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

Most common
vaginitis (up to 13.8%)
mood changes (up to 6.4%)
device-related events (up to 6.3%)
nausea/vomiting (up to 5.9%)

Skyla

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

NuvaRing vs. Skyla Dosage

NuvaRing

Dosage
Dosage Table
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

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

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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