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

OBJECTIVES

Intrauterine devices (IUDs) are highly effective forms of contraception but may be underutilized by Canadian youth. Youth 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, 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, with this frequency decreasing 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 counselling for contraceptive method selection and IUD continuation decision-making soon after placement.