Revisiting the Intrauterine Contraceptive Device in Adolescents

Abstract 

Study Objective

The purpose of this study was to report on our experience with the intrauterine contraceptive device (IUCD) in a group of properly counseled adolescents and to determine whether traditional hesitation with use in this population should be reconsidered.

Design

Patients who had an IUCD inserted between April 1999 and March 2003 were identified using medical records and chart review.

Setting

A single Canadian University teaching hospital supervised by a single gynecologist.

Participants

Twenty-eight patients, 21 years of age and under, were identified. Twenty agreed to participate in the study.

Interventions

Patients were contacted by mail to inform them of the study and subsequently interviewed using a 10-minute structured phone interview that contained seven primary questions with additional follow-up questions.

Main Outcome Measures

Duration of use, reasons for removal, side effects experienced, satisfaction with use, prior contraception.

Result

The average age at insertion was 18.7 years, the average time of use was 19.6 months and the average number of pregnancies prior to insertion was 1.4. Seven patients (35%) had discontinued use of their IUCD prior to the interview, with an average of 13.4 months between the time of insertion and removal. The most common reason for removal was increased bleeding. The most common side effect was increased cramping. Eighty-five percent (17/20) of users were either somewhat satisfied, satisfied or very satisfied with the IUCD.

Conclusions

Following pre-insertion screening for STI-related cervicitis and with consistent follow-up following insertion, IUCDs are well-tolerated by properly selected and counseled adolescents who require an easy and effective long-term method of birth control.

Key Words: Contraceptive device, Intrauterine device, Copper intrauterine contraceptive device, Levonorgestrel intrauterine system, Female, Women's health, Adolescents, Family planning