Kyleena vs. Mirena: Differences, similarities, and which is better for you

Drug overview & main differences | Conditions treated | Efficacy | Insurance coverage and cost comparison | Side effects | Drug interactions | Warnings | FAQ

Kyleena and Mirena are two brand-name medications used for birth control. Both medications are approved by the United States Food and Drug Administration (FDA) and contain a progestin called levonorgestrel (LNG).

Unlike traditional birth control pills that are taken by mouth, Kyleena and Mirena are both intrauterine devices (IUDs). A hormonal IUD is a tiny device that is inserted into your uterus by your healthcare provider and releases the hormone LNG slowly over time. The way these IUDs work is not entirely understood, but it’s suggested that LNG prevents ovulation and changes the cervical mucus and endometrial lining to prevent pregnancy.

One Kyleena IUD can be used for up to five years to prevent pregnancy. A Mirena IUD can be used for up to eight years to prevent pregnancy, or for up to five years to treat heavy menstrual bleeding. Bayer HealthCare Pharmaceuticals, Inc. makes both products. (Bayer also makes an IUD called Skyla.)

Although both of these medications are IUDs that contain LNG, Kyleena and Mirena have some differences. Continue reading to learn all about Kyleena and Mirena.

What are the main differences between Kyleena and Mirena?

Kyleena and Mirena are both hormonal IUDs that contain a progestin called levonorgestrel (LNG). Both medications are available in brand name only. Kyleena contains a lower dose of LNG, as you can see in the information below.

Kyleena is also distinguished from other intrauterine devices by a blue-colored removal thread and the visibility of a silver ring on ultrasound. Your healthcare provider must insert Kyleena or Mirena. The IUD can stay in your body for five to eight years, depending on the IUD and indication for use. At that point, your healthcare provider must remove it. If you wish to continue using an IUD, a new IUD can be put in as soon as the previous one is removed.

Conditions treated by Kyleena and Mirena

Kyleena and Mirena are both indicated to prevent pregnancy. For this use, Kyleena can be used for up to five years, or Mirena can be used for up to eight years. Mirena is also indicated for the treatment of heavy menstrual bleeding for up to five years. Kyleena does not have this indication, but some doctors may prescribe it off-label to help with heavy periods. It is important to note that IUDs do not protect against HIV/AIDS or other sexually transmitted infections.

Is Kyleena or Mirena more effective?

Studies are not available comparing Kyleena to Mirena. Looking at each drug individually, Kyleena’s information states that the Kyleena IUD is over 99% effective at preventing pregnancy for each year of use. Over five years, it is 98.5% effective.

Mirena states similar information—it is over 99% effective at preventing pregnancy for up to eight years.

Each IUD works as an effective method of contraception. They are appropriate for long-term use. Also, unlike birth control pills, you don’t have to remember to take it every day. (You just check for the threads once a month.)

These IUDs are also reversible contraception, meaning that when the IUD is removed, you can get pregnant. Most patients are able to get pregnant within 12 months after IUD removal. Only your healthcare provider can determine which medication is better for you, taking into account your medical history.

Coverage and cost comparison of Kyleena vs. Mirena

Because your healthcare provider administers Kyleena or Mirena in the office, he or she will provide the device. You will not typically visit a pharmacy for Kyleena or Mirena. Therefore, your healthcare provider will submit Kyleena or Mirena to your medical insurance.

The out-of-pocket price of one Kyleena IUD is approximately $1,400. You can ask your healthcare provider if they will accept a SingleCare coupon, bringing the price down to about $1,037.

The out-of-pocket price of a Mirena IUD is about $1,300. You can ask your healthcare provider if you can use your SingleCare coupon, reducing the cost to approximately $1,037.

Get the SingleCare discount card

Common side effects of Kyleena vs. Mirena

Because Kyleena and Mirena contain the same active ingredient, levonorgestrel, side effects are very similar. The most common side effects of Kyleena and Mirena include vaginal inflammation, abdominal pain, menstrual cramps, nausea, acne, breast discomfort, and changes in menstrual bleeding patterns. Device expulsion occurred in a small percentage of patients in clinical trials.

This is not a full list of side effects. Other adverse effects may occur. Consult your healthcare provider for a complete list of side effects.

Source: DailyMed (Kyleena), DailyMed (Mirena)

Drug interactions of Kyleena vs. Mirena

Drug interaction studies have not been conducted with Kyleena or Mirena, which both contain LNG. However, drugs that induce enzymes that process LNG may decrease LNG levels, making the IUD less effective. On the other hand, drugs that inhibit enzymes that process LNG may increase LNG levels, causing more side effects. Due to the local effect of the medication (the drug is released into the uterine cavity), the drug interactions may not be clinically relevant. Ask your healthcare provider if there are any drug interactions with medicines you take.

The manufacturer of both Kyleena and Mirena recommends that any drug prescribed along with one of these IUDs should be checked for potential drug interactions with LNG.

This is not a full list of drug interactions. Consult your healthcare provider for medical advice.

Warnings of Kyleena and Mirena

Because both Kyleena and Mirena contain the same ingredient, levonorgestrel, warnings are the same.

• Kyleena or Mirena should not be used in patients:
  • Who are pregnant or suspected to be pregnant
  • With uterine problems, such as fibroids
  • Who have acute pelvic inflammatory disease (PID), a history of PID, or who are susceptible to pelvic infections
  • With uterine or cervical neoplasia (growth)
  • Who have breast cancer or other progestin-sensitive cancer (or a history)
  • With uterine bleeding of unknown cause
  • Who have untreated cervical or vaginal infections (until the infection is controlled)
  • With liver disease or tumor
  • Who currently have an IUD inserted
  • Who are hypersensitive to the ingredients
• Kyleena or Mirena should not be used as emergency contraception.
• The patient should be evaluated four to six weeks after IUD insertion.
• Kyleena or Mirena should be removed if pregnancy occurs. There is an increased risk of ectopic pregnancy, which could lead to pregnancy loss, fertility loss, septic abortion (including death), and premature labor and delivery.
• The healthcare provider must use strict aseptic technique to prevent infection upon IUD insertion.
• The healthcare provider should consider the risks of pelvic inflammatory disease.
• Uterine perforation may occur, which can decrease the IUD’s effectiveness and/or require surgery. There is an increased risk in postpartum and breastfeeding women.
• Partial or complete expulsion may occur (it may be unnoticed), which leads to loss of efficacy.
• Kyleena or Mirena may alter bleeding patterns, possibly causing irregularity and/or amenorrhea (not having periods).
• Ovarian cysts may occur. Enlarged ovarian follicles or ovarian cysts should be evaluated by your healthcare provider.
• Kyleena can be scanned in MRI under certain conditions. If you need an MRI, notify your healthcare provider and radiology/hospital staff that you have an IUD.
• IUDs do not protect against HIV/AIDS or other sexually transmitted diseases.
• Contact your healthcare provider immediately if you experience:
  • A stroke or heart attack
  • Migraine headaches
  • Unexplained fever
  • Signs of liver problems (yellow skin or whites of the eyes)
  • Pregnancy or suspected pregnancy
  • Pelvic or abdominal pain
  • Pain during intercourse
  • An HIV positive test (in yourself or your partner)
  • Exposure to sexually transmitted infections
  • Unusual vaginal discharge
  • Genital sores
  • Severe or long-lasting bleeding
  • Inability to feel the IUD threads

Frequently asked questions about Kyleena vs. Mirena

What is Kyleena?

Kyleena is a birth control method used to prevent pregnancy for up to five years. It is an intrauterine device (IUD) and contains a progestin called levonorgestrel.

What is Mirena?

Mirena is also an IUD that contains levonorgestrel. It is indicated for the prevention of pregnancy (for up to eight years) as well as to treat heavy menstrual bleeding (for up to five years).

Are Kyleena and Mirena the same?

Both Kyleena and Mirena are IUDs that contain levonorgestrel. Kyleena can be used for up to five years to prevent pregnancy. Mirena can be used for up to eight years to prevent pregnancy, or up to five years to treat heavy menstrual bleeding. The dose of hormones (levonorgestrel) is different. Mirena contains a higher amount of hormone than Kyleena. Side effects are similar. Other hormonal IUDs include Skyla and Liletta.

You may have also heard of the Paragard IUD. Paragard is different from Kyleena and Mirena because it is a copper IUD and does not contain hormones.

Are the Kyleena and Mirena IUDs the same size?

Kyleena is slightly smaller than Mirena. The difference is small, so you can ask your healthcare provider if the size would make a difference in your case. 

Is Kyleena or Mirena better?

Both Kyleena and Mirena are very effective, over 99% effective in preventing pregnancy for each year of use. Kyleena is 98.5% effective after five years, and Mirena is over 99% effective after eight years. Your healthcare provider can help you determine if Kyleena or Mirena is better for you.

Can I use Kyleena or Mirena while pregnant?

Call your healthcare provider right away if you have a Kyleena or Mirena device and think that you may be pregnant. The IUD can cause an ectopic pregnancy (pregnancy outside of the uterus), a severe medical emergency. If you have a device inserted and get pregnant, and the pregnancy is in the uterus, severe infection, miscarriage, premature delivery, and even death could occur. Your healthcare provider may try to remove the IUD, which may cause a miscarriage. It is unknown if LNG IUDs can cause long-term effects on the fetus if the IUD stays in place during a pregnancy. Your healthcare professional can direct you on the safest course of action.

Can I use Kyleena or Mirena with alcohol?

Kyleena or Mirena do not have an interaction with alcohol. An IUD may actually be a preferred method of birth control for a patient who drinks alcohol.

Is Kyleena less painful than Mirena?

IUD insertion (either Kyleena or Mirena) may cause some pain, bleeding, dizziness, and discomfort. You should feel better within about 30 minutes after placement. If you do not feel better by this time, your healthcare provider will need to examine you to ensure the device was placed correctly. Kyleena is slightly smaller in size than Mirena, so some patients tolerate insertion better.

Which IUD is the best?

IUDs are a popular and effective method of contraception. Your healthcare provider can help you sort through birth control options and determine if an IUD is right for you, and if so, which one is best, taking into account your medical history.

Can the Kyleena and Mirena IUDs affect your weight?

While the prescribing information for Kyleena does not mention weight gain as a side effect, the prescribing information for Mirena does note that weight gain may be a side effect. However, although 6% of women who used Mirena reported weight gain, it was not known if the weight gain was due to Mirena. 

In general, hormonal birth control can cause side effects such as bloating and water retention, which is not the same as weight gain due to an increase in body fat. For many, the weight gain is small (about 5 pounds), and the benefits of birth control outweigh the possibility of a small weight gain. Most adults naturally gain one or two pounds per year, regardless of birth control. If weight gain is a concern, consult your healthcare provider before deciding on a hormonal IUD or another form of birth control. 

Does Kyleena cause facial hair?

Kyleena may cause acne or greasy skin. The manufacturer’s information does not list facial hair as a side effect. Consult your healthcare provider for more details.

Does Kyleena make your hair fall out?

In clinical trials, about 1% of women who used Kyleena reported hair loss. Hair loss was also noted in less than 5% of women who used Mirena. If you are concerned about hair loss, consult your healthcare provider before using Kyleena or any form of hormonal birth control. 

How do the Kyleena and Mirena IUDs affect your period?

Different people may react to IUDs differently. Some women will have irregular bleeding, and some may have spotting. Some patients will not have periods at all (or will have infrequent periods) while on Kyleena or Mirena after a period of time. 

Does Kyleena stop periods?

Kyleena can cause irregular bleeding. Some patients may even have increased bleeding at first. Some patients have spotting as well, or lighter periods. Some patients have amenorrhea (the absence of periods). In clinical trials, about 12% of patients on Kyleena had amenorrhea after one year. After three years, about 20% had amenorrhea, and after five years, about 23% had amenorrhea.