12 Kyleena IUD Side Effects You Should Know About

The Kyleena (levonorgestrel) intrauterine device (IUD) is a very effective, long-acting form of hormonal birth control. Compared to the Mirena IUD, it’s smaller and contains a lower amount of hormones. Kyleena’s pregnancy protection lasts for up to 5 years.

If you’re considering your birth control options, Kyleena might be a good fit. But you should know about possible side effects before you make your decision. Some Kyleena side effects may go away over time, while others can be more serious.

Let’s review the 12 side effects that you should know.

1. Vaginitis

Almost 1 out of every 4 women using Kyleena reported vaginitis during clinical trials. Vaginitis is inflammation or infection of the vagina. And it can happen when the balance of microbes (e.g., bacteria, yeast) in the vagina changes.

You may not experience any vaginitis symptoms. But if you do, they commonly include vaginal itching, abnormal discharge, and/or an unpleasant smell. Let your healthcare provider know if these symptoms develop while Kyleena is in place.

In some cases, vaginitis goes away on its own. But this can depend on what’s causing it — some situations may need treatment. And it may not be worth waiting it out, especially if your symptoms are bothersome. Your healthcare provider can help you find out if treatment is needed. This may include oral or topical medications.

2. Ovarian cysts

Ovarian cysts are another common Kyleena side effect. Sometimes, these cysts are painful, causing pelvic or lower abdominal pain. They can also make sex uncomfortable. But in most cases, they don’t cause any symptoms.

Ovarian cysts usually disappear on their own within 2 to 3 months. Your healthcare provider may keep a close eye on them until they do. If they become very large or painful, surgery may be required.

3. Abdominal pain

Lower abdominal pain is a commonly reported Kyleena side effect. But it can also be a sign of other problems, including ovarian cysts, pelvic infection, or ectopic pregnancy.

Let your healthcare provider know if you’re experiencing abdominal pain while Kyleena is in place. This is especially the case if it’s accompanied by abnormal bleeding, discharge, or fever. They can figure out the cause and possible next steps.

4. Headache

Headaches or migraines are possible with all forms of hormonal birth control, including Kyleena. But they should improve as your body gets used to the hormone changes from your IUD. If they’re bothersome, ask about taking an over-the-counter (OTC) pain reliever like acetaminophen (Tylenol).

Let your healthcare provider know if your headaches or migraines become severe, or if they don’t get better over time. Depending on the situation, they may recommend removing Kyleena.

5. Acne

Acne is also a common Kyleena side effect. Your skin may also feel more oily than usual. This can be more common with progestin-containing birth control, like hormonal IUDs.

Having a good skin care routine can help manage this side effect. But if you develop acne that starts affecting your quality of life, discuss possible treatment options with your healthcare provider. They may also suggest a different type of birth control that’s less likely to cause acne if it’s still a problem.

6. Painful periods

You may experience painful periods and/or cramping from Kyleena, especially at first. This should improve within 3 to 6 months after insertion as your body gets used to the IUD.

In the meantime, your healthcare provider may suggest an OTC pain reliever, like ibuprofen (Advil, Motrin), to make this side effect more manageable. Let them know if it becomes worse or doesn’t go away over time.

7. Breast pain

Breast pain or tenderness is another common side effect of hormonal birth control. It tends to be more common with oral birth control pills, but it can also happen with Kyleena. As with other hormone-related side effects, breast pain is usually temporary.

Wearing a supportive bra or placing a warm or cool compress on your chest may help. Your healthcare provider may also suggest an OTC pain reliever. Let them know if your breast pain gets worse or doesn’t improve over time.

8. Bleeding changes

Within the first 3 to 6 months of using Kyleena, you may notice bleeding changes, like spotting or heavier or lighter periods. This should improve as your body adjusts to the hormone changes.

For many women, their periods become shorter and lighter with Kyleena over time. And as many as 12% end up not having a period at all (called amenorrhea) after using it for a year.

But if you’re experiencing more bleeding accompanied by other symptoms, like pain or fever, let your healthcare provider know right away. This could be a sign of an infection or that your IUD has moved out of place.

9. Amenorrhea

By the fifth year of using Kyleena, more than 1 in 5 women develop amenorrhea. Amenorrhea is when you don’t have a period. Some women may like this side effect, including those using Kyleena for this purpose. But, this can make it harder to tell if you’re pregnant.

Take an at-home pregnancy test and call your healthcare provider if you think you might be pregnant or haven't had a period in 6 weeks. After removing Kyleena, your periods should return to the way they were before you had it placed.

10. IUD expulsion

Although rare, IUD expulsion can happen. This is when Kyleena is pushed partially or completely out of the uterus. It happens to just over 3% of all women within 5 years of use. This risk might be slightly higher if you have Kyleena placed right after giving birth.

There’s also a small risk of Kyleena moving and becoming stuck in the wall of the uterus. If this happens, it can be difficult to remove.

Kyleena could also very rarely perforate or go through part of the uterus and move to another area of the body. IUD movement can cause pain, bleeding, or no symptoms at all. In these cases, surgery may be needed to remove it.

Two thin threads will hang out of your cervix after Kyleena is inserted. It’s recommended to check for the threads once a month. If you ever don’t feel them or if they feel a different length, contact your healthcare provider. This could be a sign it has moved out of place. If it has been pushed out or moved, you’re not protected against pregnancy.

11. Ectopic pregnancy

Pregnancies that happen when an IUD is in place are more likely to be ectopic. Ectopic pregnancies are those that start outside of the uterus. They can be life-threatening, and they can also affect your future ability to get pregnant.

Watch for signs of an ectopic pregnancy, like unusual vaginal bleeding, abdominal pain or cramping, or low back pain on one side of the body. Contact your healthcare provider right away if you have these symptoms.

If you become pregnant while using the Kyleena IUD, speak to your healthcare provider right away. Removing an IUD while you’re pregnant has a risk of miscarriage. But leaving it in place can also raise your risk of miscarriage and early delivery. And it can raise your risk of an infection, too. So, it’s important to remove it if you become pregnant.

12. Pelvic inflammatory disease

Although rare, pelvic inflammatory disease (PID) has developed in some people after having an IUD placed. This tends to happen within the first 3 weeks after insertion.

Symptoms of an infection or PID can include lower abdominal pain, unusual vaginal discharge, or fever. Contact your healthcare provider right away if you have any of these symptoms. Untreated PID can cause serious problems and put you at higher risk of infertility and ectopic pregnancy.

You shouldn’t have Kyleena placed if you currently have PID or an untreated sexually transmitted infection (STI). If you have these conditions while an IUD is placed, it can put you at a higher risk of developing a serious infection afterwards.

When should I contact my healthcare provider about Kyleena side effects?

Spotting and other bleeding changes are common short-term Kyleena side effects. For many women, their periods become lighter and happen less often. Contact your healthcare provider if bleeding remains heavy or if it gets heavier after being light for a while.

Kyleena also has some serious side effects to consider. Contact your healthcare provider if you experience any symptoms of PID (especially shortly after placement) or ectopic pregnancy.

Similarly, let them know if your threads feel different or you don’t feel them at all during your monthly self-check.

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Written by:

Alyssa Billingsley, PharmD

Alyssa Billingsley, PharmD, is the director of pharmacy content for GoodRx. She has over a decade of experience as a pharmacist and has worked in clinical, academic, and administrative roles.

Reviewed by:

Christina Aungst, PharmD

Christina Aungst, PharmD, is a pharmacy editor for GoodRx. She began writing for GoodRx Health in 2019, transitioning from freelance writer to editor in 2021.

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