User characteristics, experiences and continuation rates of copper intrauterine device use in a cohort of Australian women

Bateson, Deborah, Harvey, Caroline, Trinh, Lieu, Stewart, Mary and Black, Kirsten I. (2016) User characteristics, experiences and continuation rates of copper intrauterine device use in a cohort of Australian women. The Australian and New Zealand Journal of Obstetrics and Gynaecology, 56 6: 655-661. doi:10.1111/ajo.12534


Author Bateson, Deborah
Harvey, Caroline
Trinh, Lieu
Stewart, Mary
Black, Kirsten I.
Title User characteristics, experiences and continuation rates of copper intrauterine device use in a cohort of Australian women
Journal name The Australian and New Zealand Journal of Obstetrics and Gynaecology   Check publisher's open access policy
ISSN 1479-828X
0004-8666
Publication date 2016-12-01
Year available 2016
Sub-type Article (original research)
DOI 10.1111/ajo.12534
Open Access Status Not yet assessed
Volume 56
Issue 6
Start page 655
End page 661
Total pages 7
Place of publication Richmond, VIC Australia
Publisher Wiley-Blackwell Publishing Asia
Language eng
Subject 2729 Obstetrics and Gynaecology
Abstract Background: Copper intrauterine device (Cu-IUD) use in Australia is low despite being a highly effective, cost effective non-hormonal contraceptive with reported 12-month continuation rates of 85% compared to 59% for oral contraception. Aims: To describe the characteristics of Cu-IUD users in the Australian context, their experiences of side effects, continuation rates and reasons for discontinuation. Methods: Between August 2009 and January 2012 we undertook a prospective cohort study of consecutive women presenting for Cu-IUD insertion to three family planning clinics in Queensland and New South Wales. We used survival analysis for continuation rates and univariate and multivariable analyses to characterise users, their experiences up to three years and reasons for discontinuation. Results: Of the 211 enrolled women, a third (36.0%) were aged under 30 and a third were nulliparous (36.5%). Efficacy and lack of hormones were the most frequently cited reasons to choose the method. Four women were lost to follow-up. Overall continuation rates were 79.1% at one year and 61.3% at three years. Early discontinuation was reduced in those with two or more children (adjusted hazards ratio 0.22, 95% CI 0.09–0.50). Heavy menstrual bleeding was the commonest reason for removal in 28 of 59 (47.5%) discontinuations due to complications or side effects. One uterine perforation and one method failure resulting in an ectopic pregnancy occurred. Conclusions: Cu-IUDs were chosen for their efficacy and lack of hormones by a range of Australian women, including young and nulliparous women. While bleeding-related side effects were relatively common, overall continuation rates were high. Serious complications and failures were rare.
Formatted abstract
Background

Copper intrauterine device (Cu-IUD) use in Australia is low despite being a highly effective, cost effective non-hormonal contraceptive with reported 12-month continuation rates of 85% compared to 59% for oral contraception.

Aims

To describe the characteristics of Cu-IUD users in the Australian context, their experiences of side effects, continuation rates and reasons for discontinuation.

Methods

Between August 2009 and January 2012 we undertook a prospective cohort study of consecutive women presenting for Cu-IUD insertion to three family planning clinics in Queensland and New South Wales. We used survival analysis for continuation rates and univariate and multivariable analyses to characterise users, their experiences up to three years and reasons for discontinuation.

Results

Of the 211 enrolled women, a third (36.0%) were aged under 30 and a third were nulliparous (36.5%). Efficacy and lack of hormones were the most frequently cited reasons to choose the method. Four women were lost to follow-up. Overall continuation rates were 79.1% at one year and 61.3% at three years. Early discontinuation was reduced in those with two or more children (adjusted hazards ratio 0.22, 95% CI 0.09–0.50). Heavy menstrual bleeding was the commonest reason for removal in 28 of 59 (47.5%) discontinuations due to complications or side effects. One uterine perforation and one method failure resulting in an ectopic pregnancy occurred.

Conclusions

Cu-IUDs were chosen for their efficacy and lack of hormones by a range of Australian women, including young and nulliparous women. While bleeding-related side effects were relatively common, overall continuation rates were high. Serious complications and failures were rare.
Keyword Bleeding
Continuation rates
Discontinuation
Intrauterine devices
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: HERDC Pre-Audit
School of Nursing, Midwifery and Social Work Publications
 
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