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Contraceptive Pearl: Why Use the Low Dose Progestin IUD

The LNG-IUD 13.5mg Progestin IUD, also known by its brand name, Skyla®, is the newest IUD approved by the FDA. It prevents pregnancy by releasing a small dose of progestin.

The LNG-IUD 13.5mg lasts for a maximum of 3 years (compared with 7 years for the LNG-IUD 52mg or Mirena®). This decreases its cost effectiveness. The 13.5mg IUD  measures 1.1 by 1.2 inches compared to the 52mg IUD at 1.3 square inches. The smaller size may result in slightly easier and less painful insertion.

The LNG-IUD 13.5mg is less likely than the 52mg IUD to cause amenorrhea. Additionally, it has not been shown to be an effective treatment for heavy menstrual bleeding. Women who want lighter periods but feel wary of having no period at all may want to choose the lower dose progestin IUD.  Those who want to avoid hormones entirely can choose the copper IUD, which generally causes heavier periods with more cramps. Thus, for women who prefer an IUD that doesn’t stop their monthly period but doesn’t make it heavier, the LNG-IUD 13.5mg may be the best choice.

Providers should be cautioned that in earlier studies when a patient did become pregnant with the low dose progestin IUD (which is rare), 50% of the time it was an ectopic pregnancy, so the location of the pregnancy should be determined urgently.


Helpful Resources

IUD Fact Sheet



Wu JP, Pickel S. Extended use of the intrauterine device: a literature review and recommendations for clinical practice. Contraception 2014; 89: 495-503

Gemzell-Danielsson K, Schellschmidt I, Apter D. A randomized, phase II study describing the efficacy, bleeding profile, and safety of two low-dose levonorgestrel-releasing intrauterine contraceptive systems and Mirena. Fertility and Sterility 2012; 97: 616- 622

A New Low-Dose Levonorgestrel-Releasing IUD (Skyla). The Medical Letter 2013; 1412: 21-23



The Reproductive Health Access Project does not accept funding from pharmaceutical companies. We do not promote specific brands of medication or contraception. The information in the Contraceptive Pearls is unbiased, based on science alone.

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