Adolescent experience with intrauterine device insertion and use: A retrospective cohort study

Lisa L. Bayer, Jeffrey Jensen, Hong Li, Mark D. Nichols, Paula Bednarek

Research output: Contribution to journalArticle

31 Citations (Scopus)

Abstract

Background: Adolescents contribute disproportionately to the epidemic level of unintended pregnancy in the USA. Intrauterine devices (IUDs) are highly effective but underutilized in this age group. Study Design: We searched our electronic clinic database to identify females ≤ 19 years old who underwent attempted IUD insertion between January 2007 and June 2009. This retrospective cohort study primarily compared the insertion and postinsertion experiences between nulliparous and parous teens. Results: Of the 307 charts reviewed, the majority of subjects were white (73.4%) and nulliparous (77.5%), with a median age of 18 years (range 15-19). The vast majority (96.4%, 296/307) had a successful IUD insertion upon first attempt; all of the 11 unsuccessful IUD insertion attempts were among nulliparous teens. Follow-up was available for 56% (172/307). During the first 12 months of use, there were 2.9% (5/172) IUD expulsions and 24.4% (42/172) removals, with no differences between nulliparous and parous teens. IUD continuation at 6 months was 83.3%. Pelvic inflammatory disease was diagnosed in 4.6% (8/172) of post-IUD insertions. There were no pregnancies reported in those teens with IUD continuation, while six were reported in subjects who underwent IUD removal. Independent predictors of IUD discontinuation were a history of chronic pelvic pain or dysmenorrhea, and bleeding and/or pain complaints at any post-IUD visit. Conclusions: Overall, adolescents experience minimal complications with IUD use, with similar rates of successful insertion as adults. IUD discontinuation rates were not significantly different between nulliparous and parous teens. While discontinuation was higher than reported in adults, it was lower than reported among teens using other forms of contraception.

Original languageEnglish (US)
Pages (from-to)443-451
Number of pages9
JournalContraception
Volume86
Issue number5
DOIs
StatePublished - Nov 2012

Fingerprint

Intrauterine Devices
Cohort Studies
Retrospective Studies
Intrauterine Device Expulsion
Device Removal
Pelvic Inflammatory Disease
Pregnancy
Dysmenorrhea
Pelvic Pain
Contraception
Chronic Pain
Age Groups

Keywords

  • Adolescent
  • Contraception
  • Intrauterine device
  • IUD
  • Nullipara

ASJC Scopus subject areas

  • Reproductive Medicine
  • Obstetrics and Gynecology

Cite this

Adolescent experience with intrauterine device insertion and use : A retrospective cohort study. / Bayer, Lisa L.; Jensen, Jeffrey; Li, Hong; Nichols, Mark D.; Bednarek, Paula.

In: Contraception, Vol. 86, No. 5, 11.2012, p. 443-451.

Research output: Contribution to journalArticle

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abstract = "Background: Adolescents contribute disproportionately to the epidemic level of unintended pregnancy in the USA. Intrauterine devices (IUDs) are highly effective but underutilized in this age group. Study Design: We searched our electronic clinic database to identify females ≤ 19 years old who underwent attempted IUD insertion between January 2007 and June 2009. This retrospective cohort study primarily compared the insertion and postinsertion experiences between nulliparous and parous teens. Results: Of the 307 charts reviewed, the majority of subjects were white (73.4{\%}) and nulliparous (77.5{\%}), with a median age of 18 years (range 15-19). The vast majority (96.4{\%}, 296/307) had a successful IUD insertion upon first attempt; all of the 11 unsuccessful IUD insertion attempts were among nulliparous teens. Follow-up was available for 56{\%} (172/307). During the first 12 months of use, there were 2.9{\%} (5/172) IUD expulsions and 24.4{\%} (42/172) removals, with no differences between nulliparous and parous teens. IUD continuation at 6 months was 83.3{\%}. Pelvic inflammatory disease was diagnosed in 4.6{\%} (8/172) of post-IUD insertions. There were no pregnancies reported in those teens with IUD continuation, while six were reported in subjects who underwent IUD removal. Independent predictors of IUD discontinuation were a history of chronic pelvic pain or dysmenorrhea, and bleeding and/or pain complaints at any post-IUD visit. Conclusions: Overall, adolescents experience minimal complications with IUD use, with similar rates of successful insertion as adults. IUD discontinuation rates were not significantly different between nulliparous and parous teens. While discontinuation was higher than reported in adults, it was lower than reported among teens using other forms of contraception.",
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