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Skyla

levonorgestrel
Used for Birth Control
Used for Birth Control

Skyla IUD (levonorgestrel) is a progestin intrauterine device (IUD). It's approved for females of reproductive age to prevent pregnancy for up to 3 years. Skyla 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 spotting. Skyla IUD (levonorgestrel) contains the lowest hormone dose compared all other hormonal IUDs.

Last reviewed on December 4, 2023
basics-icon

What is Skyla IUD (levonorgestrel)?

What is Skyla IUD (levonorgestrel) used for?

  • Prevent pregnancy for up to 3 years

How Skyla IUD (levonorgestrel) works

Skyla 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.

Are you looking for information on Mirena (levonorgestrel) or levonorgestrel (Plan B One-Step) oral tablet instead?

Drug Facts

Common BrandsSkyla
Drug ClassProgestin
Controlled Substance ClassificationNot a controlled medication
Generic StatusNo lower-cost generic available
AvailabilityPrescription only

More on Skyla IUD (levonorgestrel) essentials

basics-icon

What are the side effects of Skyla IUD (levonorgestrel)?

The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.

Common Side Effects

  • Vaginal inflammation or irritation (20%)
  • Acne (14%)
  • Stomach pain (13%)
  • Ovarian cyst (13%)
  • Headache (12%)
  • Menstrual cramps (9%)
  • Heavier menstrual bleeding (8%)
  • Breast pain or discomfort (5%)
  • Nausea (6%)

Other Side Effects

  • Depression
  • Hair loss
  • Expulsion (the device comes out on its own)
  • Genital discharge
  • Migraines
  • Upper genital tract infection

Serious Side Effects

Contact your healthcare provider immediately if you experience any of the following.
  • Ectopic pregnancy: severe, unexplainable pelvic pain along with unusual vaginal bleeding
  • Severe infection: fever, chills, confusion, fatigue

Source: DailyMed

The following side effects have also been reported

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor or nurse immediately if any of the following side effects occur:

More common

Absent, missed, or irregular menstrual periods

longer or heavier menstrual periods

mild bloating

stomach or pelvic pain

stopping of menstrual bleeding

unusually heavy or unexpected menstrual bleeding

uterine bleeding between menstrual periods

vaginal bleeding or spotting

Less common

Blurred vision

cramps

dizziness

headache

heavy bleeding

itching of the vagina or genital area

nervousness

pain

pain during sexual intercourse

pale skin

pounding in the ears

slow or fast heartbeat

swelling

thick, white vaginal discharge with mild or no odor

trouble breathing

unusual bleeding or bruising

unusual tiredness or weakness

white or brownish vaginal discharge

Rare

Chills

confusion

dizziness, lightheadedness, fainting

fast heartbeat

fast, weak pulse

fever

pale, cold, clammy skin

rapid, shallow breathing

sudden increase in stomach or shoulder pain

sweating

unusual or large amount of vaginal bleeding

Incidence not known

Clear or bloody discharge from the nipple

dimpling of the breast skin

dull or aching stomach pain

foul-smelling vaginal discharge

increased blood pressure

increased urge to urinate

inverted nipple

large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs

lump in the breast or under the arm

pain during urination

persistent crusting or scaling of the nipple

redness or swelling of the breast

severe stomach pain or cramping

sharp pain on insertion

shivering fever

sores on the skin of the breast that does not heal

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common

Blemishes on the skin

depression

pimples

Less common

Back pain

breast tenderness or pain

decreased interest in sexual intercourse

full or bloated feeling

hair loss

hives or welts, itching, or rash

increased hair growth, especially on the face

increased weight

loss in sexual ability, desire, drive, or performance

nausea

pressure in the stomach

redness of the skin

skin rash, encrusted, scaly, and oozing

swelling of the stomach area

thinning of the hair

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

pros-and-cons

Pros and cons of Skyla IUD (levonorgestrel)

thumbs-up

Pros

More effective than oral birth control pills to prevent pregnancy

One of the smallest IUDs

Contains a lower dose of hormone compared some other IUDs, like Mirena

Possible birth control option while breastfeeding

thumbs-down

Cons

Can raise your risk of an ectopic pregnancy

Breakthrough bleeding, acne, and headache are common side effects

Not safe to use if you have liver problems or have ever had breast, uterine, or cervical cancer

Doesn't work for as long as other IUDs

pharmacist-tips

Pharmacist tips for Skyla IUD (levonorgestrel)

pharmacist
  • You might feel some pain, dizziness, or have some light vaginal bleeding after the Skyla 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 Skyla IUD (levonorgestrel) is placed properly.

    • After the Skyla 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 Skyla 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 Skyla 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 Skyla 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 Skyla 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 Skyla IUD (levonorgestrel). If so, your provider might need to remove the IUD.

              • If you need to get any magnetic resonance imaging (MRI) scans done, let your care team know that you have Skyla IUD (levonorgestrel) in place. Depending on the MRI machine, you might need to have the IUD removed before the scan.

                More on Skyla IUD (levonorgestrel) tips

                faqs

                Frequently asked questions about Skyla IUD (levonorgestrel)

                How long does Skyla IUD (levonorgestrel) IUD last?
                Skyla IUD (levonorgestrel) works to prevent pregnancy for up to 3 years. But if you no longer want to use it, your provider can help you remove the IUD at any time.
                How effective is Skyla IUD (levonorgestrel)?
                Skyla IUD (levonorgestrel), like other IUDs, is over 99% effective at preventing pregnancy. This means that it works better compared to many other forms of birth control, including the pill, ring, or patch. In order for Skyla IUD (levonorgestrel) to continue to work well, it needs to be replaced every 5 years.
                Is Skyla IUD (levonorgestrel) hormonal?
                Yes, Skyla IUD (levonorgestrel) contains a progestin called levonorgestrel, which is a lab-made form of progesterone. If you're thinking about a hormone-free IUD option, ask your provider about the copper IUD, Paragard.
                Can Skyla IUD (levonorgestrel) cause hair loss?
                Though rare, it's possible to experience hair loss from Skyla IUD (levonorgestrel). If you notice your hair thinning or falling out after starting this IUD, talk with your provider. They can help you figure out what might be causing the hair loss.
                Can Skyla IUD (levonorgestrel) cause infertility?
                Skyla IUD (levonorgestrel) isn't known to cause infertility as a side effect. But rarely, using IUD might raise the risk for pelvic infections, which can lead to infertility if left untreated. And if you're thinking about becoming pregnant while using Skyla IUD (levonorgestrel), talk with your provider. After the IUD is removed, you can get pregnant by as early as the next time you ovulate.
                Does Skyla IUD (levonorgestrel) cause weight gain?
                People who used Skyla IUD (levonorgestrel) in clinical trials didn't report weight gain as a side effect. But in general, it's possible for the levonogestrel in Skyla to cause some bloating. It's because this hormone can makes your body hold on to more water. Keep in mind that everyone responds to the medication differently, so you might not experience this side effect. But if you notice that you've gained a lot of weight since starting on the Skyla IUD (levonorgestrel), let your provider know and they can try to help you figure out the cause.
                Do antibiotics affect Skyla IUD (levonorgestrel)?
                No, it's very unlikely for oral antibiotics to interact with Skyla IUD (levonorgestrel). This IUD is placed and directly works in the uterus, so it's unlikely to interact with oral medications. But many medications, including antibiotics, can cause oral birth control to not work as well at preventing pregnancy. If you're concerned about birth control and medication interactions, talk with your provider.
                Do you get your period with Skyla IUD (levonorgestrel)?
                Skyla IUD (levonorgestrel) can cause changes to your menstrual bleeding pattern. During the first few months after Skyla IUD (levonorgestrel) is inserted, you're more likely to experience spotting, and heavier or longer periods. But over time, your period is likely to become lighter. Once your healthcare provider removes Skyla IUD (levonorgestrel), your periods should return to how they were before IUD use.
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                warings-icon

                What are the risks and warnings for Skyla IUD (levonorgestrel)?

                Skyla 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.

                risk-warning

                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 Skyla IUD (levonorgestrel) IUD, can raise your risk of ectopic pregnancies. Pregnancy is rare with all IUDs, but if you do become pregnant while the Skyla 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 Skyla IUD (levonorgestrel) IUD was placed, contact your provider right away. Your provider will recommend for you to remove Skyla IUD (levonorgestrel) because keeping it in place raises your risk for complications such as miscarriage and infection.

                  risk-warning

                  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 Skyla 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.

                    risk-warning

                    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 Skyla 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.

                      risk-warning

                      Uterine injury

                      • Risk factors: Placing the Skyla IUD (levonorgestrel) IUD less than 6 weeks after giving birth

                        There's a very small chance that the Skyla IUD (levonorgestrel) IUD can uterine injury (perforation), which is extremely dangerous. It also prevents the Skyla IUD (levonorgestrel) IUD from working properly, meaning you can get pregnant if this happens. The risk of perforation is higher if you've the Skyla 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.

                        risk-warning

                        Body ejecting the device

                        • Risk factors: Placing the Skyla IUD (levonorgestrel) IUD less than 6 weeks after giving birth

                          There is a small chance the body can eject the Skyla 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 Skyla 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.

                          risk-warning

                          Irregular periods

                          The Skyla 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 Skyla 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.

                          risk-warning

                          Ovarian cysts

                          Since Skyla 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.

                          risk-warning

                          Possible risk of cancer

                          People who have or have had breast cancer shouldn't use hormonal birth control, including Skyla IUD (levonorgestrel). Certain types of breast cancer can be sensitive to hormones, and might grow in the presence of hormones.

                          dosage

                          Skyla IUD (levonorgestrel) dosage forms

                          Typical dosing for Skyla IUD (levonorgestrel)

                          Skyla IUD (levonorgestrel) will need to be placed inside your uterus by your provider at their office. Once placed, it can prevent pregnancy for 3 years.

                          interactions

                          Interactions between Skyla IUD (levonorgestrel) and other drugs

                          Skyla IUD (levonorgestrel) may interact with certain medications or supplements. Always let your doctor and pharmacist know about any other medications or supplements (including prescribed and over-the-counter medications, vitamins, and dietary or herbal supplements) that you are currently taking. The list below does not include all possible drug interactions with Skyla IUD (levonorgestrel). Please note that only the generic name of each medication is listed below.

                          Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are receiving this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

                          Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

                          Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

                          Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

                          contraindications-icon

                          Skyla IUD (levonorgestrel) contraindications

                          Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Skyla IUD (levonorgestrel) will not be safe for you to take.
                          • 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

                          • Uterine or cervical cancer

                          • 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

                          alternatives

                          What are alternatives to Skyla IUD (levonorgestrel)?

                          There are a number of medications that your doctor can prescribe in place of Skyla IUD (levonorgestrel). Compare a few possible alternatives below.
                          Skyla IUD (levonorgestrel)
                          Used for:
                          • Prevent pregnancy for up to 3 years

                          Used for:
                          • Prevent pregnancy for up to 5 years

                          Used for:

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                          References

                          Best studies we found

                          American College of Obstetricians and Gynecologists. (2023). Postpartum birth control.

                          Bayer. (2023). About Skyla®.

                          Bayer HealthCare Pharmaceuticals Inc. (2023). Skyla- levonorgestrel intrauterine device [package insert]. DailyMed.

                          GoodRx Health has strict sourcing policies and relies on primary sources such as medical organizations, governmental agencies, academic institutions, and peer-reviewed scientific journals. Learn more about how we ensure our content is accurate, thorough, and unbiased by reading our editorial guidelines.
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