[Bleeding patterns important factor in choosing an IUD]

Recently the Dutch College of General Practitioners issued a revised practice guideline 'The intrauterine device' (IUD). This should help women considering intrauterine contraception to choose between a conventional copper IUD and a levonorgestrel-releasing intrauterine system (LNG-IUS). This guideline states that two aspects of these IUDs are important determinants of the decision, namely reliability and expected bleeding patterns. We argue that women deserve more detailed information than the practice guideline provides, especially about bleeding patterns. We introduce 'tailor-made bleeding' as one of the aspects of contraceptive counselling that is very much determining levels of compliance and patient satisfaction. A table reviewing different aspects of possible bleeding patterns for all intrauterine and hormonal contraceptive methods is presented as an important counselling tool.