Mirena vs. Skyla

See how Mirena and Skyla compare on approved uses, dosing, side effects, and cost.

Key Takeaways

  • Mirena and Skyla are both levonorgestrel-releasing IUDs that prevent pregnancy for years without daily dosing, but Mirena lasts up to 8 years while Skyla lasts up to 3.

  • Mirena is the only levonorgestrel IUD also approved to treat heavy menstrual bleeding, a use Skyla does not have.

  • Skyla is smaller and delivers a lower hormone dose, an option specifically studied in women who haven't had children.

Mirena vs. Skyla Drug Summary

Mirena

Mirena is a progestin-releasing intrauterine device that prevents pregnancy for up to 8 years and treats heavy menstrual bleeding for up to 5 years. It releases levonorgestrel directly in the uterus and is placed by a clinician in a single office visit.

Skyla

Skyla is a smaller, lower-dose levonorgestrel intrauterine device that prevents pregnancy for up to 3 years. It is placed by a clinician in a single office visit and was specifically studied in women who have not given birth.

Mirena vs. Skyla Side Effects

Mirena

Most common
abdominal/pelvic pain (up to 22.6%)
vulvovaginitis (up to 10.5%)
amenorrhea (up to 18.4%)
genital discharge (up to 14.9%)

Skyla

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

Mirena vs. Skyla Dosage

Mirena

Dosage
Dosage Table
STAGE DOSE WHEN
Starting dose ~21 mcg/day LNG release Day 24
Maximum dose ~7 mcg/day LNG release If needed
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

Mirena vs. Skyla Indications

Mirena

Mirena is FDA-approved to prevent pregnancy for up to 8 years and to treat heavy menstrual bleeding for up to 5 years in women who choose it for contraception. It releases levonorgestrel locally in the uterus, which limits hormone exposure elsewhere in the body.

  • Prevents pregnancy for up to 8 years

  • Treats heavy menstrual bleeding for up to 5 years

  • Placed once by a clinician, no daily dosing

  • No generic version currently available

Skyla

Skyla is FDA-approved to prevent pregnancy for up to 3 years and is not approved for any other use. Like Mirena, it releases levonorgestrel locally in the uterus once placed by a clinician.

  • Prevents pregnancy for up to 3 years

  • Not approved to treat heavy menstrual bleeding

  • Placed once by a clinician, no daily dosing

  • Studied specifically in women who haven't given birth

Mirena vs. Skyla Pros and Cons

Mirena

Mirena has the longest FDA-approved duration among levonorgestrel IUDs and is the only one also approved to treat heavy menstrual bleeding in women using it for contraception. It has been on the market since 2000, giving it a long track record with prescribers.

Pros

  • Longest approval duration among levonorgestrel IUDs, up to 8 years

  • Only hormonal IUD also approved to treat heavy menstrual bleeding

  • Progestin release gradually decreases over time

  • Long-established option with FDA approval since 2000

Cons

  • Larger frame may be less comfortable for first-time IUD users

  • No generic version available

  • Requires replacement after 8 years even if still used for birth control

  • Heavy bleeding treatment approval only covers the first 5 years

Skyla

Skyla is the smallest and lowest-dose hormonal IUD in its class, with insertion data specifically studied in women who have not given birth. Its shorter three-year approval suits people who want a lower commitment or a smaller device.

Pros

  • Smallest and lowest-dose levonorgestrel IUD, easier for some to insert

  • Insertion specifically studied in women who haven't given birth

  • Smaller frame may mean less discomfort during placement

  • Shorter 3-year duration suits those wanting a lower commitment

Cons

  • Must be replaced every 3 years, sooner than other levonorgestrel IUDs

  • Not approved to treat heavy menstrual bleeding

  • Lower hormone dose may mean less predictable bleeding changes

  • Not studied or approved for uses beyond contraception

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