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N05 Intrauterine contraception (IUC) discontinuation

Sexually transmitted infections, 2022-06, Vol.98 (Suppl 1), p.A20-A21 [Peer Reviewed Journal]

Author(s) (or their employer(s)) 2022. No commercial re-use. See rights and permissions. Published by BMJ. ;2022 Author(s) (or their employer(s)) 2022. No commercial re-use. See rights and permissions. Published by BMJ. ;ISSN: 1368-4973 ;EISSN: 1472-3263 ;DOI: 10.1136/sextrans-BASHH-2022.40

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  • Title:
    N05 Intrauterine contraception (IUC) discontinuation
  • Author: Crossman, Jodie ; Fortescue-Talwar, Kim ; Siddiq, Mohammed ; Pinto-Sander, Nicolas
  • Subjects: Abstracts ; Birth control
  • Is Part Of: Sexually transmitted infections, 2022-06, Vol.98 (Suppl 1), p.A20-A21
  • Description: IntroductionLong Acting Reversible Contraception (LARC) are highly effective and cost effective forms of contraception. However, the cost effectiveness of LARC is reduced by early discontinuation. Understanding the reasons for early removal of intrauterine contraception (IUC) may reduce early discontinuation. We aimed to describe the patterns of discontinuation of IUC within a large city centre integrated sexual health clinicMethodsAll patients between Oct 2021- March 2022 attending to remove and discontinue IUC were audited to assess IUC type, length of use and reasons for removal.ResultsIn the study period, there were 541 IUC removals of which 157 (29%,95%CI=25-33) [Mirena N=67, Kyleena N=6, Jaydess N=8, 5-year IUD, N=29, 10 year IUD,N=27] discontinued IUC. The median age of discontinuing patients was 31-years(IQR=25-37). The median duration of IUC was 34 months (IQR=8-58,range=1-216). Mirena(48-months) survived significantly longer than Jaydess (28-months) and Kyleena (7-months)(p=0.001). The 10-year IUD (42 months) survived significantly longer than the 5-year IUD (13-months) (p=0.01). The most frequent reasons given for removal were abnormal vaginal bleeding (n=36,23%) and pain (n=24,15%). 51% (80/157) switched contraceptive method of which 86% (69/80) switched away from LARC to either a short acting, barrier, or fertility awareness method. 31% (10/32) of patients who declined further contraception had ongoing pregnancy risk.DiscussionA significant number of patients attend for early IUC removal due to abnormal bleeding and pain and the majority of those changing method chose methods with lower efficacy. Counselling patients about reasons for discontinuation and alternative methods remains important to help mitigate early discontinuation.
  • Publisher: London: BMJ Publishing Group Ltd
  • Language: English
  • Identifier: ISSN: 1368-4973
    EISSN: 1472-3263
    DOI: 10.1136/sextrans-BASHH-2022.40
  • Source: ProQuest Central
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