Sprintec vs. Mirena

See how Sprintec and Mirena compare on approved uses, dosing, side effects, and cost.

Key Takeaways

  • Sprintec is a pill you take every day, while Mirena is a device a clinician inserts once and that keeps working for years.

  • Both can cause headaches and genital discharge, but Sprintec's top side effect is headache/migraine while Mirena's is irregular bleeding.

  • Mirena is also approved to treat heavy menstrual bleeding, while Sprintec's off-label use is treating moderate acne.

Sprintec vs. Mirena Drug Summary

Sprintec

Sprintec is a combination oral contraceptive containing norgestimate and ethinyl estradiol, taken once daily to prevent pregnancy. It is also used off-label to treat moderate acne in women 15 and older. Each 28-day pack contains 21 active tablets followed by 7 inert ones.

Mirena

Mirena is a hormonal intrauterine device that releases levonorgestrel to prevent pregnancy for up to 8 years. It is also FDA-approved to treat heavy menstrual bleeding for up to 5 years in women using it for contraception. A clinician places and removes the T-shaped device during a brief office visit.

Sprintec vs. Mirena Side Effects

Sprintec

Most common
Headache/migraine (up to 32.9%)
Vaginal infection (up to 8.4%)
Abdominal/gastrointestinal pain (up to 7.8%)
Genital discharge (up to 6.8%)

Mirena

Most common
Unscheduled (irregular) uterine bleeding (up to 31.9%)
Abdominal/pelvic pain (up to 22.6%)
Amenorrhea (up to 18.4%)
Headache/migraine (up to 16.3%)

Sprintec vs. Mirena Dosage

Sprintec

Dosage
Dosage Table
STAGE DOSE WHEN
Starting dose 1 tablet once daily Days 1-28
Maximum dose 1 tablet once daily Same as starting
Dose changes None Fixed dose

Mirena

Dosage
Dosage Table
STAGE DOSE WHEN
Starting dose ~21 mcg/day LNG release Day 24
Maximum dose ~7 mcg/day LNG release If needed
Dose changes 2 increases As tolerated

Sprintec vs. Mirena Indications

Sprintec

Sprintec is FDA-approved to prevent pregnancy in females of reproductive potential when taken correctly every day. It is also prescribed off-label to treat moderate acne in females 15 and older who have no contraindications to hormonal contraceptives. It is not approved for emergency contraception.

  • Prevents pregnancy when taken daily

  • Off-label treatment for moderate acne (ages 15+)

  • Requires no procedure, taken at home

  • Can be stopped at any time

Mirena

Mirena is FDA-approved to prevent pregnancy for up to 8 years and to treat heavy menstrual bleeding for up to 5 years in women choosing intrauterine contraception. It is not approved for use as emergency contraception. A clinician must place and later remove the device.

  • Prevents pregnancy for up to 8 years

  • Treats heavy menstrual bleeding for up to 5 years

  • Placed and removed by a clinician

  • No daily attention needed once placed

Sprintec vs. Mirena Pros and Cons

Sprintec

Sprintec is a low-cost daily pill with a long safety track record and the added benefit of treating acne. It requires consistent daily use and carries the cardiovascular risks common to estrogen-containing contraceptives, especially in smokers over 35.

Pros

  • Also treats moderate acne (FDA-approved use)

  • Can be stopped anytime without a clinician visit

  • No insertion procedure or pelvic exam needed

  • Roughly $20 to $65 per month without insurance, far less than Mirena's upfront device cost

Cons

  • Requires daily adherence; missed pills raise pregnancy risk

  • Contraindicated in women over 35 who smoke

  • Carries added risk of blood clots, heart attack, and stroke

  • Does not treat heavy menstrual bleeding

Mirena

Mirena offers years of pregnancy prevention without daily effort and is the only hormonal IUD also approved to treat heavy menstrual bleeding. It requires a clinical procedure for placement and removal and carries a much higher upfront cost than a daily pill.

Pros

  • Lasts up to 8 years without daily attention

  • Also treats heavy menstrual bleeding for up to 5 years

  • Contains no estrogen

  • Nothing to remember once it's placed

Cons

  • Requires an in-office insertion and removal procedure

  • One-time device cost of roughly $900 to $1,725 before insurance, more than a year of Sprintec

  • Small risk of uterine perforation or expulsion

  • Irregular bleeding is common in the first months

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