The key differences between hormonal IUDs (Mirena, Skyla, Liletta, and Kyleena) and nonhormonal IUDs (Paragard) are what they’re made of, how they work, how long they last, and possible side effects.
Intrauterine devices (IUDs) are an extremely effective method of birth control. An IUD is a small, T-shaped device that’s placed in your uterus. It must be prescribed by a doctor, who will place it in your uterus during an outpatient procedure.
Five brands of IUDs approved by the Food and Drug Administration (FDA) are available today. Mirena, Skyla, Liletta, and Kyleena release hormones to prevent pregnancy. Paragard contains copper and doesn’t release hormones.
Both copper and hormonal IUDs are more effective at preventing pregnancies than other forms of birth control besides sterilization.
Overall, IUDs are more than 99% effective at preventing pregnancy. This means that fewer than 1 in 100 people who use an IUD become pregnant each year.
A note on pricing
We included average pricing information for each IUD brand without insurance coverage. But if you’re insured, the price will vary on your coverage and what your network covers.
Additionally, if you don’t have health insurance, there are options to help you pay for birth control out of pocket. You may be able to apply for financial assistance or enroll in a copay savings program.
- Average pricing: $1,214 without insurance
- Type: Hormonal
- How long it works: 8 years
- Failure rate: 0.2%
Mirena works by slowly releasing the hormone levonorgestrel (LNG) into your body each day. It can last for up to 8 years and should be replaced at the end of the cycle.
It works to prevent pregnancy by:
- Potentially making you ovulate less often
- Thickening cervical mucus, making it harder for sperm to pass into your uterus
- Helping to prevent sperm from binding to an egg and attaching to your uterus
Some common side effects include:
- 3 to 6 months of spotting or irregular periods
- lighter periods
- irregular cycles
- potential to stop periods after a year
You may also experience pain, bleeding, or dizziness before or after placement.
- Average pricing: $1,312.5 without insurance
- Type: Hormonal
- How long it works: 3 years
- Failure rate: 0.2%
Skyla works to prevent pregnancy using the same mechanisms as Mirena, also releasing the hormone LNG. The main difference, however, is that it needs to be replaced every three years instead of eight.
Common side effects of Skyla can include:
- headache or migraine
- missed menstrual periods
- changes in bleeding
- ovarian cysts
- painful periods
- inflammation of the uterus
- Average pricing: $982 without insurance
- Type: Hormonal
- How long it works: 8 years
- Failure rate: 0.2%
Liletta works by slowly releasing low doses of LNG into your body. It lasts for 8 years. The FDA approved it in February 2015, but it’s one of the newer IUD options on the market.
Some side effects of Liletta may include:
- cramps
- irregular menstrual periods
- spotting
- headache
- nausea
- breast tenderness
- weight gain
- Average pricing: $1,214 without insurance ($20 a month over a 5-year period)
- Type: Hormonal
- How long it works: 5 years
- Failure rate: 0.2%
Kyleena also works by slowly releasing low doses of LNG into your body, lasting 5 years. It was approved by the FDA in September 2016, and like Liletta, it hasn’t been researched as extensively.
Some common side effects of Kyleena include:
- vaginal itching or discharge
- ovarian cysts
- headache or migraine
- acne
- breast pain or discomfort
- Average pricing: $1,139 without insurance
- Type: Non-hormonal
- How long it works: 10 years
- Failure rate: 0.8%
Paragard has copper coiled around the vertical stem of the T-shape and around each side of the horizontal arm.
The copper produces an inflammatory reaction within your uterus, creating a harmful environment for sperm. This environment helps prevent the sperm from fertilizing an egg and may prevent an egg from attaching to your uterus.
Paragard IUDs can last for up to 10 years, but they can be removed at any time. They are also effective immediately after insertion and can also be used as a form of emergency contraception after having sex without a barrier method if inserted within 5 days.
Paragard side effects may include:
- anemia
- spotting
- pain during sex
- painful periods
- prolonged periods
- vaginal irritation or discharge
Skyla | Mirena | Paragard | Liletta | Kyleena | |
|---|---|---|---|---|---|
Size | 28 mm x 30 mm | 32 mm x 32 mm | 32 mm x 36 mm | 32 mm x 32 mm | 28 mm x 30 mm |
Type | progestin hormone | progestin hormone | copper | progestin hormone | progestin hormone |
Effective for up to | 3 years | 8 years | 10 years | 8 years | 5 years |
Notable side effect | may cause changes in your period | may cause changes in your period | may cause bleeding and discomfort | may cause painful or irregular periods | may cause irregular periods and bleeding |
Deciding whether you want a hormonal or nonhormonal IUD can help you narrow down your choices. There are benefits and risks of both.
If you decide to go the hormone-free route, your choice is simple, as there’s only one option: Paragard. If you prefer hormonal IUDs, your choices include Mirena, Skyla, Liletta, and Kyleena.
Their main differences include size, duration, and amount of hormones released. It may take up to 7 days for hormonal IUDs to become effective, depending on the time they’re inserted in relation to your menstrual cycle.
The primary function of a hormonal IUD is contraception, but they have non-contraceptive benefits, such as reducing menstrual pain and menstrual frequency.
Hormonal IUDs are often prescribed for those who experience endometriosis, severe menstrual pain or bleeding, anemia, and other conditions. A hormonal IUD may also reduce the risk of endometrial cancer.
The duration of effectiveness is a point of consideration for many. Copper IUDs last the longest. Paragard can last for up to 10 years before needing to be replaced or removed, while hormonal IUDs last between 3 and 8 years.
Of the hormonal options, Skyla lasts the shortest (3 years), Mirena and Liletta last the longest (8 years), and Kyleena lasts for 5 years.
There may be a cost associated with getting an IUD. There are ways to get free or lower cost IUDs, but the procedure and office visit may increase those costs.
Without insurance, getting an IUD can cost up to $1,800 out of pocket. On average, Liletta is the least expensive, and Skyla is the most expensive.
Mirena, Skyla, Liletta, and Kyleena have similar side effects. You may have changes in your period, such as increased menstrual bleeding, discomfort, or no period at all. You may also have:
- acne
- headache
- breast tenderness
- ovarian cysts
- depressed mood
- pain in your abdomen or pelvic area
With Paragard, you may have an allergic reaction to the copper. Other side effects include:
- heavy menstrual bleeding
- discomfort
- a longer period
- backaches and cramps when you’re not having a period
All five devices can also fall out or shift position. This can increase your risk of pregnancy. They could also tear your uterus. In addition, all five can cause pelvic inflammatory disease (PID), but this is rare.
If you do get pregnant while using an IUD, there’s a slight risk you could experience an ectopic pregnancy. However, the risk of ectopic pregnancy when not using an IUD is higher.
There’s also a small risk that the IUD may shift position or fall out. This can increase the risk of unwanted pregnancy. Learn what to do if your IUD falls out.
If you have unprotected sex, you can choose to use the Paragard IUD as a form of emergency contraception if it’s inserted within 5 days.
Although it’s a common belief that IUDs can cause weight gain, there isn’t research to support this.
If you’re concerned about gaining weight on birth control, it’s best to talk with a healthcare professional, who can help you decide on the best form of contraceptive for your lifestyle.
Since hormones are slowly released with hormonal IUDs, they can be a better option for patients wanting lower doses of hormones than what they’d get with birth control pills. Unlike many pills, they also don’t contain estrogen.
IUDs are one of the most effective methods of birth control, offering more than 99% efficacy. But no method is 100% effective, and while unlikely, it is possible to get pregnant with an IUD.
Getting pregnant with an IUD also increases your chances of miscarriage or ectopic pregnancy, so you should consult with a healthcare professional immediately if you suspect you may be pregnant.
The key differences between Mirena, Skyla, Liletta, Kyleena, and Paragard are what they’re made of, how they work, how long they last, and possible side effects.
For instance, Mirena, Skyla, Liletta, and Kyleena release hormones into your body. If you prefer to avoid hormones, you might choose Paragard.
However, the hormones in Mirena, Skyla, Liletta, and Kyleena are only released in one part of your body. They don’t have the same kind of broad effect as the hormones in birth control pills, which are delivered through your bloodstream.
On the other hand, if you already have heavy bleeding and cramping during your period, you may not want to use Paragard, which could worsen your bleeding.
To find out more about IUDs, talk with a doctor. They can give you more information about these devices and point you toward an IUD that may work well for you.