Adolescent Experiences With Intrauterine Devices: A Qualitative Study

Area of Science:

• Reproductive Health
• Adolescent Gynecology
• Contraception

Background:

• Intrauterine devices (IUDs) are highly effective reversible contraceptives.
• Understanding adolescent perspectives on IUD use is crucial for improving uptake and continuation.
• Both the levonorgestrel intrauterine system (LNG-IUS) and copper IUDs are available options.

Purpose of the Study:

• To understand adolescents' motivations for selecting an IUD.
• To explore factors influencing continuation or discontinuation of LNG-IUS and copper IUDs.
• To identify key experiences shaping IUD use in young women.

Main Methods:

• Focus groups (FGs) and in-depth interviews (IDIs) with adolescent and young women IUD users.
• Participants were stratified by IUD type and 12-month continuation/discontinuation status.
• Thematic analysis of qualitative data until thematic saturation was achieved.

Main Results:

• Key themes for choosing and continuing IUDs included effectiveness, duration, convenience, and bleeding pattern changes.
• LNG-IUS users sought amenorrhea; copper IUD users desired nonhormonal methods with continued menses.
• Discontinuation reasons included expulsion, bleeding irregularities, and pain; an adjustment period for side effects was noted.

Conclusions:

• Adolescent IUD choice and continuation are influenced by effectiveness, duration, convenience, and bleeding profile.
• Bleeding irregularities and pain are significant factors in IUD discontinuation.
• Counseling should address effectiveness, duration, convenience, and potential side effects to guide young women's IUD decisions.