Is the risk of ovarian cysts lower with Kyleena (levonorgestrel-releasing intrauterine system) IUD compared to Mirena (levonorgestrel-releasing intrauterine system) IUD?

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From the Guidelines

The risk of ovarian cysts is similar for both Kyleena and Mirena IUDs, with no significant difference between them. According to the evidence from 1, both levonorgestrel-releasing intrauterine devices (LNG-IUDs) have a classification of 1 for benign ovarian tumors, including cysts, indicating that they are considered safe for use in women with this condition. The study from 1 provides information on the failure rates and duration of use for different IUDs, including Kyleena and Mirena, but does not specifically address the risk of ovarian cysts. However, it is known that hormonal IUDs like Kyleena and Mirena can interfere with normal ovulation patterns, leading to the formation of functional cysts in some women.

  • Key points to consider when choosing between Kyleena and Mirena include:
    • Duration of effectiveness: Mirena is approved for 7 years, while Kyleena is approved for 5 years 1
    • Hormone levels: Kyleena contains a lower dose of levonorgestrel (19.5 mg) compared to Mirena (52 mg) 1
    • Menstrual bleeding patterns: The hormone levels in these IUDs can affect menstrual bleeding patterns, which may be an important consideration for some women
  • It is essential to consult a healthcare provider if persistent pelvic pain occurs, as this could indicate a cyst complication.
  • While ovarian cysts are common with hormonal IUDs, they rarely cause serious problems and should not be the primary factor in choosing between Kyleena and Mirena.

From the Research

Ovarian Cyst Risk with Kyleena and Mirena IUDs

  • The risk of ovarian cysts with Kyleena (levonorgestrel-releasing intrauterine system) IUD compared to Mirena (levonorgestrel-releasing intrauterine system) IUD is not directly addressed in the provided studies.
  • However, studies suggest that levonorgestrel-releasing IUDs, such as Mirena, may be associated with a lower risk of ovarian cancer 2.
  • Possible side effects of levonorgestrel-releasing IUDs, including Mirena, include ovarian cysts 3.
  • A study on ovarian function after seven years' use of a levonorgestrel IUD found that follicular cysts were observed in 42% of the "ovulatory" cycles studied 4.
  • There is no direct comparison between Kyleena and Mirena in terms of ovarian cyst risk in the provided studies.

Mechanism of Action and Side Effects

  • Levonorgestrel-releasing IUDs, such as Kyleena and Mirena, work by releasing progestin, causing endometrial suppression and cervical mucus thickening 2.
  • The main side effect of levonorgestrel-releasing IUDs is decreased menstrual bleeding, which may continue even with long-term use 3.
  • Other possible side effects of levonorgestrel-releasing IUDs include headaches, nausea, hair loss, breast tenderness, depression, decreased libido, and oligomenorrhea or amenorrhea 3.

Comparison of IUDs

  • There are two formulations of levonorgestrel-releasing IUDs available in the United States: one that releases 20 mcg of levonorgestrel per 24 hours (Mirena), and one that releases 14 mcg per 24 hours (Kyleena) 3.
  • The copper T 380A IUD is another type of IUD available in the United States, which works by creating a local inflammatory response to prevent fertilization 2.
  • Studies suggest that both levonorgestrel-releasing IUDs and copper IUDs reduce gynecologic cancer risk, although the evidence is less consistent for levonorgestrel-releasing IUDs and cervical and ovarian cancers 2.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Intrauterine devices: an update.

American family physician, 2014

Research

Ovarian function after seven years' use of a levonorgestrel IUD.

Advances in contraception : the official journal of the Society for the Advancement of Contraception, 1995

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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