Take any medications as prescribed by your clinician. -Switching from an injectable progestin contraceptive: Insertion may occur at any time; if inserted more than 3 months after the last injection, an additional method of contraception should be used for 7 days after insertion The same can be said for during your period, since all of your hormones, including estrogen drop during this time. Were talking. The insertion and removal of an IUD can cause some discomfort and pain. Sleep apnea is another common issue that can trigger excessive sweating at night. Kyleena can be removed anytime within its five-year use period. hey everyone. Both are very effective at preventing pregnancy and have similar side effects. About Kyleena IUD | Official HCP Website You'll need to have your Kyleena IUD removed after it's been in place for five years, after which time it's no longer as effective for preventing pregnancy. Use a non-hormone method of birth control (condom, diaphragm, cervical cap, or contraceptive sponge) to prevent pregnancy until your doctor is able to replace the IUD. * Other costs may still be incurred by the patient 95% of patients had coverage for a Bayer IUD with low or no out-of-pocket costs based on benefit investigation submissions to Bayer in 2017 (other products costs may apply; N=291,664) 2 For reference I have really oily skin and I have previously been on rigevidon pill. Kleena can be used whether or not you have given birth to a child. The IUD can increase your risk of developing a serious pelvic infection, which is often caused by sexually transmitted disease. Kyleena does not protect against HIV infection (AIDS) and other sexually transmitted infections (STIs). Does waking up in the middle of the night in a cold sweat, drenched with damp sheets and pjs sound all too familiar? Call your doctor for medical advice about side effects. Pick your sensation, grab the pack, and get to it! Just make an appointment with a healthcare professional to have it removed. Kyleena does not contain estrogen and should not be used as emergency birth control. Mirena (levonorgestrel-releasing intrauterine system). The administered dose decreases to 9.8 mcg per . Condom use and incident sexually transmitted infection after initiation of long-acting reversible contraception. [Ref], Very common (10% or more): Irregular menstrual bleeding (67%), infrequent menstrual bleeding (up to 57%), ovarian cyst (31.2%), menstrual changes (up to 31.9%), decreased uterine bleeding (23.4%), prolonged menstrual bleeding (22%), vulvovaginitis (20.2%), amenorrhea (18.4%), genital discharge (up to 14.9%), heavier menstrual bleeding (13.8%),vaginal infections (13.6%), vulvovaginal infections (13.3%), lighter menstrual bleeding (12.5%), increased scheduled uterine bleeding (11.9%), breast tenderness (10.7%), Common (1% to 10%): Dysmenorrhea, breast pain/discomfort, upper genital tract infection, genital tract bleeding, pelvic inflammatory disease, endometritis, dyspareunia, pelvic discomfort/pain, delay of menses more than 7 days, vaginal discharge, bleeding not related to menses, Uncommon (0.1% to 1%): Uterine spasm, cervicitis/Papanicolaou smear normal class II, change in vaginal secretion, Rare (less than 0.1%): Uterine perforation, Frequency not reported: Breast enlargement, vaginal candidiasis, changes in cervical erosion, changes in cervical secretion, ectopic pregnancy, Postmarketing reports: Oligomenorrhea, irregular menstruation[Ref], Very common (10% or more): Nausea (up to 23.1%), abdominal/pelvic pain (up to 22.6%), Uncommon (0.1% to 1%): Abdominal distension, Frequency not reported: Bloating, abdominal cramps[Ref], Very common (10% or more): Fatigue (16.9%), Common (1% to 10%): Partial/complete IUS expulsion, weight increased, Uncommon (0.1% to 1%): Edema, change in body weight, Frequency not reported: Decreased weight, sepsis, group A streptococcal sepsis, Postmarketing reports: IUS breakage, procedural bleeding[Ref], Very common (10% or more): Headache (up to 16.8%), dizziness (11.2%), Postmarketing reports: Stroke, syncope, IUS insertion related vasovagal reaction or seizure[Ref], Common (1% to 10%): Depression/depressed mood, mood changes, mood swings, decreased libido, nervousness, Frequency not reported: Changes in libido[Ref], Very common (10% or more): Acne/seborrhea (15%), Uncommon (0.1% to 1%): Pruritus, eczema, pigmentation changes/hyperpigmentation, Frequency not reported: Chloasma, melasma, Postmarketing reports: Increased blood pressure, arterial/venous thrombotic events, pulmonary emboli, deep vein thrombosis, stroke[Ref], Frequency not reported: Benign/malignant liver tumors, Postmarketing reports: Breast cancer[Ref], Frequency not reported: Contact lens intolerance[Ref], Frequency not reported: Diabetes mellitus[Ref], Frequency not reported: Allergic reaction, Postmarketing reports: Hypersensitivity reactions[Ref], Mirena, Plan B One-Step, Liletta, Skyla, +15 more. Both can cause irregular bleeding or spotting for the first year and both may make your periods lighter or stop entirely after a year of use. You should also not use Kyleena if you have had PID in the past, unless you have a had a normal pregnancy after you were diagnosed with PID. Kyleena (levonorgestrel-releasing intrauterine system). What side effects are possible with the Kyleena IUD? It explains what the IUD is (and is not) used for, Kyleena's side effects and risks, and how the Kyleena IUD compares to other IUDs. The Kyleena IUD is smaller in size and has a slimmer insertion tube than other IUDs, which may make the insertion process less painful than a Mirena or. Kyleena releases the hormone levonorgestrel into your uterus and may work to prevent pregnancy in a few different ways. The Kyleena website says it's the smallest, lowest dose, five-year IUD. (2019). Kyleena (levonorgestrel): Uses, Dosage, Side Effects - RxList After each menstrual period, make sure you can still feel the removal strings at the opening of your cervix. Last medically reviewed on July 27, 2022. The copper IUD is another option to talk to your doctor about (it is a non-hormonal IUD.). Last updated on Aug 2, 2022. I use an IUD & had it checked at my annual gyno 1 week ago and it was in place. All rights reserved. Bayer. Emergency Contraception: Types, Side Effects & More, Poll Finds Many U.S. Women Confused About Medical Abortion, Kyleena 19.5 mg levonorgestrel-releasing intrauterine system (medicine). Kyleena and Skyla IUDs are the same sizes28 millimeters wide and 30 millimeters long. According to DeSimone, being overweight is one factor, but losing 5-10 percent of body weight can often relieve a lot of pressure that causes it. Kyleena - levonorgestrel intrauterine device [label]. Common Birth Control and Contraceptive Options, Kyleena - levonorgestrel intrauterine device, Levonorgestrel-releasing intrauterine systems for long-acting contraception: current perspectives, safety, and patient counseling, Skyla - levonorgestrel intrauterine device, Mirena - levonorgestrel intrauterine device. Kyleena is over 99 percent effective for each year of use, and 98.6% effective over 5 years. And underactive thyroid, or hypothyroidism could also cause night sweats in certain situations. Mirena, Kyleena, Skyla & Liletta - What's the difference? How long does the Paragard IUD last? However, these changes usually settle down after about 6 months with most women experiencing shorter and lighter periods once their body adjusts. They're effective for 3 to 5 years, depending on which one you get. Kyleena does not have a set weight limit and was tested on people at a range of weights. If the IUD has only come out part way, do not try to remove it yourself. So back in December my Skyla IUD was at its 3 year mark and the nurse practitioner at my OBGYN suggested I get the Kyleena IUD because it's similar in size to Skyla, has a small increase in hormones, and lasts 5 years. The condom aisle can be overwhelming, especially if you're making a last-minute purchase. norethindrone, levonorgestrel, medroxyprogesterone, Depo-Provera, Mirena, Provera. Women's Capital Corporation (2003): 3. Intrauterine Device insertion should be performed by a trained healthcare provider thoroughly familiar with product; product manufacturer labeling should be consulted: vulvovaginitis (swelling or infection of . I had pretty much the same experiance! Does it hurt to have Kyleena inserted or removed? The Fix: Get tested for sleep apnea to rule out the cause or seek further treatment. "Product Information. The Healing Power of Root-Cause Resolution Medicine and the Tools Parsley Uses to Optimize Health, How Parsley Health Helped My Sinus Problems, Brain Fog and Outlook on Life, Whats Causing your Seasonal Allergies & How to Resolve Your Symptoms. That will cause the fight or flight response that activates the sympathetic nervous system and raises your body temperature, DeSimone says. Bayer Pharmaceutical Inc (2018): Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances. Reversibility: Fertility is rapidly restored once hormone-releasing IUDs like Kyleena are removed 3,4. National Library of Medicine: DailyMed. Night sweats are one of the main signs that someone with an overactive thyroid might notice.. Kyleena is completely reversible, and your fertility rapidly comes back once it's taken out. You can have your IUD replaced with Kyleena or another IUD during the same appointment. Kyleena works by gradually releasing progestin inside your uterus to prevent pregnancy. Kyleena (levonorgestrel-releasing intrauterine system) is a hormone-releasing IUD that prevents pregnancy for up to 5 years. (n.d.). Consider it one of Kyleenas older siblings, because its bigger and has been around longer. If you want to switch to a new birth control method and have continuous pregnancy protection after you stop using Kyleena, schedule your IUD removal during the first seven days of your period and immediately start using your new method. You will need to make an appointment with your provider to have it taken out. The chance of pregnancy is very low while using Kyleena, but it can still happen. Levonorgestrel IUDs: Mirena, Kyleena and Skyla. The actual IUD insertion should only take about a minute or two, but your appointment from start to finish could take a half-hour or so. If you need to have an MRI (magnetic resonance imaging), tell your caregivers ahead of time that you have a Kyleena IUD in place. IUDs cannot be used for emergency contraception after sexual intercourse. Kyleena IUD Safety and Side Effects | Official Patient Site "Product Information. Very effective! Subscribe to Drugs.com newsletters for the latest medication news, new drug approvals, alerts and updates. For most people who menstruate, estrogen levels are lowest right before you get your period, or during the luteal phase of the menstrual cycle. According to DeSimone, thyroid issues could cause night sweats since one (of the many) important functions that the thyroid regulates is body temperature. Tell your doctor right away if you become pregnant. (An active ingredient is . "The body will start producing adrenaline and cortisol and this causes the body to go into fight or flight mode, which increases . The risk of uterine complications from insertion of the Kyleena IUD is greater while you are breastfeeding. Only your doctor should remove the IUD. Available for Android and iOS devices. However, IUDs do come with risks, including: If your KyleenaIUD comes out on its own (expulsion), you probably won't notice. The risk of perforation is increased if Kyleena is inserted while you are breastfeeding, or if you have recently given birth. Subscribe to Drugs.com newsletters for the latest medication news, new drug approvals, alerts and updates. So we can get a backup of estrogen. Kyleena IUD Prescribing Information | Official Patient Site Night sweats are repeated episodes of very heavy sweating during sleep, heavy enough to soak your nightclothes or bedding. However, since Kyleena is smaller than other IUDs, some people find it's less uncomfortable. i had the kyleena iud put in place in early december 2020. this is the first birth control ive been on in about a decade. The rate over five years is 98.6%. There are a lot of similarities between Kyleena and Mirena, with the key differences between the two being size, duration, and the impact on heavy periods. Kyleena is inserted through the vagina and placed into the uterus by a doctor. This can be trickier to pinpoint since you may not be having trouble falling asleep, but the stress is catching up to you later on (in the form of sweating at night while sleeping!). Pregnancy protection from the IUD will begin after seven days. i wake up two or three times a night, dripping wet, soaking through multiple layers of bedding. Although not all of these side effects may occur, if they do occur they may need medical attention. Our experts continually monitor the health and wellness space, and we update our articles when new information becomes available. Here are more ways to explore how we can help you heal. How to Prevent Pregnancy With the Right Contraceptive Choices, An Overview of Birth Control While Breastfeeding. An overdose of levonorgestrel released from the intrauterine system is very unlikely to occur. Excessive sweating at night is actually a common complaint for women (and sometimes men) of all ages. Contact a healthcare professional if you have concerns about your Kyleena IUD or if you want to change or stop birth control. Continue reading, Mirena, Plan B One-Step, Liletta, Skyla, +5 more. Think You Have A Food Allergy? Me and my husband have been trying to conceive for 28 days This is a sign that the sympathetic nervous system is overreacting, explains DeSimone. So people who are experiencing it outside of menopause (including men who can get night sweats too) are usually really confused about whats going on, says Danielle DeSimone , a health coach at Parsley Health. Some side effects may not be reported. It contains 19.5 mg of levonorgestrel, which is released into the uterus as 17.5 mcg per day for 24 days. Levonorgestrel is a synthetic hormone that is used in many types of birth control pills (oral contraceptives). Contraception: Do the pill or other hormonal contraceptives cause weight gain? Even though many people only expect night sweats during menopause, there are many other causes of night sweats, meaning they can happen to plenty of younger people who are far from entering menopause (for some people, its common to get night sweats before your period). Perimenopause is also a time of hormonal fluctuation, and symptoms such as heavy menstrual bleeding, mood swings, breast tenderness, hot flushes and night sweats, can influence contraceptive choice. Kyleena should not cause weight gain or weight loss. You maybecome pregnant as soon as Kyleena is taken out. The most common side effects of Kyleena include: vaginal itching and discharge, ovarian cysts, abdominal pain, pelvic pain, headache or migraine, acne, abdominal cramps, breast pain or discomfort, increased vaginal bleeding, depression, and hair loss Tell the doctor if you have any side effect that bothers you or that does not go away. This means that out of every 100 people who use the Kyleena IUD in one year, less than 1 will become pregnant with typical use as well as with perfect use. even my mattress is starting to smell funky. Intense Night Sweats 3 Months After Kyleena Insertion Kyleena IUD Uses, Side Effects, Warnings - Drugs.com These side effects may go away during treatment as your body adjusts to the medicine. Profuse sweating at night. This is not a complete list of side effects and others may occur. If you're looking to purchase birth control online, the Optum Store is one place you can do it. Mirena thins the endometrial lining to a greater extent than Kyleena does. You will not need to use any back-up contraception. What are the pros and cons of the Kyleena IUD? Actavis Pharma, Inc. (2016): 7. You may have irregular periods for 3 to 6 months. Never try to remove Kyleena by yourself. When you visit the site, Dotdash Meredith and its partners may store or retrieve information on your browser, mostly in the form of cookies. If youre wondering why you sweat at night, keep reading to find out the most common causes and how to stop night sweats in order to have a cool, dry nights sleep . Kyleena is hassle-freeonce inserted, you dont have to do anything other than check for the strings to make sure the device remains in place. Emergency Contraception: Types, Side Effects & More, Poll Finds Many U.S. Women Confused About Medical Abortion, Kyleena 19.5 mg levonorgestrel-releasing intrauterine system (medicine). -Switching from an oral, transdermal, or vaginal hormonal contraceptive: Insertion may occur at any time; if inserted during the hormone phase, continue use for 7 days after insertion or until the end of the current treatment cycle You should not use Kyleena if you are allergic to levonorgestrel, silicone, silica, silver, barium, iron oxide, or polyethylene, or if you have: abnormal vaginal bleeding that has not been checked by a doctor; an untreated or uncontrolled pelvic infection (vaginal, cervical, uterine); endometriosis or a serious pelvic infection following a pregnancy or abortion in the past 3 months; pelvic inflammatory disease (PID), unless you had a normal pregnancy after the infection was treated and cleared; uterine fibroid tumors or conditions that affect the shape of the uterus; past or present cancer of the breast, cervix, or uterus; liver disease or liver tumor (benign or malignant); a condition that weakens your immune system, such as AIDS, leukemia, or IV drug abuse; if you have another intrauterine device (IUD) in place; if you had an abortion or miscarriage in the past 6 weeks; or. Continue reading, Yes, Kyleena may make your period stop. O 0. Kyleena has some advantages over other forms of birth control, including other IUDs. It contains 19.5 mg of the progestin levonorgestrel. Eligible commercially insured patients may pay as little as $20 for the Kyleena IUD. Insertion hurt. I haven't gained any BC related weight, my hair is thick again, and condoms are a choice. These side effects should begin to subside over the next few hours. Side effects for Kyleena and Mirena usually go away after 3 to 6 months, once your body gets used to the hormones. Liletta (levonorgestrel-releasing intrauterine system). So you can consider reducing or maybe eliminating those, DeSimone says. pelvic pain, painful or irregular menstrual periods, changes in bleeding patterns or flow; temporary pain, bleeding, or dizziness during insertion of the IUD; ovarian cysts (pelvic pain that disappears within 3 months); stomach pain, nausea, vomiting, bloating; headache, migraine, depression, mood changes; weight gain, acne, oily skin, changes in hair growth, loss of interest in sex; or. Levonorgestrel (Intrauterine Route) Side Effects - Mayo Clinic Common (1% to 10%): Diarrhea, vomiting Uncommon (0.1% to 1%): Abdominal distension Frequency not reported: Bloating, abdominal cramps [ Ref] Other Very common (10% or more): Fatigue (16.9%) Common (1% to 10%): Partial/complete IUS expulsion, weight increased Uncommon (0.1% to 1%): Edema, change in body weight Very rare (less than 0.01%): Face edema Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use Kyleena only for the indication prescribed. Unfortunately, mine is not the norm, but it was minimal pain and then light cramping/spotting afterwards. Finally, if youre having wine with dinner each night or perhaps a nightcap even later, it may be a reason for your night sweats, impacting your quality of sleep and hormones more than youd expect. Schedule a free 15-minute consultation call to find out how personalized medicine can transform your health. Other symptoms to watch for include fever, chills, and body and bone aches. I got my IUD inserted with no pain management offered. However, isolated cases of decreased milk production have been reported. Because the IUD releases levonorgestrel into your uterus, only small amounts of the hormone enter your blood. Levonorgestrel IUDs: Mirena, Kyleena and Skyla. Contains 19.5 mg of the progestin, levonorgestrel; releases about 17.5 mcg per day. Kyleena Prescribing Information. Reddit - Dive into anything So that could be a hormone imbalance , like maybe not enough progesterone to keep estrogen in check, DeSimone said. Most of the time, these will go away after the first few weeks but some can last for months. Well, at least your IUD insertion was shorter than the time it takes for me to decide what to order at a restaurant. UpToDate You're also more likely to get PID if you have an STI when Kyleena is put in. While all IUDs are inserted into your uterus using the same procedure, Kyleena is smaller and has a thinner insertion tube than Mirena and Paragard. The Kyleena levonorgestrel-releasing intrauterine system is a small, flexible plastic T-shaped device containing 19.5 mg levonorgestrel. ajog.org/article/S0002-9378(21)00026-0/fulltext, accessdata.fda.gov/drugsatfda_docs/nda/2015/021225orig1s031.pdf, plannedparenthood.org/learn/birth-control/iud, labeling.bayerhealthcare.com/html/products/pi/Kyleena_PI.pdf, uhs.berkeley.edu/sites/default/files/iud_hormonal.pdf, Everything You Need to Know About IUD Insertion, How to Access Free or Lower-Cost Birth Control in Each State. If you have a pelvic or genital infection, get infections easily, or have certain cancers, don't use Kyleena. All three IUDs are highly effective birth control methods. Other methods may be equally effective if used perfectly, but typical use results in a lower, Birth control isnt just to prevent pregnancy. It's worth noting that Plan B is linked to a higher likelihood of menstrual changes compared to regular birth control pills, due to its increased dosage. You can also check with yourhealth insurance provider to see how much they will pay for. I still have 2 more years before my IUD expires. The IUD obscures evaluation of the endometrium." and "Impression: IUD positioned within the endometrium" Some examples are reading, taking a bath, journaling, meditating, or doing some deep breathing. Their periods may become lighter or more irregular or spotting may occur in between periods. Consider also reducing your intake of caffeine, alcohol, and sugar as much as possible to help the liver do its job even better. You may report side effects to FDA at 1-800-FDA-1088. Kyleena (levonorgestrel-releasing intrauterine system). The Kyleena IUD is a safe, reliable, long-term birth control method. Those are common side effects. Periods over time usually become shorter, lighter, or may stop. Call your doctor if you think you might be pregnant. Scan this QR code to download the app now. Mirena, Kyleena, Liletta, and Skyla are hormonal IUDs, meaning they release a small amount of progestin levonorgestrel. The hormonal IUD is one option, since hormonal IUDs (like Mirena) tend to have lower doses of hormones than the pill, and the hormones are not meant to circulate in the bloodstream. The Kyleena IUD may come out by itself. Kyleena begins working right away if its inserted: If inserted at any other time in your cycle youll need to use a backup birth control method for seven days. Kyleenacan be used if you are breastfeeding. Version: 11.01. norethindrone, levonorgestrel, medroxyprogesterone, Depo-Provera, Mirena, Provera. What Happens If You Get Pregnant With an IUD? How was your experience with getting a IUD? : r/AskReddit Learn how your body is affected by. (2021). Do not use Kyleena during pregnancy. You can learn more about how we ensure our content is accurate and current by reading our. During clinical trials for Kyleena, 14.1 percent of participants developed acne and 1.8 percent developed greasy skin. That said, everyones different and some people experience pain or bleeding, or feel dizzy or faint when they have their IUD removed. Kyleena has a thin, flexible insertion tube (3.8 mm) with a small, rounded, flexible T-body Kyleena features the same innovative Bayer Inserter design as other Bayer IUDs Kyleena is delivered through the Bayer Inserter, which may be familiar to many HCPs Step-by-step insertion and removal instructions1 immediately after a first or second-trimester, inflammation or infection of the vulva and vagina (, Perforation. Anthony MS, et al. Medically reviewed by Drugs.com. Kyleena is 99% effective at preventing pregnancy for up to five years. Everything You Need To Know About Kyleena, The New IUD How quickly does the Kyleena IUD start working? You can also have your Kyleena IUD removed at any time before the five-year use period ends if you decide that you want to get pregnant. Acne or oily skin can be a side effect of IUDs, including Kyleena. Serious complications from using Kyleena are very rare. If you decide not to stop taking the birth control pill, you can also try adjusting the time that you take your pill to see if it affects your night sweats. Repulsive-Bend-5125 42 min. The result? The condom aisle can be overwhelming, especially if you're making a last-minute purchase. (2021). Its not surprising that stress and anxiety can make you lose sleep, but it can also cause night sweats. Although breakthrough bleeding and spotting will most likely decrease within the first three months after you have Kyleena put in, your periods may continue to be irregular. Other possible side effects of Kyleena include: Serious risks while using Kyleena are very rare but possible. -Inserting after abortion or miscarriage: Pregnancy while using Kyleena is uncommon but can be life threatening and may result in loss of pregnancy or fertility. Some people cannot get Kyleena or other types of IUDs, including people who: While discussing IUDs with your provider, let them know if you have had an infection in your reproductive tract within the last three months. For the vast majority of people, they are going to get better quality sleep, and that can be a good starting point for evaluating nightly habits.. Can you get a new IUD immediately after removal? Kyleena is a hormonal intrauterine device (IUD), a tiny, flexible T-shaped device placed inside your uterus to prevent pregnancy for five years. How Long Does It Take for Birth Control to Work? They can help you decide if Kyleena is a good option or if there's another birth control method that's better suited to your needs. Typically, most women experience some sort of change in their periods, usually during the first three to six months after Kyleena insertion. Coverage for Kyleena should be covered with no out-of-pocket costsby all non-grandfathered insurance plans. Now instead of a period, I get my normal PMS symptoms for a week and 3 days of light spotting. Applies to levonorgestrel: oral tablet. Your bleeding may be heavier than usual at first, but will eventually become lighter. When not writing, she enjoys reading, trying out new recipes, and going to new workout classes all over New York City. After one year, it releases 9.8 mcg per day. Add healthy fats to every meal and every snack to try to balance blood sugar, DeSimone suggests. Dawn Stacey, PhD, LMHC, is a published author, college professor, and mental health consultant with over 15 years of counseling experience. Mild side effects that have been reported with Kyleena include: abdominal pain. Weight gain associated with Kyleena is most likely due to water retention caused by the progestin contained in Kyleena, rather than an increase in body fat percentage. Dry skin from birth control. Bayer Pharmaceutical Inc (2013): 6. The most commonly reported adverse effects are alterations of menstrual bleeding patterns, nausea, abdominal/pelvic pain, headache/migraine, dizziness, fatigue, amenorrhea, ovarian cysts, genital discharge, acne/seborrhea, breast tenderness, and vulvovaginitis. About seven out of 10 people trying to get pregnant will conceive within 12 months of having Kyleena removed. Kyleena IUD side effects - anyone else experience these? Pick your sensation, grab the pack, and get to it! We avoid using tertiary references. Our root-cause resolution medicine has helped thousands feel better, with 85% of members reducing symptoms in their first year. Drugs.com provides accurate and independent information on more than 24,000 prescription drugs, over-the-counter medicines and natural products. Levonorgestrel-releasing intrauterine systems for long-acting contraception: current perspectives, safety, and patient counseling.
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