NuvaRing vs. Skyla
See how NuvaRing and Skyla compare on approved uses, dosing, side effects, and cost.
Key Takeaways
NuvaRing is a monthly vaginal ring combining estrogen and progestin, while Skyla is a progestin-only IUD placed once and left in for up to three years.
NuvaRing requires the user to insert and remove the ring on a monthly schedule, while Skyla only needs a single clinical insertion and removal appointment.
Both methods prevent pregnancy but do not protect against HIV or other sexually transmitted infections, and neither is approved for emergency contraception.
NuvaRing vs. Skyla Drug Summary
NuvaRing
NuvaRing is a combination hormonal vaginal ring containing etonogestrel and ethinyl estradiol, used to prevent pregnancy. It stays in place for three weeks, is removed for a ring-free week, then replaced with a new ring each cycle.
Skyla
Skyla is a small, low-dose levonorgestrel-releasing intrauterine device that prevents pregnancy for up to three years. A clinician inserts it once, and it works continuously inside the uterus until removal or expiration.
NuvaRing vs. Skyla Side Effects
NuvaRing
Skyla
NuvaRing vs. Skyla Dosage
NuvaRing
Skyla
| STAGE | DOSE | WHEN |
| Starting dose | 1 ring vaginally | Weeks 1-3 |
| Maximum dose | ring-free interval | Week 4 |
| Dose changes | 1 increase | Every 3 weeks |
| 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 |
NuvaRing
| STAGE | DOSE | WHEN |
| Starting dose | 1 ring vaginally | Weeks 1-3 |
| Maximum dose | ring-free interval | Week 4 |
| Dose changes | 1 increase | Every 3 weeks |
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 |
NuvaRing vs. Skyla Indications
NuvaRing
NuvaRing is FDA approved solely for pregnancy prevention in women who choose a monthly, self-inserted contraceptive method. Because it combines estrogen and progestin, it isn't appropriate for women with certain cardiovascular risks, including smokers over 35.
Inserted vaginally once a month
Worn continuously for three weeks, removed for one
Requires remembering insertion and removal dates
Not approved for emergency contraception
Not recommended for women over 35 who smoke
Skyla
Skyla is FDA approved for pregnancy prevention for up to three years, including in women who have never been pregnant. As a progestin-only IUD, it avoids estrogen-related risks but requires an in-office insertion and removal.
Single insertion by a clinician
Effective for up to 3 years
Studied in women who have never been pregnant
Not approved for emergency contraception
Requires a provider for removal
NuvaRing vs. Skyla Pros and Cons
NuvaRing
NuvaRing offers a user-controlled option that doesn't require a clinical procedure to start or stop, but it carries the same estrogen-related clotting risks as other combined hormonal contraceptives. Insurance coverage varies, and generic versions can lower the out-of-pocket cost.
Pros
Can be removed or restarted without a doctor visit
No insertion procedure needed
Regulates cycle with predictable withdrawal bleeding
Generic versions available
Cons
Requires monthly ring changes and tracking
Not appropriate for women over 35 who smoke
Carries estrogen-related blood clot risk
Skyla
Skyla provides long-acting, low-maintenance protection without estrogen, making it an option for women who can't use combined hormonal contraceptives. It requires a clinician for insertion and removal, and the higher upfront cost is spread over three years of use.
Pros
Set-and-forget protection for up to three years
No estrogen, suitable for those avoiding combined hormones
Studied specifically in women without prior pregnancies
One-time cost of roughly $1,028 to $1,329 covers three years, less than NuvaRing over that time
Cons
Requires a clinical procedure for insertion and removal
Rare risks include uterine perforation and ectopic pregnancy
Shortest approved duration among current hormonal IUDs
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