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How Does Skyla Work?

Skyla is a small device that is placed into the uterus by a healthcare provider. Once in place, it releases a low level of the hormone levonorgestrel into the uterus. Levonorgestrel is a progestin hormone. Skyla does not contain estrogen.
Although it is not entirely known how Skyla works to prevent pregnancy, it is thought to work in several ways, including:
  • Thickening the cervical mucus, which makes it more difficult for sperm to enter the uterus
  • Inhibiting sperm movement
  • Reducing the ability of sperm to survive in the uterus
  • Thinning the lining of the uterus.
Skyla does not appear to affect ovulation. In clinical studies, all but one woman studied for ovulation continued to ovulate in the first and second year of use, and all women ovulated in the third year of use.

Clinical Effects

Skyla is quite effective at preventing pregnancy. In clinical studies, only about 0.9 percent of women using Skyla became pregnant over the three years of use. The medication was also shown to be reversible. Once the device was removed, 77 percent of women wishing to become pregnant were able to do so within a year.

When and How to Use This Contraceptive

Some general considerations to keep in mind while using this contraceptive include the following:
  • This contraceptive comes as a small plastic device that is placed into your uterus by a trained healthcare provider. The device is usually inserted within seven days after your period starts, immediately after a first-trimester abortion or miscarriage, or at least six weeks after giving birth.  
  • Your healthcare provider will use a slim plastic tube to place Skyla into your uterus. Once Skyla is in place, the plastic tube will be removed. It only takes a few minutes for Skyla to be inserted.
  • You may experience some dizziness, pain, or bleeding during or right after placement. If your symptoms do not improve within 30 minutes, let your healthcare provider know. Skyla may not be placed properly.
  • Your healthcare provider may recommend you take a pain reliever, such as acetaminophen (Tylenol®), before the device is placed.
  • It is a good idea to check the placement of Skyla once a month. You can do this by washing your hands with soap and water and feeling for the threads at the top of your vagina. If you do not feel the threads, or feel plastic, let your healthcare provider know right away. Skyla may not be properly placed, and may not prevent pregnancy.
  • Do not pull on the Skyla threads. Doing so could displace the device and prevent it from working properly to prevent pregnancy.
  • It is okay to use tampons during Skyla treatment. Tampons will not affect the device.
  • Although Skyla may be left in place for up to three years, your healthcare provider can remove it at any time. If you wish to continue using this form of birth control after three years, your healthcare provider will need to remove your current device and replace it with a new one. 
  • For the contraceptive to work properly, it must be used as prescribed. If Skyla is not inserted properly, or if it becomes displaced, it may not prevent pregnancy.
Written by/reviewed by:
Last reviewed by: Kristi Monson, PharmD;
Last updated/reviewed:
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