Ortho Tri-Cyclen vs. Skyla

See how Ortho Tri-Cyclen and Skyla compare on approved uses, dosing, side effects, and cost.

Key Takeaways

  • Ortho Tri-Cyclen is a daily pill that also treats moderate acne, while Skyla is a set-and-forget IUD approved only for pregnancy prevention.

  • Skyla is inserted once and works for up to 3 years, removing the risk of missed doses that comes with a daily pill like Ortho Tri-Cyclen.

  • Ortho Tri-Cyclen carries estrogen-related clot risks, while Skyla's progestin-only design avoids that concern but needs an in-office insertion and removal.

Ortho Tri-Cyclen vs. Skyla Drug Summary

Ortho Tri-Cyclen

Ortho Tri-Cyclen is a triphasic combination oral contraceptive containing norgestimate and ethinyl estradiol. It is FDA-approved to prevent pregnancy and to treat moderate acne in females 15 and older, taken as one tablet daily in a 28-day pack with 21 active pills and 7 placebo pills.

Skyla

Skyla is a levonorgestrel-releasing intrauterine device, a progestin-only method placed in the uterus by a clinician. One insertion prevents pregnancy for up to 3 years and requires no daily action from the user.

Ortho Tri-Cyclen vs. Skyla Side Effects

Ortho Tri-Cyclen

Most common
headache (up to 14%)
breast tenderness (up to 10%)
vaginal infection (up to 8%)
abdominal pain (up to 7%)

Skyla

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

Ortho Tri-Cyclen vs. Skyla Dosage

Ortho Tri-Cyclen

Dosage
Dosage Table
STAGE DOSE WHEN
Starting dose 0.180 mg/0.035 mg daily Days 1-7
Maximum dose Placebo tablet daily Days 22-28
Dose changes 3 increases Every 7 days

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

Ortho Tri-Cyclen vs. Skyla Indications

Ortho Tri-Cyclen

Ortho Tri-Cyclen is approved to prevent pregnancy and to treat moderate acne in females who also want oral contraception. It combines an estrogen and a progestin that work together to stop ovulation and thicken cervical mucus.

  • Prevention of pregnancy

  • Treatment of moderate acne vulgaris in females 15+

  • Not approved for women over 35 who smoke

  • Not approved as emergency contraception

Skyla

Skyla is approved only to prevent pregnancy, with effectiveness lasting up to 3 years after a single insertion. It releases a low, steady dose of levonorgestrel directly into the uterus.

  • Prevention of pregnancy for up to 3 years

  • Not approved for use before menarche

  • Not approved as emergency contraception

  • Not approved for women over 65

Ortho Tri-Cyclen vs. Skyla Pros and Cons

Ortho Tri-Cyclen

Ortho Tri-Cyclen offers the added benefit of treating moderate acne alongside contraception, but it requires daily adherence and carries estrogen-related cardiovascular risks. Generic versions are widely available and inexpensive.

Pros

  • Also treats moderate acne

  • Can be started or stopped without a procedure

  • Low-cost generics widely available (roughly $10 to $25 a month)

  • Hormone dose can be adjusted by switching formulations

Cons

  • Requires taking a pill at the same time every day

  • Not safe for women over 35 who smoke

  • Carries estrogen-related clot and cardiovascular risks

  • Effectiveness drops sharply with missed doses

Skyla

Skyla removes the burden of daily dosing since one insertion protects against pregnancy for up to 3 years. It has a much higher upfront cost and needs a clinician for insertion and removal, but its progestin-only formula avoids estrogen-related risks.

Pros

  • No daily dosing to remember

  • Effective for up to 3 years per insertion

  • Avoids estrogen-related clot and cardiovascular risks

  • Studied specifically in nulliparous women at approval

Cons

  • Requires an in-office insertion and removal procedure

  • High one-time device cost (roughly $1,028 to $1,329)

  • Small risk of uterine perforation or expulsion

  • Does not treat acne or other skin conditions

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