What the Kyleena is and why consider it

The Kyleena is the latest hormonal intrauterine device (IUD) to be approved for use in Australia. IUDs are a great option for women who want effective contraception but prefer a lower or non-hormonal method; such as women who get migraine headaches or women who experience side-effects from the oral contraceptive pill.

It is exciting to have a new IUD available because it releases a very low dose of hormone – less than half the dose in the popular Mirena IUD. It is also slightly smaller; studies have shown that it is easier and less painful to insert, especially for women who have never given birth vaginally. And it still provides excellent contraception for five years.


How do the Kyleena and Mirena work?

The Kyleena and Mirena are small, plastic, T-shaped medical devices which release a steady low dose of progesterone hormone into the uterus (womb). Copper IUDs are also an option (more on these another time.)



All IUDs have to be inserted by a trained medical person in a procedure which is similar to a cervical screening test (Pap smear).

The Kyleena works in several ways to prevent pregnancy:

- Changes or thickens the cervical mucus making it very difficult for the sperm to make its way up into the uterus to find and fertilise the egg

- Thins the lining of the uterus, making it less suitable for a pregnancy


What’s the difference between a Kyleena and a Mirena?

There are a few key differences between the Kyleena and the Mirena. While Mirena can be an excellent treatment for heavy periods and can also be used in combination with oestrogen as menopause hormone therapy (also called HRT), the dose of progesterone in the Kyleena is too low to be used specifically for these reasons. However, Kyleena still does lighten the period (menstrual bleed) for nearly all users and some may find their period stops for a while.


When using an IUD, the body continues to release eggs (ovulate) and this can be good for sex drive. This can sometimes be a problem with contraceptive pills and implants (Implanon) which work by stopping ovulation. This does mean that there is a “menstrual cycle”, usually monthly, and people may experience premenstrual symptoms like moodiness or breast fullness, even if the actual period bleed is much lighter or absent.


Side effects

Side effects with Kyleena are not very common but can occur. These include expulsion (pushing out) of the plastic IUD, pelvic pain or infection, failure (pregnancy), hormone side effects and changes in menstrual bleeding pattern. Ovarian cysts can occur especially in the first year following Kyleena insertion but these are not usually painful and most go away by themselves without any treatment.


Cost

Both Kyleena and Mirena require a prescription to buy from a pharmacy and cost around $37-40 with Medicare (or less with a low-income healthcare card or CTG). This means they usually work out a lot cheaper than pills over time. Even the full cost of around $280 without Medicare can still be cost effective over five years. There is a fee for the IUD insertion procedure


Is this the best contraceptive choice for you?

The World Health Organisation (WHO) and the Australian College of Gynaecologists (RANZCOG) and Family Planning NSW all highly recommend IUD use for contraception in young people and for people who intend to become pregnant in future because they are safe and effective and reversible.


It is always very important to protect against sexually transmitted infections (STIs), like chlamydia, because studies have shown that chlamydia infections (especially if had more than once) can be associated with fertility problems. However, there is no evidence to link IUD use with difficulty getting pregnant.


We would be very happy to spend the time with you to look at your health needs and provide you with information to help you decide what method is right for you.


See these links for more useful information:

https://www.fpnsw.org.au/factsheets/individuals/contraception/hormonal-iud

https://www.familyplanningallianceaustralia.org.au/larc/

https://www.nps.org.au/radar/articles/levonorgestrel-kyleena-for-contraception

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