Is the Kyleena (levonorgestrel-releasing) intrauterine device (IUD) less painful to insert than the Mirena (levonorgestrel-releasing) IUD due to differences in size?

Medical Advisory BoardAll articles are reviewed for accuracy by our Medical Advisory Board
Educational purpose only • Exercise caution as content is pending human review
Article Review Status
Submitted
Under Review
Approved

Last updated: April 13, 2025View editorial policy

Personalize

Help us tailor your experience

Which best describes you? Your choice helps us use language that's most understandable for you.

From the Research

The Kyleena IUD is likely to be less painful to insert than the Mirena IUD due to its smaller size, with most participants rating the placement pain as 'none' or 'mild' in a recent study 1. Kyleena is 28mm x 30mm with a 3.8mm insertion tube diameter, while Mirena is 32mm x 32mm with a 4.4mm insertion tube diameter. This difference means Kyleena requires less cervical dilation during placement, potentially resulting in less discomfort. Some key points to consider:

  • Individual pain experiences vary significantly based on factors like cervical tightness, previous pregnancies, pain tolerance, and provider technique.
  • Both insertions typically cause cramping pain that lasts seconds to minutes.
  • To minimize discomfort with either IUD, consider taking 600-800mg ibuprofen 1-2 hours before the procedure, scheduling during your period when the cervix is naturally more open, and discussing pain management options with your provider, such as lidocaine gel or cervical blocks.
  • A recent study found that lidocaine-prilocaine cream is the most effective medication for reducing IUD insertion-related pain 2.
  • Despite size differences, both IUDs are effective long-acting contraceptives, with Mirena lasting up to 7 years and Kyleena up to 5 years.
  • Real-world evidence from the Kyleena Satisfaction Study in routine clinical practice shows high bleeding profile satisfaction with levonorgestrel 19.5 mg IUD regardless of age or parity, and confirmed that device placement is easy and associated with no more than mild pain in most cases 1.

References

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.

Have a follow-up question?

Our Medical A.I. is used by practicing medical doctors at top research institutions around the world. Ask any follow up question and get world-class guideline-backed answers instantly.