How long is long acting? Recent trends in mean duration of intrauterine device use

Abstract

Objectives: Intrauterine device (IUD) use has increased fivefold since 2002, yet little is known about how women are using IUDs, including the typical duration of use. Methods: Drawing on 2006–2010 and 2011–2013 National Survey of Family Growth data, we calculated women’s mean completed duration of IUD use by survey wave, age group and method dissatisfaction. Results: The mean completed duration of IUD use declined from 47 months in 2006–2010 to 31 months in 2011–2013 (p<.05). Among women aged 25–44, mean use declined from 51 months in 2006–2010 to 34 months in 2011–2013 (p=.09). Among younger women (aged 15–24), mean use declined from 23 months in 2006–2010 to 13 months in 2011–2013 (p=.07). The proportion of women with a mean duration of use less than 12 months increased, from 24% in 2006–2010 to 36% in 2011–2013 (p=.08). Women who discontinued their IUD due to dissatisfaction had shorter mean periods of use: For example, 22 months versus 40 months among those who did not discontinue due to dissatisfaction in 2011–2013 (p<.05). Conclusions: As more women have chosen IUDs, mean duration of use has decreased. This may reflect more women “testing the waters” with IUDs, owing to increased insurance coverage and provider skills, targeted counseling, same-day insertion protocols and growing patient awareness; as well as a shift toward hormonal IUDs, with a shorter maximum duration of use. These results suggest the need for patient-centered counseling approaches and the mitigation of policy, payer and procedural barriers to facilitate desired and timely IUD removal and contraceptive method switching.