The Skyla IUD

The New Low-Dose Hormone Intrauterine Device

Skyla IUD
Skyla IUD. Photo © Dawn Stacey

Skyla is the newest available intrauterine device (IUD). It was FDA approved on 01/09/2013, making it the first FDA-approved IUD in over 12 years! The Skyla IUD is made of soft, flexible plastic. This T-shaped device is referred to as the "mini IUD" because it is smaller than it's counterpart Mirena. Skyla must be inserted by a qualified health-care professional. This mini IUD slowly releases the progestin, levonorgestrel, over a 3-year period as a way to prevent pregnancy. The Skyla IUD contains 13.5 mg of levonorgestrel and releases 14 mcg of this hormone daily. This rate slowly decreases to 5 mcg per day after 3 years.

    How the Skyla IUD Works:

    The Skyla IUD prevents pregnancy by getting in the way of sperm -- making it difficult for them to fertilize an egg. So, Skyla interferes with the movement of sperm. The progestin in the Skyla IUD also thickens your cervical mucus, thins the lining of your uterus, and lowers sperm survival. 

    Your Skyla IUD should be inserted during the first seven days of your menstrual cycle or immediately after a first-trimester abortion. If inserted at this time, Skyla is immediately effective and no back-up contraception is needed.

    If you have your Skyla inserted at any other time during your monthly cycle, you will need yo use another method of birth control (like spermicide or condoms) during the first week after insertion. Pregnancy protection will begin after one week (seven days).

    Advantages of the Skyla IUD:

    • It provides continuous pregnancy prevention for up to 3 years!
    • Skyla can be removed anytime within this 3-year period -- it is also completely reversible, so your fertility rapidly returns.
    • The Skyla IUD is FDA-approved for women who have never had children.
    • It is hassle-free – once inserted, you don’t really have to do anything else.
    • It may help to improve your sex life by allowing for spontaneity.
    • Skyla is an eco-friendly birth control method.
    • The Skyla IUD is a good alternative if you who can't use estrogen-based contraceptives.
    • It is an extremely discreet birth control method -- there is no packaging or other evidence of use that may embarrass some women.
    • Skyla can be used if you are breastfeeding.
    • The Skyla IUD is a smaller size and has a slimmer insertion tube -- this may make IUD insertion less painful during Mirena IUD or ParaGard IUD insertion.
    • It can be a good IUD option for women who have only had cesarean deliveries.
    • Skyla may be better tolerated than other IUDs if you have a smaller uterus (such as young teens and perimenopausal women).
    • Neither you nor your partner should be able to feel Skyla during sex.

    Skyla IUD - Disadvantages:

    Although most women do not have any trouble adjusting to an IUD, you may experience pain, bleeding or dizziness during and/or after your Sklya IUD has been inserted. If these symptoms do not stop within 30 minutes after insertion, there may be the chance that the Skyla IUD was not inserted correctly.

    • Some women may have to deal with bad cramping or backache for several days or weeks after their Skyla IUD is inserted.

    Changes to Your Period:

    • During the first 3-6 months after insertion of your Skyla IUD: bleeding and spotting days may increase, your period may be irregular, and/or your period may be heavier than usual.
    • Over time, your periods are likely to become shorter and lighter. Because the progestin in Skyla thins the uterine lining, bleeding may decrease the longer your Sklya IUD has be in place. Your periods may stop altogether (about 6% of women stop having periods after using Skyla for one year).
    • For some women, the unpredictable bleeding between periods does not stop after the first few months. This is the most common reason why women request having their Sklya IUD removed.

    Skyla Side Effects:

    You may experience side effects after having Skyla inserted, but in most cases, these will go away after the first few weeks to months. Skyla IUD side effects include:

    • Increased bleeding
    • Acne or seborrhea
    • Dysmenorrhea
    • Stomach or pelvic pain
    • Vulvovaginitis (vaginal infection)
    • Headache
    • Breast pain or discomfort
    • Nausea
    • Ovarian cysts have been diagnosed in about 14% of Skyla users. In most cases, these disappear on their own within 1-2 months.

    Skyla Risks and Complications:

    Serious problems with Skyla are very rare. Make sure to tell your doctor right away if any problems occur.

    Who Should Get a Skyla IUD?

    Skyla has been specifically researched with nulliparous women (the fancy medical term for women who have never given birth) -- so, the FDA has approved Skyla use in this population. Skyla's product labeling states that this mini IUD can be used whether or not a woman has had a child. 

    Removal of Your Skyla IUD:

    • After 3 years are up, you must have your Skyla removed (it won't disappear into your body). You can choose to have another Skyla IUD inserted during the same visit. You should NEVER try to remove your Skyla IUD by yourself (come on, this is why we have doctors!). Under rare cases, your Skyla IUD may come out on its own -- but, generally speaking, you will need to schedule an appointment with your doctor to have it removed.
    • You can also have your Skyla IUD taken out at anytime before the 3-year period ends.
    • If your Skyla IUD is expelled (comes out on its own), there is a good chance that you won't even notice. This is why it is important to feel for the strings (if possible) -- since this is the only way to show you that your Skyla IUD is still in place. If your Skyla has been expelled, contact your doctor. Your doctor will most likely perform a pregnancy test (to make sure that you are not pregnant) before inserting a new Skyla IUD.
    • If your Skyla IUD has become partially expelled, call your doctor right away (and use a back up birth control method). Again, don't try to yank the rest of it out by yourself.

    Costs Associated with the Skyla IUD:

    Skyla has a higher upfront cost than other contraceptives. The cost of the exam, the Skyla IUD, insertion, and follow up visits can cost around $650-$750. Medicaid may possibly cover these costs. You can also check with your health insurance policy since coverage for Skyla should be covered with no out-of-pocket costs for all non-grandfathered insurance plans.

    Skyla IUD Effectiveness:

    Skyla is super effective. This reversible, long-acting contraceptive method is 99.1% effective. This means that out of every 100 women who use the Skyla IUD in one year, less than 1 will become pregnant with typical use as well as with perfect use.

    It May be Helpful to Know: When using the Skyla IUD, most pregnancies happen because your Skyla slipped out, and you most likely didn't realize it. Even though the chance of pregnancy while using Skyla is very low, it could happen. If you become pregnant when your Skyla IUD is still in place, call your doctor as soon as you realize that you're pregnant -- since there can be possible pregnancy risks.

    STD Protection:

    The Skyla IUD offers no protection against sexually transmitted infections.

    Source:

    Bowers R. "FDA approves smaller levonorgestrel intrauterine system - A 'mini Mirena." Contraceptive Technology Update. 2013 March; 34(3):25-36. Accessed July 9, 2014

    Hardeman J, Weis B. "Intrauterine devices: An update." American Family Physician.2014 March; 89(6):445-450. Accessed July 9, 2014.

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