Reasons for Insertion and Predictors of Removal of Intrauterine Contraceptive Devices in an Outpatient Clinic [1O

Abstract

INTRODUCTION: The objective of this study was to examine reasons for insertion and discontinuation of IUDs as well as evaluate factors that predict discontinuation. METHODS: Medical charts of 84 female patients who had an IUD inserted from January 1999 through June 2014 were reviewed. Variables of interest included demographic variables, age, body mass index, parity, type of IUD, indications for insertion, removal of IUDs, and side effects. Descriptive and inferential statistical methods were used. RESULTS: Contraception (81%) was the main reason for insertion of IUDs followed by dysfunctional uterine bleeding (11.9%). With regard to removal, side effects of IUDs (13.1%) were the major reason revealed. Other minor reasons for removal included 5-year limit for Mirena, pregnancy desired, IUD fell out, and no follow up. Obese patients were more likely to have IUD removed than normal or overweight patients (P=.018). Patients with lower parity were more likely to have had their IUDs removed in fewer years before first removal (P=.001). Younger patients were more likely to have had their IUDs removed in fewer years than older patients (P=.002). CONCLUSION: Higher BMI, younger age, and lower parity were significant predictors of IUD discontinuation fewer years before first removal. Side effects necessitating removal were vaginal issues including bleeding, spotting, discharge, and cramping. Health care providers should counsel and educate their patients on IUD side effects at the time of insertion. Furthermore, patient characteristics associated with IUD removal should be considered in offering options of contraceptive methods.