Microgestin vs. Skyla
See how Microgestin and Skyla compare on approved uses, dosing, side effects, and cost.
Key Takeaways
Microgestin is a daily oral contraceptive pill, while Skyla is a hormonal IUD inserted once by a clinician and effective for up to three years.
Skyla's most common side effects, like vulvovaginitis and pelvic pain, occur far more often than Microgestin's headache and vaginal candidiasis, reflecting its localized hormone delivery.
Microgestin has a much lower monthly cost, but Skyla requires no daily routine once placed and avoids the risk of a missed pill.
Microgestin vs. Skyla Drug Summary
Microgestin
Microgestin is a combination oral contraceptive containing norethindrone acetate and ethinyl estradiol, with some packs adding iron supplement tablets. It is taken once daily to prevent pregnancy, using either a 21-day or 28-day pill pack.
Skyla
Skyla is a levonorgestrel-releasing intrauterine device inserted once by a clinician to prevent pregnancy for up to three years. It delivers a low, steady dose of progestin directly in the uterus and requires no daily action from the patient.
Microgestin vs. Skyla Side Effects
Microgestin
Skyla
Microgestin vs. Skyla Dosage
Microgestin
Skyla
| STAGE | DOSE | WHEN |
| Starting dose | 1 mg/20 mcg once daily | Days 1-21 |
| Maximum dose | 75 mg ferrous fumarate/day | Days 22-28 |
| Dose changes | 2 increases | Every 21 days |
| 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 |
Microgestin
| STAGE | DOSE | WHEN |
| Starting dose | 1 mg/20 mcg once daily | Days 1-21 |
| Maximum dose | 75 mg ferrous fumarate/day | Days 22-28 |
| Dose changes | 2 increases | Every 21 days |
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 |
Microgestin vs. Skyla Indications
Microgestin
Microgestin is FDA-approved solely for pregnancy prevention in women who choose an oral contraceptive. It does not protect against sexually transmitted infections, including HIV, so a barrier method is still needed for that protection.
Daily pill taken around the same time each day
Available in 21-day and 28-day (Fe) pack options
Combines a progestin and estrogen hormone daily
Does not protect against STIs, including HIV
Skyla
Skyla is FDA-approved for pregnancy prevention for up to three years after a single insertion. It is not approved for emergency contraception, use before a first period, or in women over 65, and it does not protect against STIs.
Single insertion, effective for up to 3 years
Requires a clinician for placement and removal
Releases progestin locally within the uterus
Does not protect against STIs, including HIV
Microgestin vs. Skyla Pros and Cons
Microgestin
Microgestin has decades of real-world use dating back to 1968, with predictable daily dosing and a low monthly cost. It requires remembering a daily pill and carries systemic hormone risks, including clotting concerns in some users.
Pros
Decades of real-world safety data since 1968
Roughly $20 to $50 per month without insurance
Can be stopped immediately if side effects occur
No procedure or clinician visit needed to start
Cons
Requires taking a pill at the same time daily
Systemic hormones raise clotting and stroke risk
Not recommended for smokers over age 35
Effectiveness depends on consistent daily use
Skyla
Skyla provides long-acting, low-maintenance contraception from a single insertion lasting up to three years. It requires a clinical procedure to place and remove, has a large upfront cost, and carries small risks of perforation or expulsion.
Pros
No daily action needed once device is placed
Effective for up to three years per insertion
Localized hormone dose limits systemic exposure
Studied specifically in women who haven't given birth
Cons
Requires an in-office insertion and removal visit
Roughly $1,028 to $1,329 upfront before insurance
Small risk of uterine perforation or expulsion
Higher rates of pelvic pain and acne than pills
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