Lo Loestrin Fe vs. Skyla

See how Lo Loestrin Fe and Skyla compare on approved uses, dosing, side effects, and cost.

Key Takeaways

  • Lo Loestrin Fe is a daily pill with the lowest estrogen dose of any FDA-approved oral contraceptive, while Skyla is a hormonal IUD placed once and left in for up to three years.

  • Lo Loestrin Fe requires remembering a pill every day, whereas Skyla works continuously after a single in-office insertion.

  • Both prevent pregnancy but neither protects against HIV or other sexually transmitted infections.

Lo Loestrin Fe vs. Skyla Drug Summary

Lo Loestrin Fe

Lo Loestrin Fe is a combination oral contraceptive containing norethindrone acetate, ethinyl estradiol, and iron, taken once daily in a 28-day pack. It has the lowest estrogen dose of any FDA-approved birth control pill. It's approved to prevent pregnancy and is sometimes used off-label to manage acne or hormonal symptoms.

Skyla

Skyla is a levonorgestrel-releasing intrauterine device inserted by a clinician into the uterus to prevent pregnancy for up to three years. It's a small, low-dose hormonal IUD studied specifically in women who haven't given birth. After insertion, it requires no daily action from the patient.

Lo Loestrin Fe vs. Skyla Side Effects

Lo Loestrin Fe

Most common
nausea/vomiting (up to 7%)
headache (up to 7%)
bleeding irregularities (up to 5%)
dysmenorrhea (up to 4%)

Skyla

Most common
vulvovaginitis (up to 20%)
abdominal/pelvic pain (up to 19%)
acne/seborrhea (up to 15%)
ovarian cyst (up to 13%)

Lo Loestrin Fe vs. Skyla Dosage

Lo Loestrin Fe

Dosage
Dosage Table
STAGE DOSE WHEN
Starting dose 1 mg/10 mcg once daily Days 1-24
Maximum dose Ferrous fumarate 75mg daily Days 27-28
Dose changes 2 increases As tolerated

Skyla

Dosage
Dosage Table
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

Lo Loestrin Fe vs. Skyla Indications

Lo Loestrin Fe

Lo Loestrin Fe is FDA-approved to prevent pregnancy in women who choose an oral contraceptive. Some clinicians prescribe it off-label to help manage acne or other hormone-related symptoms. It does not protect against HIV or other sexually transmitted infections.

  • Prevents pregnancy with daily pill use

  • Off-label: may help manage acne

  • Off-label: may ease hormonal symptoms

  • Does not protect against STIs

Skyla

Skyla is FDA-approved to prevent pregnancy for up to three years after a single insertion. It was specifically studied in women who have not given birth, unlike some other hormonal IUDs. It does not protect against HIV or other sexually transmitted infections.

  • Prevents pregnancy for up to 3 years

  • Studied specifically in nulliparous women

  • One-time insertion, no daily action needed

  • Does not protect against STIs

Lo Loestrin Fe vs. Skyla Pros and Cons

Lo Loestrin Fe

Lo Loestrin Fe offers the lowest estrogen dose among approved birth control pills, which may reduce estrogen-related side effects for some users. As a daily pill, it depends on consistent use and carries a boxed warning about smoking and cardiovascular risk. Coverage and cost can vary widely depending on insurance.

Pros

  • Lowest estrogen dose of any approved pill

  • Can be stopped at any time without a procedure

  • May help manage acne or hormonal symptoms (off-label)

  • No insertion procedure required

Cons

  • Must be taken at the same time every day

  • Boxed warning for smokers over 35

  • Risk of blood clots, stroke, and heart attack

  • Effectiveness depends on user adherence

Skyla

Skyla provides continuous pregnancy prevention for up to three years after a single insertion, removing the need to remember a daily pill. It carries procedural risks like perforation and expulsion, and insertion can cause cramping or pain. It's a smaller, lower-dose IUD, which may suit those seeking less hormone exposure but a shorter duration than other IUDs.

Pros

  • No daily action needed for up to 3 years

  • Smallest and lowest-dose hormonal IUD available

  • Studied specifically in women without prior births

  • Fertility returns quickly after removal

Cons

  • Requires a clinician for insertion and removal

  • Risk of uterine perforation or device expulsion

  • Shortest approved duration among levonorgestrel IUDs

  • Higher rates of pelvic pain and vulvovaginitis reported

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