Skyla vs. Kyleena

See how Skyla and Kyleena compare on approved uses, dosing, side effects, and cost.

Key Takeaways

  • Skyla and Kyleena are both levonorgestrel-releasing IUDs, but Skyla is approved for up to 3 years while Kyleena is approved for up to 5 years.

  • Skyla is the only levonorgestrel IUD with FDA efficacy data specifically studied in a large number of nulliparous women.

  • Kyleena delivers a higher hormone dose than Skyla, which lines up with somewhat higher reported rates of vulvovaginitis and ovarian cysts.

Skyla vs. Kyleena Drug Summary

Skyla

Skyla is a progestin-only intrauterine device that releases a low dose of levonorgestrel to prevent pregnancy for up to 3 years. It is placed once by a clinician and needs no daily attention afterward.

Kyleena

Kyleena is a progestin-only intrauterine device that releases levonorgestrel to prevent pregnancy for up to 5 years. Like Skyla, it is inserted once by a clinician and requires no daily maintenance.

Skyla vs. Kyleena Side Effects

Skyla

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

Kyleena

Most common
vulvovaginitis (up to 24%)
abdominal/pelvic pain (up to 21%)
ovarian cysts (up to 22%)
headache/migraine (up to 15%)

Skyla vs. Kyleena Dosage

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

Kyleena

Dosage
Dosage Table
STAGE DOSE WHEN
Starting dose 19.5 mg IUS, one device At the start
Maximum dose 19.5 mg IUS, one device Same as starting
Dose changes None Fixed dose

Skyla vs. Kyleena Indications

Skyla

Skyla is FDA-approved to prevent pregnancy for up to 3 years and is the levonorgestrel IUD with efficacy data specifically studied in nulliparous women. It is not approved for emergency contraception or for use before a first period.

  • Prevents pregnancy for up to 3 years

  • FDA efficacy data include nulliparous women

  • Not for emergency contraception

  • Not for use before menarche

Kyleena

Kyleena is FDA-approved to prevent pregnancy for up to 5 years, the longest duration among low-dose hormonal IUDs. It is not approved for emergency contraception or for use before a first period.

  • Prevents pregnancy for up to 5 years

  • Lowest hormone dose among Bayer's levonorgestrel IUDs

  • Not for emergency contraception

  • Not for use before menarche

Skyla vs. Kyleena Pros and Cons

Skyla

Skyla's smaller frame and lower hormone dose make it a common choice for younger or nulliparous patients, and it is the only levonorgestrel IUD with FDA efficacy data specifically studied in that group. Its tradeoff is a shorter approved lifespan than Kyleena.

Pros

  • FDA efficacy data specifically include nulliparous women

  • Smallest frame and lowest hormone dose among current levonorgestrel IUDs

  • Longest real-world track record, approved since 2013

  • May cause fewer hormone-related side effects due to lower dose

Cons

  • Shortest approved duration among current levonorgestrel IUDs, at 3 years

  • Needs replacement sooner than Kyleena for those wanting longer coverage

  • Lower hormone dose may mean less reduction in menstrual bleeding

Kyleena

Kyleena's higher hormone dose and 5-year duration make it a good option for patients wanting fewer replacements over time, though it was not specifically studied in nulliparous women at approval. Its reported rates of common reactions like vulvovaginitis and ovarian cysts run somewhat higher than Skyla's.

Pros

  • Longest duration among low-dose hormonal IUDs, up to 5 years

  • Fewer replacement procedures needed over a 5-year span

  • Higher hormone dose than Skyla, which may more effectively lighten periods

  • Newer design with a smaller frame than older levonorgestrel IUDs like Mirena

Cons

  • Not specifically studied in nulliparous women at FDA approval, unlike Skyla

  • Higher reported rates of vulvovaginitis, ovarian cysts, and headache than Skyla

  • Higher hormone dose than Skyla, which may increase hormone-related side effects

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