11 Side Effects of Skyla You Should Know About

The Skyla (levonorgestrel) intrauterine device (IUD) is a long-acting, highly effective form of birth control. It’s over 99% effective at preventing pregnancy. By comparison, the birth control pill is only about 91% effective with typical use.

Once the Skyla IUD is placed, it can provide effective birth control for up to 3 years. This means no daily pills or trips to the pharmacy to pick up a prescription. IUDs are also reversible. So you can have it removed at any time if you decide to try to become pregnant.

If you’re considering getting Skyla placed, you may be looking for more information about it. One common concern many people have about birth control methods is their potential side effects. If this is on your mind, we’ve got you covered. Below, we’ll discuss 11 notable side effects of the Skyla IUD.

1. Side effects during Skyla placement

Skyla is inserted into your uterus by a healthcare provider. There are a few side effects that can happen when you have your Skyla IUD placed. Sometimes, people report feeling pain during the placement. But the pain is typically mild and lasts a few minutes.

A small amount of bleeding after Skyla is placed is also normal. Some people may even have bleeding or spotting for a few weeks. Having stomach or pelvic pain after the IUD is inserted is also common. But if you experience severe or persistent bleeding or pain, contact your healthcare provider. This isn’t typical and could point to a more serious problem.

Your healthcare provider might recommend that you take an over-the-counter (OTC) pain reliever, such as ibuprofen (Advil, Motrin) before your appointment. This can help make the insertion more comfortable.

Some healthcare providers apply a small amount of numbing medication to the cervix before placing Skyla. This can also help lessen discomfort.

2. Side effects during Skyla removal

Some people also have side effects when their IUD is removed. Most often, people report mild spotting or cramping. But this usually improves quickly.

Symptoms like fever, severe pain, or unusual vaginal discharge after having Skyla removed aren’t typical. If you experience any of these symptoms, contact your healthcare provider.

If you aren’t having another Skyla IUD placed or switching to another hormonal birth control method, your periods will likely return to the way they were before the IUD. But this could take several months after it’s removed.

3. Changes to your period

Skyla can cause changes to your period. It’s possible you may have less frequent or no menstrual bleeding. But your bleeding could also be irregular, heavier, or last longer.

Longer or heavier periods are more common during the first 3 months of having the IUD. But bleeding usually lessens over time. Lighter or less frequent periods tend to happen more often as time goes on.

4. Vaginal inflammation and infection

Vulvovaginitis — inflammation or infection of the vulva or vagina — is a common Skyla side effect. About 20% of Skyla users experienced this side effect in clinical studies.

Let your healthcare provider know if you have vaginal irritation or changes to your vaginal discharge while using Skyla. These are typical symptoms of vulvovaginitis, which you may need an antibiotic or antifungal to treat.

5. Acne

The Skyla IUD also commonly causes acne. In clinical studies, about 14% of women using Skyla reported this side effect. Worsening acne is a common side effect of IUDs that contain levonorgestrel, like Skyla.

Mild acne may be manageable at home with OTC topical treatment. Two popular options include benzoyl peroxide and salicylic acid. If your acne is more severe, your healthcare provider may discuss prescription acne medication options with you.

If the acne becomes too bothersome, discuss alternate birth control options with your healthcare provider.

6. Headache

Headaches are a common side effect of many hormonal birth control methods. In clinical trials, about 12% of Skyla users experienced headaches. Migraines were also reported, though less frequently.

OTC pain relievers like acetaminophen (Tylenol) and naproxen (Aleve) can be helpful for headaches. But if your headaches worsen or are persistent, contact your healthcare provider. Skyla may not be the right birth control for you.

7. Ovarian cysts

In studies, about 13% of Skyla users developed cysts on their ovaries. Most of the time, people with ovarian cysts have no symptoms. But sometimes these cysts can cause pelvic pain or pain during sex.

Ovarian cysts typically don’t need to be treated. They usually go away on their own within 2 to 3 months.

8. Skyla expulsion or movement

With any IUD, including Skyla, there’s a risk that it can move out of place. If your IUD moves, your risk of getting pregnant is higher.

In rare cases, Skyla is pushed out of the uterus (expulsion). In clinical trials, about 4% of women experienced expulsion. Some women have also reported the IUD getting stuck in the wall of the uterus or moving through the uterine wall (perforation). But perforation is extremely rare, happening to less than 1 in every 1,000 Skyla users.

After having Skyla placed, two thin threads will hang out of your cervix. Checking for the threads once a month is recommended. Contact your healthcare provider if you notice a change to their length, or if you can’t feel them at all. This could be a sign the IUD has moved out of place.

9. Ectopic pregnancy

If you become pregnant while using Skyla, speak to your healthcare provider right away. In this scenario, you’re more likely to have an ectopic pregnancy (one that begins outside of the uterus). An ectopic pregnancy can be life-threatening and requires immediate medical care.

Symptoms of an ectopic pregnancy include:

• Vaginal bleeding

• Lower stomach pain

• Lower back pain

• Lower stomach cramps

10. Pelvic inflammatory disease and endometritis

Serious infections can develop while using Skyla. These can include pelvic inflammatory disease (PID) and endometritis (a bacterial infection in the uterus). While rare, these infections are most likely to happen within a month of having the IUD placed.

Signs of PID and endometritis include fever, lower stomach pain, and unusual vaginal bleeding or discharge. Speak with your healthcare provider if you have any of these symptoms, especially shortly after having Skyla placed.

You shouldn’t have Skyla inserted if you currently have PID or endometritis. The same is true if you have an untreated sexually transmitted infection (STI). In these situations, there’s an increased risk of serious complications.

11. Breast cancer

Skyla isn’t recommended if you currently have or have a history of breast cancer. Some types of breast cancer are sensitive to hormones. Since Skyla contains a progestin hormone, it could worsen breast cancers that are sensitive to progesterone.

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

Mild side effects of Skyla, like acne or headaches, don’t usually need medical intervention. They can often be managed at home with OTC medications. But if they continue to be bothersome or seem severe, contact your healthcare provider.

If you experience any symptoms of the serious side effects discussed above — such as IUD movement or serious infections — contact your healthcare provider immediately. You should also seek medical care if you become pregnant while using Skyla.

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Written by:

Nicole E. Cieri-Hutcherson, PharmD, BCPS, NCMP

Nicole E. Cieri-Hutcherson, PharmD, BCPS, NCMP, has over a decade of experience as a pharmacist, professor, and researcher. She was a full-time clinical professor in the pharmacy practice department at D’Youville School of Pharmacy before subsequently joining the faculty of the pharmacy practice department at the University at Buffalo School of Pharmacy and Pharmaceutical Sciences.

Edited 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.

Reviewed by:

Stacia Woodcock, PharmD

Stacia Woodcock, PharmD, is a pharmacy editor for GoodRx. She earned her Doctor of Pharmacy degree from the University of Kentucky and is licensed in New York and Massachusetts.

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