Kyleena
Kyleena IUD (levonorgestrel) is a progestin intrauterine device (IUD). It's approved for females of reproductive age to prevent pregnancy for up to 5 years. Kyleena IUD (levonorgestrel) is inserted into the uterus by a provider in their office. Some of the more common side effects of this IUD include vaginal irritation or infection, acne, and stomach cramps. Kyleena IUD (levonorgestrel) has a lower dose of hormone and is smaller in size compared to some other hormonal IUDs, such as Mirena (levonorgestrel).
What is Kyleena IUD (levonorgestrel)?
What is Kyleena IUD (levonorgestrel) used for?
Prevent pregnancy for up to 5 years
How Kyleena IUD (levonorgestrel) works
Kyleena IUD (levonorgestrel) is a small device placed in the uterus that slowly releases a progestin hormone called levonorgestrel. This hormone prevents pregnancy by stopping your ovaries from releasing an egg. Levonorgestrel also makes it difficult for sperm to reach the egg and for a fertilized egg to implant in the uterus.
Drug Facts
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What are the side effects of Kyleena IUD (levonorgestrel)?
Common Side Effects
- Vaginal inflammation or irritation (24%)
- Ovarian cyst (22%)
- Acne (14%)
- Stomach cramps (13%)
- Headaches (13%)
- Breast discomfort or pain (7%)
- Changes in menstrual bleeding (8%)
Other Side Effects
- Depression
- Expulsion (the device comes out on its own)
- Nausea
- Genital discharge
Serious Side Effects
- Ectopic pregnancy: severe, unexplainable pelvic pain along with unusual vaginal bleeding
- Severe infection: fever, chills, confusion, fatigue
Source: DailyMed
More on Kyleena IUD (levonorgestrel) side effects
The following side effects have also been reported
Side effects that you should report to your care team as soon as possible:
- Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat
- Blood clot—pain, swelling, or warmth in the leg, shortness of breath, chest pain
- Gallbladder problems—severe stomach pain, nausea, vomiting, fever
- Increase in blood pressure
- Liver injury—right upper belly pain, loss of appetite, nausea, light-colored stool, dark yellow or brown urine, yellowing skin or eyes, unusual weakness or fatigue
- New or worsening migraines or headaches
- Pelvic inflammatory disease (PID)—fever, abdominal pain, pelvic pain, pain or trouble passing urine, spotting, bleeding during or after sex
- Stroke—sudden numbness or weakness of the face, arm, or leg, trouble speaking, confusion, trouble walking, loss of balance or coordination, dizziness, severe headache, change in vision
- Unusual vaginal discharge, itching, or odor
- Vaginal pain, irritation, or sores
- Worsening mood, feelings of depression
Side effects that usually do not require medical attention (report to your care team if they continue or are bothersome):
- Breast pain or tenderness
- Dark patches of skin on the face or other sun-exposed areas
- Irregular menstrual cycles or spotting
- Nausea
- Weight gain
Pros and cons of Kyleena IUD (levonorgestrel)
Pros
Works for up to 5 years
More effective than oral birth control pills to prevent pregnancy
Can be used during breastfeeding as long as it's been 6 weeks since you gave birth
Contains a lower dose of hormone compared some other IUDs, like Mirena
Cons
Can raise your risk of an ectopic pregnancy
Breakthrough bleeding, acne, and headaches are common side effects
Not safe to use if you've liver problems or have ever had breast, uterine, or cervical cancer
Can only be removed by a healthcare provider at their office
Pharmacist tips for Kyleena IUD (levonorgestrel)
You might feel some pain, dizziness, or have some light vaginal bleeding after the Kyleena IUD (levonorgestrel) has been placed, but it should be temporary. If these symptoms don't lessen after a few days, tell your provider. They'll want to see if Kyleena IUD (levonorgestrel) is placed properly.
After the Kyleena IUD (levonorgestrel) has been placed, there will be 2 thin threads hanging inside the vagina. Your provider might recommend that you check for these threads once a month with a clean finger. Never tug or pull on the threads when you're checking for them. If you can't feel them, call your provider right away because it might be a sign that Kyleena IUD (levonorgestrel) isn't positioned properly.
If you haven't had a period for 6 weeks, call your provider. It's typical for some people to stop having their periods after using Kyleena IUD (levonorgestrel) for a year or longer. But keep in mind that having no menstrual bleeding can also be a sign of pregnancy. Your provider will want to check to see if you're pregnant, especially if you've an ectopic pregnancy.
The Kyleena IUD (levonorgestrel) can be used while breastfeeding. But your provider will likely ask you to wait at least 6 weeks since you gave birth to minimize injury to the uterus. The medication from the device will not hurt your baby, but you might notice a slight drop in your milk supply.
It's possible for your body to push the Kyleena IUD (levonorgestrel) back out of the uterus into the vagina. If this happens, call your healthcare provider right away and use a back-up method of protection (condoms, diaphragms) until you have a new device placed.
Let your provider know right away if you experience high blood pressure, blood clotting problems (e.g., heart attack or stroke), migraines, or severe headaches while using Kyleena IUD (levonorgestrel). If so, your provider might need to remove the IUD.
The Kyleena IUD (levonorgestrel) doesn't protect you from human immunodeficiency virus (HIV) or other sexually transmitted infections (STIs). Only abstinence and condoms can help protect you from STIs. Talk to your provider right away if this is a concern for you.
If you're thinking about becoming pregnant, talk with your provider about removing Kyleena IUD (levonorgestrel). After the IUD is out, it's possible for you to become pregnant the next time you ovulate, which can take days or a few weeks.
If you need to get any magnetic resonance imaging (MRI) scans done, let your care team know that you have Kyleena IUD (levonorgestrel) in place. Depending on the MRI machine, you might need to have the IUD removed before the scan.
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What are the risks and warnings for Kyleena IUD (levonorgestrel)?
Kyleena IUD (levonorgestrel) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Ectopic pregnancy
Risk factors: Previous ectopic pregnancy | Past surgery performed on your fallopian tubes | Current pelvic infection
Ectopic pregnancies happen when a fertilized egg implants somewhere other than your uterus. They're very rare, but can be life-threatening and sometimes need to be treated with surgery. Progestin-only contraception, including the Kyleena IUD (levonorgestrel) IUD, can raise your risk of ectopic pregnancies. Pregnancy is rare with all IUDs, but if you do become pregnant while the Kyleena IUD (levonorgestrel) IUD is inserted, the chance of it being an ectopic pregnancy is high. If you experience unexplained or severe pelvic pain along with unusual vaginal bleeding, let your provider know.
If you do become pregnant after the Kyleena IUD (levonorgestrel) IUD was placed, contact your provider right away. Your provider will recommend for you to remove Kyleena IUD (levonorgestrel) because keeping it in place raises your risk for complications such as miscarriage and infection.
Sepsis (blood infection)
Risk factors: Placement of device in an unhygienic environment
Sepsis is when bacteria infect your bloodstream, and it can be life-threatening. Your risk of getting this infection goes up if Kyleena IUD (levonorgestrel) wasn't placed using proper antibacterial technique. Sepsis would typically happen shortly after the device was inserted, sometimes even within a few hours. Tell your provider right away if you have pelvic pain, a high fever, or any other symptoms of being sick shortly after the device was placed.
Pelvic inflammatory disease (PID)
Risk factors: History of or current pelvic inflammatory disease | Current sexually transmitted infections | Multiple sex partners
IUDs raise your risk of developing pelvic inflammatory disease (PID) because there's always a small chance bacteria can get into your uterus when the device is placed. Because of this, the Kyleena IUD (levonorgestrel) IUD isn't safe to use if you've ever had or are prone to PID. If you start to experience any unusual pelvic pain, funny-smelling discharge, unusual vaginal bleeding, sores or cuts in your genital area, or a high fever, call your provider right away.
Uterine injury
Risk factors: Placing the Kyleena IUD (levonorgestrel) IUD less than 6 weeks after giving birth
There's a very small chance that the Kyleena IUD (levonorgestrel) IUD can uterine injury (perforation), which is extremely dangerous. It also prevents the Kyleena IUD (levonorgestrel) IUD from working properly, meaning you can get pregnant if this happens. The risk of perforation is higher if you've the Kyleena IUD (levonorgestrel) IUD placed less than 6 weeks after you give birth to a baby. Your provider will need to remove the IUD if there's an injury, and this might require surgery. Tell your provider right away if you can't feel the threads that hang freely inside your vagina after it has been placed.
Body ejecting the device
Risk factors: Placing the Kyleena IUD (levonorgestrel) IUD less than 6 weeks after giving birth
There is a small chance the body can eject the Kyleena IUD (levonorgestrel) IUD from the uterus back into your vagina. If this happens, the device won't work and you can get pregnant. Your risk of having this happen is higher if you have the IUD placed less than 6 weeks after you gave birth. If you notice your menstrual bleeding suddenly becomes heavier than usual and it's been more than 3 to 6 months since your provider placed the device, this could be a sign your body is ejecting the Kyleena IUD (levonorgestrel) IUD. Tell your provider if this happens and use non-hormonal protection (condoms, diaphragms) until your provider places a new device or tells you the device is in the right place.
Irregular periods
The Kyleena IUD (levonorgestrel) IUD can cause you to experience irregular menstrual periods. Most women will have heavier or longer periods for the first 3 to 6 months after the device is placed, followed by very light or no periods. But, you might notice changes of any kind to your menstrual cycle while using the Kyleena IUD (levonorgestrel) IUD. If you are worried about the changes to your periods, talk to your provider, especially if you are having sudden or unusually heavy bleeding after the first 3 to 6 months. This could be a sign that the device is not in the correct place.
Ovarian cysts
Since Kyleena IUD (levonorgestrel) is located within the uterus, it can sometimes lead to the development of ovarian cysts. Although most ovarian cysts don't cause any symptoms, some might cause pelvic pain or pain during sex. In most cases, the cysts go away on their own after a few months, but your provider will keep an eye on things just to make sure. Surgery is usually not required for these.
Possible risk of cancer
People who have or have had breast cancer shouldn't use hormonal birth control, including Kyleena IUD (levonorgestrel). Certain types of breast cancer can be sensitive to hormones, and might grow in the presence of hormones.
Kyleena IUD (levonorgestrel) dosage forms
Typical dosing for Kyleena IUD (levonorgestrel)
Kyleena IUD (levonorgestrel) will need to be placed inside the uterus by your provider at their office. Once placed, it can prevent pregnancy for 5 years.
Kyleena IUD (levonorgestrel) contraindications
Pregnancy or suspicion of pregnancy
Use as emergency contraception
Certain abnormal uterine anatomy
Acute pelvic inflammatory disease (PID) or a history of PID
Postpartum endometritis or infected abortion in the past 3 months
Breast cancer or other progestin-sensitive cancer
Uterine bleeding without a known cause
Untreated inflammation of the cervix or vagina, or other lower genital tract infections
Liver disease or liver tumor
A previous intrauterine device (IUD) that hasn't been removed
What are alternatives to Kyleena IUD (levonorgestrel)?
Prevent pregnancy for up to 8 years
Relieve heavy menstrual periods for up to 5 years
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References
Best studies we foundAmerican College of Obstetricians and Gynecologists. (2023). Postpartum birth control.
Bayer. (2024). Kyleena IUD placement.
Bayer HealthCare Pharmaceuticals Inc. (2023). Kyleena- levonorgestrel intrauterine device [package insert]. DailyMed.
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