Factors associated with contraceptive satisfaction in adolescent women using the IUD.

STUDY

OBJECTIVE

To estimate satisfaction and to identify factors contributing to an adolescent woman's satisfaction with the levonorgestrel-containing or copper intrauterine device (IUD).

DESIGN

Adolescent women presenting to an urban clinic within 1 month of IUD insertion completed survey questionnaires about prior use of contraception, gynecologic/obstetric history, and a pain scale. Participants were contacted at 3 and 6 months post-insertion to complete surveys regarding satisfaction with the IUD, their menstrual bleeding patterns, and pain and cramping due to the IUD. Chi-square test, Fisher exact test, and logistic regression were used for analysis.

SETTING

Mount Sinai Adolescent Health Center in New York City.

PARTICIPANTS

Seventy-nine adolescent women aged 15-24 y.

INTERVENTIONS: None.

MAIN OUTCOME MEASURE: Satisfaction was measured at 3 and 6 months post-IUD insertion as a 10-point Likert item.

RESULTS

82% and 76% percent of participants were available for follow-up at 3 and 6 months, respectively. Satisfaction with the IUD was high overall with 75.4% (49/65) of participants choosing a satisfaction rating of eight or higher on the 10-point scale at 3 months and 76.7 % (46/60) at 6 months. Prior history of pregnancy and selecting the levonorgestrel containing IUD were predictive of higher satisfaction at 3 months, but not at 6 months. Parity and prior use of contraceptive methods were not predictive of satisfaction.

CONCLUSION

The finding of high satisfaction across participants supports the current recommendation for the IUD as a first-line contraceptive for adolescents. Nulliparous young women and those who are naïve to contraception should be considered as candidates for the IUD.