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
Skyla
Mirena vs. Skyla Dosage
Mirena
Skyla
| 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 |
| 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
| 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
| 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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