Early discontinuation of intrauterine device in Nepal - a retrospective study

The Intrauterine Device (IUD) is the least popular method of contraception for family planning in Nepal. In addition, discontinuation in the early days after insertion is very high and information related to factors affecting early discontinuation is very limited.

A retrospective study was carried out over a 5-year period to determine the associated factors for early discontinuation of the IUD. Insertion, consultation and removal records of IUD users of Kshetrapati Family Welfare Centre, Kathmandu, were reviewed. Removal within 12 months of insertion is defined as early discontinuation. The study participants were selected randomly. Uni-variate and logistic regression analysis were used to analyse predictors of early discontinuation of IUD.

The results showed that one fifth of the 230 women using IUD discontinued within the first year of insertion. Side-effects were the main reason for early discontinuation followed by expulsion. Woman's occupational status, husband's occupational status, husband's educational status, experience of side-effects and follow-up practice were associated with early discontinuation of IUD. Menstrual disorder and abnormal vaginal discharge were also associated with early discontinuation.

Risks of IUD discontinuation were found to be very high during the early days of insertion and side-effects were identified as the major cause. So, proper management of side-effects would be very important to reduce early discontinuation of IUD.