Yes, you should check that LILETTA is in proper position by feeling the threads. It is a good habit to do this once a month.

Your healthcare provider should teach you how to check that LILETTA is in place.

• First, wash your hands with soap and water.
• You can check by reaching up to the top of your vagina with clean fingers to feel the threads.
• Do not pull on the threads.

If you feel more than just the threads or if you cannot feel the threads, LILETTA may not be in the right position and may not prevent pregnancy. Use nonhormonal back-up birth control (such as condoms) and ask your healthcare provider to check that LILETTA is still in the right place.

Call your healthcare provider if you have any questions or concerns. Generally, patients have a follow-up visit 4 to 6 weeks after LILETTA is placed to make sure that LILETTA is in the right position, and routine visits thereafter. Follow-up plans may vary according to patient needs.

For the first 3 to 6 months, your period may become a little unpredictable and you may bleed more than usual. You may also have frequent spotting or light bleeding and cramping. Some women have heavy bleeding during this time.

After you have used LILETTA for a while, the number of days you experience bleeding and spotting is likely to lessen. For some women, menstrual periods may stop altogether. When LILETTA is removed, your menstrual periods will likely return to their former pattern.

If you have any concerns that you may be pregnant while using LILETTA, call your healthcare provider and, if possible, complete a urine pregnancy test.

LILETTA should not be felt during sexual intercourse because it’s placed in the uterus, not the vagina. However, there is a chance that your partner may feel the threads. If this occurs, or if you or your partner experiences pain during sex, talk with your healthcare provider.

Call your healthcare provider right away if you think you are pregnant. If possible, also do a urine pregnancy test. If you get pregnant while using LILETTA, you may have an ectopic pregnancy. This means that the pregnancy is not in the uterus. Unusual vaginal bleeding or abdominal pain, especially with missed periods, may be a sign of ectopic pregnancy.

Ectopic pregnancy is a medical emergency that often requires surgery. Ectopic pregnancy can cause internal bleeding, infertility, and even death.

There are also risks if you get pregnant while using LILETTA and the pregnancy is in the uterus. Severe infection, miscarriage, premature labor, premature delivery, and even death can occur with pregnancies that continue with an intrauterine system (IUS). Because of this, your healthcare provider may try to remove LILETTA, even though removing it may cause a miscarriage. If LILETTA cannot be removed, talk with your healthcare provider about the benefits and risks of continuing the pregnancy.

If you continue your pregnancy, see your healthcare provider regularly. Call your healthcare provider right away if you get flu-like symptoms, fever, chills, cramping, pain, bleeding, vaginal discharge, or fluid leaking from your vagina. These may be signs of infection.

It is not known if LILETTA can cause long-term effects on the fetus if it stays in place during a pregnancy.

Call your healthcare provider if you have any concerns about LILETTA. Be sure to call if you have any of the conditions listed below:

• are pregnant or think you are pregnant
• pelvic pain or pain during sex
• unusual or foul-smelling vaginal discharge or genital sores
• unexplained fever, chills, or flu-like symptoms
• might be exposed to sexually transmitted infections (STIs)
• concern that LILETTA may have come out or expelled
• cannot feel LILETTA's threads
• very severe or migraine headaches
• yellowing of the skin or whites of the eyes (these may be signs of liver problems)
• stroke or heart attack
• you or your partner becomes HIV positive
• severe vaginal bleeding, bleeding that lasts a long time, or you miss your period

Call your healthcare provider if you have any concerns about LILETTA after it has been placed.