Improving information on intrauterine contraception: providing advice in primary care.

Abstract

More women choosing to use very effective contraceptive methods like intrauterine contraception (IUC) can lead to higher standards of sexual and reproductive health and wellbeing. Fear may inhibit some women in the UK from using IUC. Although information that can potentially address this problem is available,1,2 in practice inaccurate information and consequently inadequate care are sometimes still offered to women. More accurate information and positive experiences could lead to more women choosing to use IUC and recommending it to others. This article offers suggestions for changes and improvements to some aspects of IUC information and care based on the available evidence. IUC is very effective, long acting, and the commonest reversible method of contraception used in the world. It is provided by the insertion of a flexible plastic device impregnated with either copper or a hormone into the woman’s uterus. Copper IUC acts immediately, is the most effective form of emergency (postcoital) contraception, and is associated with a reduced risk of cervical cancer. Hormonal IUC users tend to experience less menstrual bleeding and amenorrhoea. Intrauterine devices (IUDs) impregnated with up to 52 mg of levonorgestrel (for example, Mirena® [levonorgestrel, Bayer Plc]) are recommended for heavy menstrual bleeding, as the progestogen component of hormone replacement therapy, and reduce the risk of endometrial cancer.2 IUC has the highest satisfaction and continuation rates of all long-acting reversible contraceptives irrespective of age, race, parity, education, socioeconomic status, and history of sexually transmitted infection.3 This is similar for contraception use post-termination of pregnancy (TOP): compared with combined oral contraceptive users, copper …