IUDs at 1 year: predictors of early discontinuation

To assess baseline dysmenorrhea and insertion-related pain as predictors of intrauterine device (IUD) removal within 1 year following insertion.

System-wide medical record abstraction 1 year after IUD insertion to identify removals and comparison of baseline characteristics (dysmenorrhea, insertion pain) among women with a removal versus women who continued IUD use was used. Baseline data came from a randomized trial of pain control during insertion.

Among 199 insertions, we identified 21 removals and 7 expulsions, a continuation rate of 85.9%. Women with IUD removal had higher median dysmenorrhea scores before insertion than those who continued (42 vs. 25.5, p=.03). Insertion pain and other characteristics were not associated with removal.

Preexisting dysmenorrhea may predict IUD removal within 1 year.