Higher discontinuation rate with a standard-sized compared to a small-sized 'gold standard' copper intrauterine device: a case-control review. Issue 4 (4th September 2019)

• Record Type: Journal Article
• Authors: Akintomide, Hannat; Barnes, Pam; Brima, Nataliya; Mansour, Diana
• Is Part Of: BMJ sexual & reproductive health. Volume 45:Issue 4(2019)
• Page Start: 263
• Page End: 268
• Publication Date: 2019-09-04
• Subjects: copper intrauterine contraceptive device -- discontinuation -- size -- pain and bleeding; Reproductive health -- Periodicals; Sexual health -- Periodicals; Birth control -- Periodicals; Contraception -- Periodicals; 613.905
• DOI: 10.1136/bmjsrh-2018-200296
• Languages: English
• ISSNs: 2515-1991

Abstract

Abstract : Background: T-shaped intrauterine devices (IUDs) with a copper surface area of 380 mm 2 and copper bands on the transverse arms are the most effective types of copper-containing IUDs. A small-sized 'gold standard' IUD is available but there has been little research to compare the effects of this small-sized IUD to its standard-sized counterpart. Aim: To determine discontinuation rates and reasons for discontinuation at 1 year of the small-sized Mini TT380 Slimline IUD compared with the standard-sized TT380 Slimline. Methods: The clinical records of women fitted with Mini TT380 Slimline ('mini') IUDs were compared with those of women fitted with standard-sized TT380 Slimline ('standard') IUDs over a 3-year period (2013–2016). Results: Clinical records were available for 67 women fitted with a mini IUD (mean age 23 years, 64% nulliparous) and 63 women fitted with a standard IUD (mean age 25 years, 39% nulliparous). At 1 year, twice as many standard IUD users (32%, n=20) had discontinued their IUD use compared with mini IUD users (15%, n=10). Complaints of pain and bleeding were more than double (70%, n=14) in those women who discontinued standard IUD use compared with those who discontinued using the mini IUD (30%, n=3). These differences were statistically significant and were unrelated to parity. Conclusions: More women using a standard-sized 'gold standard' IUD rather than its smaller counterpart complained of pain and bleeding, leading to higher discontinuation at 1 year. More research on the association between size and discontinuation of these IUDs is needed.