Can a Kyleena (levonorgestrel-releasing intrauterine device (IUD)) be used for 7 or 8 years?

From the Guidelines

Kyleena should not be used for 7 or 8 years, as its FDA-approved duration is 5 years. The provided evidence does not specifically mention Kyleena, but it discusses levonorgestrel-releasing IUDs in general, including Mirena, which has a similar formulation and is approved for 5 years, although data suggest it remains effective for up to 7 years 1. However, this information cannot be directly applied to Kyleena, as it is a different product with a specific approval for 5 years. Using Kyleena beyond its approved duration would mean operating outside of established clinical guidelines, potentially resulting in decreased contraceptive effectiveness as hormone levels decline over time.

Some key points to consider when evaluating the use of Kyleena or any other IUD include:

• The type of IUD and its specific FDA-approved duration
• The potential for decreased effectiveness over time
• The importance of following established clinical guidelines for contraceptive use
• The need for regular monitoring and potential replacement or alternative contraceptive methods after the approved duration.

Given the information available, the most prudent decision, prioritizing morbidity, mortality, and quality of life, is to adhere to the FDA-approved duration for Kyleena, which is 5 years, and to consider replacement or an alternative contraceptive method at that time to ensure continued effective contraception and minimize risks associated with unintended pregnancy 1.

From the Research

Kyleena IUD Usage Duration

• The Kyleena IUD is a type of levonorgestrel-releasing intrauterine device (LNG-IUS) with a lower hormone dose compared to other LNG-IUSs like Mirena 2.
• According to the available studies, there is limited information on the use of Kyleena beyond 5 years 2.
• However, a study on the Mirena IUD, which has a similar mechanism of action, found that it can be used for up to 8 years with high contraceptive efficacy and a favorable safety profile 3.
• Another study reviewed the extended use of various IUDs, including the levonorgestrel intrauterine system, and found that the Mirena IUD can be used for up to 7 years, but there is no data to support the use of the Kyleena IUD beyond 3 years 4.
• It is essential to note that the Kyleena IUD has a different hormone dose and design compared to the Mirena IUD, and more research is needed to determine its efficacy and safety beyond 5 years 2.

Key Findings

• The Mirena IUD has been shown to be effective for up to 8 years, with a 3-year Pearl Index of 0.28 and a cumulative failure rate of 0.68% 3.
• The extended use of IUDs can provide continued contraceptive and non-contraceptive benefits, but the risk of pregnancy and other adverse events should be carefully considered 4.
• The Kyleena IUD has a lower hormone dose and may have different bleeding patterns and side effects compared to the Mirena IUD 2.

Recommendations

• Clinicians should consider the individual patient's characteristics, preferences, and medical history when deciding on the use of the Kyleena IUD or other LNG-IUSs 2.
• More research is needed to determine the efficacy and safety of the Kyleena IUD beyond 5 years, and clinicians should carefully monitor patients who choose to use the device for extended periods 4, 2.