Dear Alice,

I just read about Skyla. Tell me more! Who is the best candidate for it? How does it differ from the other two options on the market (ParaGard and Mirena)? If I have had sensitivities to hormonal birth control ("the pill") in the past, would this be a good option for me to explore?

Thanks, Alice!

Sincerely,

Looking for New Birth Control Options

Dear Looking for New Birth Control Options,

Choices are great, aren’t they? Since there’s no one-size-fits-all birth control (BC) method, the arrival of the newest intrauterine device (IUD) on the market is exciting news for those who wish to prevent pregnancy! Skyla was approved by the U.S. Food and Drug Administration (FDA) and made available by prescription in February 2013. To your question, it was designed with a particular user in mind: Skyla, by design, was made with folks who have not yet had children (though it can also be used by someone who has given birth previously). It’s slightly smaller and has a narrower insertion tube that aids in the placement of the device into the uterus of a younger person or a person who hasn’t had a child. Beyond the specific design, other differences between Skyla and other IUDs are in how they protect against pregnancy (hormonal or non-hormonal) and for how long they can prevent pregnancy (more on this later). It’s possible that this method may be suitable for you, given your previous sensitivities to hormonal birth control, but getting some advice from a medical professional will help you know for sure. That said, keep reading for more on this pregnancy prevention option!

Starting with the similarities to other IUDs, Skyla is a small, T-shaped device that is inserted into the uterus by a health care provider (takes a couple of minutes). Studies have found that it’s about 99 percent effective in preventing pregnancy — boasting a similarly high effectiveness rate as other IUDs. Fertility and the ability to conceive typically returns quickly after removal, which can occur at the end of three years or sooner if desired. It’s also good to keep in mind that, just as with other IUDs, it doesn't reduce the risk of sexually transmitted infections (STIs) — so the use of barrier methods (e.g., condoms) are recommended and can help reduce the risk of STI transmission between partners. Similar to Mirena, but unlike ParaGard (a non-hormonal copper IUD), Skyla releases a progestin hormone called levonorgestrel, which has been shown to thicken cervical mucus and block sperm. It’s a slightly lower-dose than Mirena and remains effective for a shorter amount of time (compared to Mirena at five years and ParaGard at ten). Since Skyla releases levonorgestrel into the uterus, it's milder than other hormonal birth control methods that release hormones into the blood stream, which may be of interest to those who’ve experienced undesirable side effects from hormonal BC methods in the past.

Sound good so far? Well, there are also some potential side effects that it might be helpful to know about as you consider this option. Common side effects include pain, bleeding or dizziness during and up to 30 minutes after placement, and expulsion (where the IUD comes out by itself). Some users experience spotting or bleeding between periods, cysts on the ovary which may (or may not) disappear on their own, and missing menstrual periods (often users experience lighter and shorter periods after the first six months of use). This IUD may not be appropriate for some people particularly if for those prone to pelvic infections, unexplained vaginal bleeding, have liver disease or a liver tumor, uterine, cervical, or breast cancer, or any cancer that is sensitive to progestin.

It’s always wise to learn about any option in the contraceptive marketplace. There’s a lot to consider and plenty of methods from which to choose. If you want to learn more about IUDs and the plethora of other contraceptive methods, check out some related Q&As in the Contraception category in the Go Ask Alice! archives. After you’ve done your homework on what options interest you, a good next step is to make an appointment with a health promotion specialist to review your list and then your health care provider. You can chat about your top choices while taking your personal health and lifestyle into consideration to determine the best BC fit for you.

Alice!

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