Yaz vs. Mirena

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

Key Takeaways

  • Yaz is a daily pill that also treats PMDD and moderate acne, while Mirena is a long-acting IUD placed once by a clinician and left in for years.

  • Mirena's most common side effect is irregular uterine bleeding, while Yaz's most common side effect is headache.

  • Yaz carries a boxed warning about cardiovascular risk in smokers over 35 because it contains estrogen, while Mirena is progestin-only but requires an insertion procedure.

Yaz vs. Mirena Drug Summary

Yaz

Yaz is a combination oral contraceptive containing drospirenone and ethinyl estradiol, taken once daily to prevent pregnancy. It is also FDA-approved to treat premenstrual dysphoric disorder and moderate acne in women who want an oral contraceptive.

Mirena

Mirena is a progestin-releasing intrauterine system placed by a clinician to prevent pregnancy for up to 8 years. It is also approved to treat heavy menstrual bleeding for up to 5 years in women who choose it for contraception.

Yaz vs. Mirena Side Effects

Yaz

Most common
Headache/migraine (up to 6.7%)
Menstrual irregularities (up to 4.7%)
Nausea/vomiting (up to 4.2%)
Breast pain/tenderness (up to 4.0%)

Mirena

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

Yaz vs. Mirena Dosage

Yaz

Dosage
Dosage Table
STAGE DOSE WHEN
Starting dose 3 mg/0.02 mg once daily Days 1-24
Maximum dose inert tablet once daily Days 25-28
Dose changes 1 increase Every 24 days

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

Yaz vs. Mirena Indications

Yaz

Yaz prevents pregnancy when taken correctly every day and is also approved to ease the mood and physical symptoms of PMDD. It carries a separate approval for treating moderate acne in women 14 and older who also want oral birth control.

  • Prevent pregnancy

  • Treat premenstrual dysphoric disorder (PMDD)

  • Treat moderate acne vulgaris in women 14 and older

  • Not approved for use during pregnancy

Mirena

Mirena prevents pregnancy for up to 8 years after a single placement, with no daily or weekly action needed. It is also approved to treat heavy menstrual bleeding for up to 5 years in women using it for contraception.

  • Prevent pregnancy for up to 8 years

  • Treat heavy menstrual bleeding for up to 5 years

  • Placed once by a clinician, no daily dosing

  • Not approved for emergency contraception

Yaz vs. Mirena Pros and Cons

Yaz

Yaz gives women daily control over their contraception and doubles as treatment for PMDD and acne, appealing to those who want more than pregnancy prevention. Because it contains estrogen, it carries a boxed warning about smoking-related cardiovascular risk and is not suitable for women with certain kidney, liver, or adrenal conditions.

Pros

  • Also treats PMDD and moderate acne

  • Effects reversible immediately after stopping

  • No insertion procedure required

  • Can be started or stopped independently

Cons

  • Requires remembering a daily pill

  • Estrogen raises risk of blood clots and stroke

  • Not safe for smokers over 35

  • Contraindicated with kidney, liver, or adrenal disease

Mirena

Mirena offers years of pregnancy prevention without daily effort and can also reduce heavy menstrual bleeding, appealing to women who prefer a set-it-and-forget-it option. Because it is progestin-only and placed directly in the uterus, it avoids estrogen-related clotting risks but requires a clinical procedure for insertion and removal.

Pros

  • Lasts up to 8 years with no daily action

  • Also treats heavy menstrual bleeding

  • Progestin-only, avoids estrogen-related clot risk

  • Highly effective with minimal user error

Cons

  • Requires clinician insertion and removal

  • Risk of uterine perforation or device expulsion

  • Irregular bleeding common in first months

  • Not approved for emergency contraception

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