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IUDs at 1 year: predictors of early discontinuation

Karla Maguire1, Sophie Joslin-Roher2, Carolyn L Westhoff3

  • 1Department of Obstetrics and Gynecology, University of Miami Miller School of Medicine, Miami, FL 33136, USA.

Contraception
|September 15, 2015
PubMed

Insights

Preexisting dysmenorrhea, or painful periods, may predict the removal of an intrauterine device (IUD) within one year. Insertion pain did not appear to influence IUD retention.

Area of Science:

  • Reproductive Health
  • Contraception
  • Gynecology

Background:

  • Intrauterine devices (IUDs) are highly effective reversible contraceptives.
  • Patient-reported outcomes, such as pain, can influence IUD continuation.
  • Understanding predictors of IUD removal is crucial for improving patient satisfaction and long-term use.

Purpose of the Study:

  • To evaluate whether baseline dysmenorrhea and insertion-related pain predict IUD removal within one year of insertion.
  • To identify factors associated with IUD discontinuation.

Main Methods:

  • A system-wide medical record abstraction was conducted one year post-IUD insertion.
  • Baseline data on dysmenorrhea and insertion pain were collected from a randomized trial on pain control during insertion.
  • Characteristics of women who removed their IUD were compared to those who continued IUD use.

Main Results:

  • The study included 199 IUD insertions, with a continuation rate of 85.9% (21 removals, 7 expulsions).
  • Women who removed their IUD reported significantly higher median dysmenorrhea scores prior to insertion compared to those who continued using the IUD (42 vs. 25.5, p=.03).
  • Insertion pain and other assessed baseline characteristics were not found to be associated with IUD removal.

Conclusions:

  • Preexisting dysmenorrhea is a potential predictor of IUD removal within the first year.
  • Further research may explore the mechanisms linking dysmenorrhea to IUD discontinuation.
Abstract

Keywords:
DiscontinuationDysmenorrheaIUDPain

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