Can the Kyleena (levonorgestrel-releasing intrauterine device (IUD)) cause decreased libido and vaginal dryness?

Kyleena IUD and Sexual Side Effects

Yes, the Kyleena IUD (levonorgestrel-releasing intrauterine device) can cause decreased libido and vaginal dryness in some women, though these side effects are not universally experienced.

Hormonal Effects on Sexual Function

• Levonorgestrel-releasing IUDs like Kyleena can affect sexual function through their hormonal effects, though the evidence is mixed regarding the prevalence and severity of these effects 1.
• While some women experience decreased sexual desire with hormonal IUDs, others report no change or even improvements in sexual function parameters 2.
• Sexual desire can decrease with age, in nulliparous women, and in those with relationship difficulties, regardless of contraceptive method 1.

Vaginal Dryness

• Hormonal IUDs can cause vaginal dryness in some users, which may lead to dyspareunia (painful intercourse) 3.
• Vaginal dryness is more commonly associated with systemic hormonal changes but can occur with local progestin exposure from IUDs 3.
• Vaginal dryness tends to be less severe with levonorgestrel IUDs compared to other hormonal contraceptives since the hormone is primarily released locally 2.

Timing of Side Effects

• Some sexual side effects may improve over time as the body adjusts to the IUD 1.
• Sexual desire may actually increase between 6-12 months of contraceptive use as women adjust to the method 1.
• Other side effects, particularly intermenstrual spotting and pain, may persist or even increase over time 4.

Management Options

• For vaginal dryness, non-hormonal lubricants and moisturizers (like Replens or Sylk) can be effective first-line treatments 3.
• If vaginal dryness persists and causes significant discomfort, consider evaluation for other causes such as vaginal infections 3.
• For decreased libido that significantly impacts quality of life, consider:
  • Ruling out other causes of sexual dysfunction (relationship issues, stress, medications) 5
  • Evaluating if the timing of symptoms correlates with IUD placement 1
  • Discussing alternative contraceptive options if symptoms are severe and persistent 3

When to Consider IUD Removal

• If sexual side effects persist beyond 6 months and significantly impact quality of life despite management attempts 3.
• If vaginal dryness leads to recurrent infections or persistent dyspareunia unresponsive to lubricants 3.
• When counseling about removal, discuss alternative contraceptive options that might have fewer sexual side effects 3.

Important Considerations

• Sexual dysfunction is multifactorial - before attributing problems solely to the IUD, consider other potential causes including relationship factors, stress, medications, and age-related changes 5.
• The benefits of the IUD (highly effective contraception, reduced menstrual bleeding for many users, convenience) should be weighed against these potential side effects 3.
• Some women actually experience improved sexual function with levonorgestrel IUDs due to reduced menstrual symptoms and contraceptive confidence 2.