Dear Alice,

I just read that a new IUD has been approved by the FDA. Tell me more! Who is the best candidate for it? How does it differ from the other two options on the market (ParaGard and Mirena)? If I have had sensitivities to hormonal birth control ("the pill") in the past, would this be a good option for me to explore?

Thanks, Alice!


Looking for New Birth Control Options

Dear Looking for New Birth Control Options,

Choices are great, aren’t they? Since there’s no one-size-fits-all birth control method, the arrival of a new intrauterine device (IUD) on the market is good news for women who would like to prevent pregnancy. Skyla, the newest IUD to be approved by the US Food and Drug Administration (FDA), was made available by prescription in February 2013. Like other IUDs, it is a small, T-shaped device that is inserted into the uterus by a health care provider within a matter of minutes. Like other IUDs, it is highly-effective at preventing pregnancy, long-lasting, and reversible. But, like other IUDs, it does not protect against HIV or sexually transmitted infections (STIs). You will need to use male condoms (or female condoms) to protect against STI’s during intercourse. Studies have found Skyla to be 99 percent effective in preventing pregnancy and while it was designed to work for three years, it can be removed at any time before that (removal also only takes a few minutes) and you should be able to get pregnant right away.

Who is the best candidate for using this new option? Drumroll, please! Skyla was actually designed for women who have not yet had children (though it can also be used by women who have had children). It’s slightly smaller and has a narrower insertion tube than other IUDs that helps place the device into the uterus of a younger woman or a woman who hasn’t had a child. Similar to Mirena and unlike ParagGard, Skyla releases a progestin hormone called levonorgestrel, which has been shown to thicken cervical mucus and block sperm. However, it’s slightly lower-dose than Mirena and lasts a shorter amount of time (three years compared to Mirena’s five and ParaGard’s twelve). Since Skyla releases levonorgestrel into the uterus, it is milder than other hormonal birth control methods that release hormones into the blood stream, so you may not have issues with it even if you’ve had issues with other hormonal methods in the past.

Sound good so far? Common side effects include pain, bleeding or dizziness during and up to 30 minutes after placement, and expulsion (where Skyla comes out by itself). Some women experience spotting or bleeding between periods, cysts on the ovary which may (or may not) disappear on their own, and missing menstrual periods, though often women experience lighter and shorter periods after the first six months. Skyla should not be used if you are prone to pelvic infections, unexplained bleeding from the vagina, liver disease or a liver tumor, or any cancer that is sensitive to progestin.

Skyla, like many other prescription birth control methods, should be covered by your insurance under the 2010 Affordable Care Act. However, if you don’t have insurance or you do but it’s exempt from the new health care rules, the price of Skyla will be comparable to other IUDs (somewhere in the USD $400 — $1000 range). This up-front cost may sound like a lot of money, but if you consider that Skyla lasts for three years, it could end up being a cheaper investment than condoms, oral contraceptives, or other birth control methods. Also, you may be able to get payment assistance or get birth control for free.

In the end, after you’ve done your homework on available birth control methods, determining the best method is a decision to be made with your health care provider.


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