pregnancy for up to 3 years after a single insertion. It delivers a low, steady dose of levonorgestrel directly to the uterus and is approved for women who have and have not been pregnant. It is not approved for emergency contraception or for use before the first period.
Prevents pregnancy for up to 3 years per insertion
Approved for both nulliparous and parous women
Not approved for emergency contraception
Not approved for use before the first menstrual period
Depo-Provera vs. Skyla Pros and Cons
Depo-Provera
Depo-Provera offers effective contraception without a device or procedure, which appeals to people who want to avoid insertion or removal. Its main tradeoff is the boxed warning for bone mineral density loss with prolonged use, plus a return to fertility that can take several months after stopping. Cost is spread across quarterly visits rather than paid upfront.
Pros
No insertion or removal procedure required
Can be discontinued at any time without a clinical procedure
Cost is spread out over quarterly injections rather than one lump sum
Available as a subcutaneous option (Depo-SubQ Provera 104)
Cons
Boxed warning for bone mineral density loss with prolonged use
Requires a clinic visit every 3 months to stay protected
Fertility may take several months to return after stopping
Weight gain and irregular bleeding are common early on
Skyla
Skyla provides long-acting contraception from a single insertion, with no ongoing visits needed for up to 3 years. Its tradeoffs are the insertion and removal procedures themselves, plus rare but serious risks like uterine perforation or ectopic pregnancy if the device fails. The device requires one large upfront payment rather than smaller recurring costs.
Pros
Effective for up to 3 years from one insertion
No repeat dosing or clinic visits needed once placed
Effectiveness does not depend on remembering routine care
Fertility returns immediately once the device is removed
Cons
Requires a clinician procedure for both insertion and removal
Small risk of uterine perforation or device displacement
Requires one large upfront payment rather than smaller recurring costs
Ectopic pregnancy risk if pregnancy occurs with device in place
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