WHY IS CHANGE NEEDED?
Younger-aged intrauterine contraception (IUC) users — adolescents and those in their 20s — often experience higher rates of unwanted effects and discontinuation compared with their older counterparts.1 This has mainly been attributed to pain and bleeding in the first year of use.1 Smaller IUC devices are theoretically expected to be associated with less pain and bleeding.2 However, evidence for smaller-sized (width <30 mm) devices is limited in comparison with standard-sized (width ≥30 mm) devices.
Some IUC providers are aware that smaller IUC devices may be associated with fewer unwanted effects, but a lack of formal guidance may hinder their provision to younger women.
HOW DID WE GO ABOUT IMPLEMENTING CHANGE?
The team embarked on a project to determine which devices currently available in their sexual health service may be better suited to younger women and how these devices could be identified and provided. A systematic review of relevant publications, a local comparative case review, and a secondary analysis of a large subset of existing data were undertaken (Figure 1).3–5 The large dataset was from the European Active Surveillance Study for Intrauterine Devices (EURAS-IUD study), a multinational prospective cohort study involving more than 30 different IUC device brands.6
Project summary including charts to support intrauterine contraception device type provision. HMB = heavy menstrual bleeding. IUD = copper intrauterine device. IUS = levonorgestrel intrauterine system.
The systematic review revealed limited evidence investigating …
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