Early discontinuation of intrauterine device in Nepal – a retrospective study

Abstract

Background: The Intrauterine Device (‎IUD)‎ is the least popular method of contraception for familyplanning in Nepal. In addition, discontinuation in the early days after insertion is very high andinformation related to factors affecting early discontinuation is very limited.Methods: A retrospective study was carried out over a 5-year period to determine the associatedfactors for early discontinuation of the IUD. Insertion, consultation and removal records of IUDusers of Kshetrapati Family Welfare Centre, Kathmandu, were reviewed. Removal within 12 monthsof insertion is defined as early discontinuation. The study participants were selected randomly.Uni-variate and logistic regression analysis were used to analyse predictors of early discontinuationof IUD.Results: The results showed that one fifth of the 230 women using IUD discontinued within thefirst year of insertion. Side-effects were the main reason for early discontinuation followed byexpulsion. Woman’s occupational status, husband’s occupational status, husband’s educationalstatus, experience of side-effects and follow-up practice were associated with early discontinuationof IUD. Menstrual disorder and abnormal vaginal discharge were also associated with earlydiscontinuation.Conclusion and recommendation: Risks of IUD discontinuation were found to be very highduring the early days of insertion and side-effects were identified as the major cause. So, propermanagement of side-effects would be very important to reduce early discontinuation of IUD