Nexplanon vs. Skyla
See how Nexplanon and Skyla compare on approved uses, dosing, side effects, and cost.
Key Takeaways
Nexplanon is a matchstick-sized arm implant and Skyla is a small T-shaped device placed in the uterus, and both prevent pregnancy for up to 3 years.
Nexplanon is inserted under the skin of the upper arm in a brief office procedure, while Skyla requires a pelvic exam and cervical insertion.
Both can cause irregular bleeding and acne, but Skyla carries added IUD-specific risks like perforation and expulsion that Nexplanon does not.
Nexplanon vs. Skyla Drug Summary
Nexplanon
Nexplanon is a progestin-only contraceptive implant containing etonogestrel, used to prevent pregnancy for up to 3 years. It is a single flexible rod inserted just under the skin of the upper arm during a short in-office procedure. Once placed, it requires no daily, weekly, or monthly action from the patient.
Skyla
Skyla is a levonorgestrel-releasing intrauterine system (IUS), a small T-shaped device placed inside the uterus to prevent pregnancy for up to 3 years. A clinician inserts it in a single office visit through the cervix. It is the lowest-dose hormonal IUD currently marketed and was specifically studied in women who have not given birth.
Nexplanon vs. Skyla Side Effects
Nexplanon
Skyla
Nexplanon vs. Skyla Dosage
Nexplanon
Skyla
| STAGE | DOSE | WHEN |
| Starting dose | 1 implant, 68 mg subdermal | Day 1 |
| Maximum dose | 1 implant, 68 mg subdermal | 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 |
Nexplanon
| STAGE | DOSE | WHEN |
| Starting dose | 1 implant, 68 mg subdermal | Day 1 |
| Maximum dose | 1 implant, 68 mg subdermal | 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 |
Nexplanon vs. Skyla Indications
Nexplanon
Nexplanon is FDA-approved for long-acting reversible contraception. A single rod is placed under the skin of the upper arm and works continuously for up to 3 years without any action needed from the patient.
Prevents pregnancy for up to 3 years
Single-rod implant placed in the upper arm
No daily, weekly, or monthly dosing
Reversible by removal at any time
Skyla
Skyla is FDA-approved to prevent pregnancy for up to 3 years using a small intrauterine device that releases levonorgestrel locally. It is placed once by a clinician and does not require any ongoing action from the patient afterward.
Prevents pregnancy for up to 3 years
T-shaped device placed inside the uterus
No daily, weekly, or monthly dosing
Reversible by removal at any time
Nexplanon vs. Skyla Pros and Cons
Nexplanon
Nexplanon avoids any pelvic procedure, since it is placed and removed through a small incision in the arm. Its radiopaque design lets clinicians locate it on imaging if it becomes difficult to find, and it carries no risk of uterine perforation.
Pros
Insertion and removal done through the arm, not the pelvis
Radiopaque rod can be located by X-ray if needed
No risk of uterine perforation or expulsion
Cons
Can be felt or seen as a small bump under the skin
Contraindicated in people with a history of blood clots
Menstrual bleeding changes are the leading cause of discontinuation
Skyla
Skyla delivers a lower, more localized dose of hormone directly in the uterus rather than systemically through the skin. It carries IUD-specific risks like perforation and expulsion that an arm implant does not, and insertion requires a pelvic exam rather than a simple arm procedure.
Pros
Lowest hormone dose among levonorgestrel IUDs
Hormone acts locally in the uterus rather than throughout the body
Specifically studied for safety and fit in women who have not given birth
Cons
Insertion requires a pelvic exam and cervical procedure
Carries a risk of uterine perforation and device expulsion
Increases risk of ectopic pregnancy if pregnancy occurs with device in place
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