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Types of IUDs

What are the differences and similarities?

The market for IUDs is growing, so, naturally, the number of IUD brands is growing as well. Although there are still only two types (hormonal and non-hormonal), there are now five separate brands of IUDs that fall under those types. They are: Paragard (the only non-hormonal), Mirena, Skyla, Liletta, and Kyleena (all hormonal).

Browse the comparison chart for a quick take, and then we'll go over each brand in detail below.



Paragard
Mirena
Skyla
Liletta
Kyleena
Hormonal?
No
Yes
Yes
Yes
Yes
Cost with insurance
Free under most plans
Free under most plans
Free under most plans
Free under most plans
Free under most plans
Cost without insurance
$500-932
$500-927
$650-780
$50-750
Not enough data yet
How long does it last?
10-12 years
5 years
3 years
3 years
5 years
Possible Side Effects
Anemia, backaches, cramps, heavier periods, spotting, vaginal discomfort for first few months
Mild discomfort, aching, itching for first few months, menstrual bleeding, mood changes, lighter periods, acne  
Similar to Mirena
Similar to Mirena
Similar to Mirena


PARAGARD

Paragard is the only non-hormonal IUD, and is produced by Teva Pharmaceutical Industries. It contains small amounts of copper, which is toxic to sperm. Paragard is the longest-lasting IUD, making it very popular among women. Better yet, Paragard can be used as an emergency contraceptive if you have it inserted within five days of unprotected sex.

What many women like about Paragard is the fact that it doesn't use hormones to prevent pregnancies. As a result, it doesn't affect your mood, skin, or appetite like the hormonal IUDs might. It may make your periods heavier or longer at first, but this side effect usually goes away within a few months.

As it lasts the longest (10-12 years), Paragard is also the most cost-effective. If you don't have insurance, it will literally cost pennies a day. If you DO have insurance, then it should be no cost at all (or very low cost).

Of course, Paragard is not for everyone. You should NOT use Paragard if you:
  1. Might be pregnant before insertion
  2. Have pelvic inflammatory disease or a history of it
  3. Have a history of uterine infections, or cancer in the uterus or cervix
  4. Are allergic to copper
  5. Have Wilson's disease (a rare disease with which you accumulate too much copper in your liver)
However, these do not apply to most women. Naturally, you should consult a doctor first, but if you are healthy and of reproductive age, Paragard should be safe for you.

The device itself measures 32 mm by 36 mm (about half the length of your index finger).


MIRENA

Mirena is the oldest and most recognized of the hormonal IUDs, and is the only one recommended to actually treat heavy periods. It, along with Skyla, Liletta, and Kyleena, uses levonorgestrel to thicken the cervical mucus and impede sperm mobility. The only difference between the hormonal IUDs is the size and amount of levonorgestrel used. In Mirena's case, it's 52 mg of levonorgestrel.

Since it's hormonal, you might experience mood fluctuations, acne, breast tenderness, and changes in appetite. It could also lessen your period, or stop it altogether after a few months. However, these side effects occur in relatively few cases.

Mirena is also suggested for women who have already had a child (simply because the research conducted on Mirena included such women) but you should NOT use Mirena if you:
  1. Have pelvic infections or are at risk of cancer there
  2. Have ovarian cysts or have had them before
  3. Have liver disease
  4. Are allergic to levonorgestrel, silicone, polyethylene, silica, barium sulfate or iron oxide (the ingredients of Mirena)
  5. Have unexplained vaginal bleeding
  6. Have or have had any progestin-sensitive cancers, like breast cancer
Mirena measures 32 mm by 32 mm.

Skyla

Skyla and Mirena are actually manufactured by the same parent company, Bayer. The only difference is the size (Skyla is 28 mm by 30 mm, so a bit smaller than Mirena) and the amount of levonorgestrel (13.5 mg as opposed to Mirena's 52 mg). Because it has less hormones, Skyla only last 3 years, not 5. And unlike Mirena, it doesn't matter if you have had a child or not - Skyla can work for anyone.

Some women prefer Skyla because it is smaller, and thus the insertion process is easier. It's also better for women with smaller uteri. But other side effects are pretty much the same, as is the list of women who should NOT use it.


Liletta

Liletta is made by Allergan, another pharma behemoth, in partner with a non-profit pharma company called Medicines360. Thanks to this partnership, Liletta should actually be cheaper than Mirena or Skyla (hence why our nifty chart says $50-750 for "Cost without insurance").

Even though Liletta contains the same amount of hormones as Mirena (52 mg), the packaging states that it lasts for only 3 years, not 5. Apparently, this is only because the producer wanted to get it past the FDA quickly, so they settled for a 3 year expiration until more studies were concluded. One such study shows that it should by able to last 5 years. Just waiting for the FDA now.

All other side effects and eligibility requirements are the same as Mirena's and Skyla's, but Liletta's insertion procedure might be easier now thanks to a new device introduced by the producer. It's a single-handed device that is more flexible, so it should be less painful for women receiving the IUD.

Liletta is 32 mm by 32 mm.


Kyleena

Kyleena, another Bayer child,  is the newest kid on the block. It's the same size as Skyla (28 mm by 30 mm), but contains 19.5 mg of levonorgestrel. Side effects and recommendations are the same as the other hormonal IUDs, and the review tests included both nulliparous women (those who have not given birth), and primiparous women (those who have).

ALL TYPES

All of the IUDs - Paragard, Mirena, Skyla, Liletta, and Kyleena:
  • Do not protect against STDs
  • Must be prescribed and inserted by a health official
  • Should be checked monthly by seeing if you can feel the strings
  • Are FDA-approved

Sources:

https://bedsider.org/methods/iud#side_effects_tab

https://www.verywell.com/skyla-vs-mirena-906769

https://bedsider.org/features/674-introducing-liletta-a-nother-new-iud

http://www.paragard.com/Safety-questions.aspxhttp://www.ctcfp.org/wp-content/uploads/March-2013-Contraceptive-Technology-Update.pdf

https://www.hhs.gov/opa/pdfs/iud-fact-sheet.pdf

http://www.webmd.com/drugs/2/drug-168141-4300/liletta-intrauterine/levonorgestrel-releasing-5-year-system---intrauterine/details/list-sideeffects

https://www.drugs.com/sfx/kyleena-side-effects.html

https://www.drugs.com/pro/kyleena.html

http://hcp.skyla-us.com/faqs/

http://www.mirena-us.com/frequently-asked-questions/?ecid=mirena:ps:de:psl:psl:41640:9016

https://uhs.berkeley.edu/sites/default/files/ParaGard%2520IUD.pdf

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