Kyleena is FDA-approved to prevent pregnancy for up to 5 years. It must be removed by the end of the fifth year, though you can have a new one placed immediately during the same appointment if you want to continue using it.
How Kyleena Works Over 5 Years
Kyleena is a small, T-shaped intrauterine device that releases a low dose of a synthetic hormone called levonorgestrel directly into the uterus. It contains 19.5 mg of the hormone total, which slowly releases over the device’s lifespan. The daily release rate starts at about 17.5 micrograms per day, then gradually tapers. By the end of the first year, it drops to roughly 9.8 micrograms per day, and by year five it’s down to about 7.4 micrograms per day.
Even at that lower dose in the final year, Kyleena still provides effective pregnancy prevention. The hormone works primarily by thickening cervical mucus so sperm can’t easily reach an egg, and by thinning the uterine lining. It may also partially suppress ovulation, though not as consistently as birth control pills do.
What Happens to Your Period
The most noticeable change for many people is lighter periods. Because the hormone thins the uterine lining, there’s simply less tissue to shed each month. Some people stop getting periods altogether, while others have light spotting instead of a full period. This effect tends to increase over time as the device continues releasing hormone.
The first three to six months are often the roughest. Irregular bleeding and spotting are common during this adjustment window. After that, bleeding typically becomes lighter and more predictable. If your periods do stop entirely, that’s not a sign of anything harmful. It’s a normal response to the local hormone exposure in your uterus.
How Kyleena Compares to Other Hormonal IUDs
Kyleena is one of the smaller hormonal IUDs available. It measures 28mm by 30mm, the same dimensions as Skyla. By comparison, Mirena and Liletta are both 32mm by 32mm, and the copper IUD (Paragard) is the largest at 32mm by 36mm. The smaller frame can make insertion more comfortable, particularly for people who haven’t been pregnant before.
The key difference between these devices isn’t just size. It’s the amount of hormone they contain. Kyleena holds 19.5 mg of levonorgestrel, which is a lower dose than Mirena’s 52 mg. This means Kyleena releases less hormone daily, which some people prefer if they’re sensitive to hormonal side effects. The tradeoff is that Mirena is approved for up to 8 years, while Kyleena tops out at 5.
What Happens After 5 Years
When Kyleena reaches the end of its approved lifespan, the hormone level has dropped low enough that it’s no longer guaranteed to prevent pregnancy reliably. You’ll need to have it removed by a healthcare provider, which is typically a quick in-office procedure that takes only a few minutes.
If you want to keep using an IUD, a new Kyleena (or a different IUD) can be inserted during the same visit. There’s no required waiting period between removal and reinsertion.
Fertility After Removal
Unlike some forms of birth control that can delay your return to fertility for weeks or months, Kyleena doesn’t typically cause a lag. Because hormonal IUDs usually don’t fully suppress ovulation, your body doesn’t need to “restart” its reproductive cycle the way it might after stopping injections or long-term pill use. You can potentially get pregnant right away after removal, and your body and fertility quickly return to their pre-IUD baseline.
Your period will generally regulate within one to three cycles after removal, though if Kyleena had stopped your periods entirely, it may take a little longer for regular bleeding to resume. This varies from person to person.
Signs It May Need Early Removal
Most people use Kyleena for the full five years without issues, but certain situations call for earlier removal. If the device partially or fully expels (slips out of position), it won’t protect against pregnancy effectively. You can check placement by feeling for the thin strings that hang through the cervix. If you can’t find the strings, or if you feel hard plastic, contact your provider.
Other reasons for early removal include persistent pelvic pain, signs of infection, or simply deciding you want to become pregnant. Removal before the five-year mark doesn’t cause any complications, and you aren’t committed to keeping it in for the full duration.