The Medical Letter on Drugs and Therapeutics
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A New Low-Dose Levonorgestrel-Releasing IUD (Skyla)

The FDA recently approved Skyla (Bayer), the first new intrauterine device (IUD) in the US in 12 years. It releases levonorgestrel, a synthetic progestin, over a period of 3 years. A table summarizing contraceptive methods available in the US appears below.

OTHER IUDs — Two other IUDs are currently available in the US. The ParaGard T380A is a copper-containing device (copper is spermicidal) that is FDA-approved for use for 10 years. The Mirena device is FDA-approved for 5 years; it releases 20 mcg/day of levonorgestrel initially, which decreases gradually over 5 years to 10 mcg/day.1

MECHANISM OF ACTION — Local progestogenic effects that interfere with pregnancy include thickening of cervical mucus, inhibition of sperm capacitation and survival, and changes in the endometrial lining. Progestins also decrease gonadotropin ... more      

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