Clinical Assessment of 3 Intrauterine Devices in Adolescent Girls: A Randomized Clinical Trial

• Published in: Journal of pediatric & adolescent gynecology Vol. 37; no. 2; pp. 165 - 170
• Main Authors: Anjos, Fabiana C.Q.S., Marcelino, Ana C., Espejo-Arce, Ximena, Pereira, Paula da C., Barbosa, Priscila F., Juliato, Cassia T., Bahamondes, Luis
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.04.2024
• Subjects: Adolescent; Continuation rate; Contraception; Copper 380 mm2 IUD; Expulsion; Intrauterine devices; Levonorgestrel IUD; Levonorgestrel IUD; Adolescent; Contraception; Copper 380 mm2 IUD; Intrauterine devices; Expulsion; Continuation rate; Copper 380 mm IUD
• ISSN: 1083-3188; 1873-4332
• DOI: 10.1016/j.jpag.2023.12.002

To assess clinical performance, bleeding pattern, dysmenorrhea, and satisfaction up to 1 year after placement of 3 types of intrauterine devices (IUDs) (TCu380A, levonorgestrel 52 mg, and levonorgestrel 19.5 mg) in adolescents The study was a randomized trial with 318 adolescents allocated to the 3 IUDs. We assessed reasons for removal, continuation, menstrual patterns, dysmenorrhea, and satisfaction. Participants aged (mean ± SD) 17.9 ± 1.4 years, with 80.8% being nulligravidae. After 1 year, 265 (83.3%) continued using the IUD; however, the continuation rate of TCu380A (75.4 ± 4.2) was lower than that of both the levonorgestrel 52-mg (88.6 ± 3.1) and 19.5-mg IUDs (86.8 ± 3.3), and bleeding/pain and expulsion were the main reasons for removal of the TCu380A IUD. The duration of menstruation was longer among the TCu380A IUD users (6.0 ± 2.0 days) than those using the levonorgestrel 52 mg (2.5 ± 3.9) and 19.5 mg (3.2 ± 3.2) devices, P < .001. Amenorrhea was reported by 49.5% and 37.8% users of the levonorgestrel 52-mg and 19.5-mg devices, respectively, P < .001. Dysmenorrhea was reported in 68.5% of all participants at the baseline; this was 67.9% of the TCu380A group and 33.3% and 36.0% of the levonorgestrel 52-mg and 19.5-mg IUD groups, respectively, P < .001. Satisfaction ranged from 80.7% in the TCu380A group to 97.8% in the levonorgestrel 52-mg group (P = .03). The 3 IUDs are suitable for adolescents, with high contraceptive efficacies and rates of continuation within 1 year of use and high degrees of satisfaction. Users of the hormonal IUDs reported lower expulsion rates, more favorable menstrual patterns, and less dysmenorrhea compared with the TCu380A IUD.