Use of hormonal intrauterine device and quarterly injection for contraception in adolescents with mental disorders.

OBJECTIVE

To evaluate the continuity and satisfaction rate with contraceptive methods over 12 months in female adolescents with mental disorders (MD).

MATERIAL AND

METHODS

Prospective cohort study carried out at a reference center for care for adolescents with MD. Adolescents with mild and moderate MD who opted for the hormonal intrauterine device (IUD) or a quarterly injectable contraceptive were included. Sociodemographic data were collected, such as age, education and gynecological data. Follow-up was quarterly for 12 months, with assessment of symptoms, desire to continue and satisfaction with the use of the quarterly injectable or hormonal IUD.

RESULTS

One-hundred and three adolescents participated in the study, 34 (33%) of whom chose to use the hormonal IUD and 69 (67%) the quarterly injectable with depot medroxy-progesterone acetate (DMPA). After 12 months, 26 adolescents (76.5%) continued to use the IUD and 34 (49.3%) maintained the use of DMPA. During IUD follow-up, one teenager (2.9%) wanted to have it removed after three months, three (8.8%) developed spontaneous expulsion of the IUD and four (11.7%) were lost to follow-up. Regarding satisfaction after 12 months of use, of the 30 who maintained the method, 29 (96.6%) adolescents were satisfied. Among the 69 adolescents who chose to use DMPA, after 12 months of follow-up, 34 (50.7%) said they were satisfied. Among the 30 (44.7%) who discontinued use, the most frequent causes were irregular bleeding and weight gain. When comparing the two methods, a significant difference was demonstrated for IUD users in terms of continuity (p=0.0001), and satisfaction (p=0.00002).

CONCLUSION

Adolescents using the IUD exhibited significantly higher rate of continuity and reported greater satisfaction at 12 months compared to DMPA users. This result corroborates evidence of the preference for long-acting reversible methods for adolescents, especially for those who are most vulnerable.