Intrauterine Contraception Device Satisfaction and Continuation in an Urban Youth Clinic in British Columbia, Canada: A Longitudinal Survey Study.

Abstract

Objective: Intrauterine devices (IUDs) are highly effective forms of contraception but may be underutilized by Canadian youth. Youth's experiences with IUDs remain poorly understood. This study examined 6-month IUD continuation and satisfaction among youth (aged 12-24 years) attending a youth contraception clinic in Vancouver, British Columbia.

Methods: Participants completed surveys at baseline (patient characteristics) and at 2-6-weeks, 3-months, and 6-months post-placement measuring IUD continuation, satisfaction, side-effects, and menstrual symptoms. We examined baseline characteristics, IUD discontinuation, planned continuation beyond 6-months for participants, and IUD type (levonorgestrel-releasing 'hormonal' or copper). We examined trajectories of reported satisfaction, side effects, and menstrual symptoms over 6-months post-placement.

Results: Among 140 participants, 86% (n = 120) chose a hormonal IUD. Five percent of participants removed their IUDs and 5% had an expulsion. Most (86%) IUDs were in-place at 6-months. Nearly all (99%) participants with an IUD in-place at 6-months planned to continue use. IUD satisfaction was >90% at each follow-up for both IUD types. Cramping and spotting were the most frequently reported side effects; 49% of all respondents reported cramping at 2-6-weeks post-placement, this frequency decreased by 6-months for hormonal users. Copper IUD users experienced more bothersome heavy periods than hormonal users. Most (>70%) hormonal IUD users reported reduced menstrual pain, reduced duration, and reduced flow at 6-months post-placement.

Conclusions: This study found low rates of IUD discontinuation, high satisfaction, and reduced menstrual side effects among youth over 6-months after IUD placement. This could inform youth-specific counseling for contraceptive method selection and IUD continuation decision-making soon after placement.