How often should Kyleena (levonorgestrel-releasing intrauterine device (IUD)) be replaced?

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Kyleena IUD Replacement Time

Kyleena (levonorgestrel-releasing intrauterine device) should be replaced after 5 years of use according to FDA approval and clinical guidelines. 1, 2

Intrauterine Device Types and Durations

Intrauterine devices (IUDs) are highly effective forms of contraception with varying durations of use depending on the specific type:

IUD Type Active Ingredient Duration of Approved Use
Paragard Copper 10 years
Mirena 52 mg levonorgestrel 5-7 years
Kyleena 19.5 mg levonorgestrel 5 years
Liletta 52 mg levonorgestrel 5 years
Skyla 13.5 mg levonorgestrel 3 years

Kyleena-Specific Information

Kyleena contains 19.5 mg of levonorgestrel and is FDA-approved for contraceptive use for 5 years 1, 2. Unlike some other IUDs that have evidence supporting extended use beyond their FDA-approved duration, there is currently no published evidence supporting the use of Kyleena beyond its 5-year approved timeframe.

Importance of Timely Replacement

Timely replacement of Kyleena after 5 years is important for several reasons:

  1. Contraceptive efficacy: The contraceptive effectiveness may decrease after the approved duration as hormone levels decline

  2. Non-contraceptive benefits: For women using Kyleena for therapeutic benefits (such as management of heavy menstrual bleeding), continued efficacy requires timely replacement

  3. Risk management: While the risk of pelvic inflammatory disease (PID) is primarily associated with insertion rather than duration of use 3, maintaining the recommended replacement schedule ensures optimal protection

Clinical Considerations for Replacement

When approaching the 5-year mark for Kyleena:

  • Schedule a replacement appointment before the 5-year expiration date
  • Consider pregnancy testing before removal if there is any possibility of pregnancy
  • The new IUD can be inserted during the same visit as removal of the expired one
  • If a gap between removal and insertion is necessary, use alternative contraception during this time

Special Populations

For perimenopausal women, Kyleena can be particularly beneficial when combined with estrogen therapy for management of menopausal symptoms 4. In these cases, timely replacement at 5 years remains important to maintain both contraceptive efficacy and endometrial protection.

Common Pitfalls to Avoid

  1. Premature routine replacement: The Society for Maternal-Fetal Medicine recommends that IUDs should be left in place up to their maximum lifespan and not routinely replaced earlier 1, 3. This minimizes the risk associated with the insertion process.

  2. Delayed replacement: Waiting beyond the 5-year mark may reduce contraceptive efficacy and expose the patient to unintended pregnancy risk.

  3. Confusing Kyleena with other LNG-IUDs: Different LNG-IUDs have different durations of effectiveness. Kyleena (5 years) should not be confused with Mirena (up to 7 years) or Skyla (3 years).

Following the recommended 5-year replacement schedule for Kyleena ensures optimal contraceptive efficacy and therapeutic benefits while minimizing risks associated with both premature replacement and extended use beyond approved duration.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Guideline

Contraception with Intrauterine Devices

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025

Research

Why perimenopausal women should consider to use a levonorgestrel intrauterine system.

Gynecological endocrinology : the official journal of the International Society of Gynecological Endocrinology, 2016

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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