Adverse reactions of the copper intrauterine device and related consequences: experiences described in discussion boards

Abstract

Background The copper intrauterine device is a recommended and effective method for contraception. Recently, agencies have seen an increase in spontaneous reports of adverse reactions, and analysis of messages in discussion boards may lead to new insights. The aim was to explore experiences of adverse reactions related to the copper intrauterine device described by posters in Swedish public discussion boards. Methods Messages containing descriptions of client experiences were collected via Swedish public discussion boards about sexual and reproductive health, identified through searches in Google. Posters with experience of adverse reactions were included (n = 145 unique posters) and their messages were inductively analyzed with qualitative manifest content analysis. Results Four categories were derived from the data; physical reactions, psychological reactions, intensity of adverse reactions, and consequences of adverse reactions. Adverse reactions were identified as physical reactions (15 sub-categories illustrating the different types of reactions) and psychological reactions (5 sub-categories illustrating the different types of reactions). Posters expressed significant intensity of adverse reactions, such as the reaction being awful, extreme, and traumatic. Some had such a negative experience of adverse reactions that they would never again consider a copper intrauterine device and that they would never had it inserted if they knew about the experienced adverse reactions. While some decided to accept adverse reactions and keep the device, others did not and removed it. Adverse reactions had negative effects on sexual health, partner relationship, and fears and worries, including fear to seek gynecologic care because of a traumatic and painful insertion. Conclusions Descriptions of both expected and unexpected adverse reactions of the copper intrauterine device can be found in discussion boards, some which can feel like being of high intensity and have burdensome consequences in the lives of clients. Midwives, nurses and physicians working in contraceptive counseling need to ensure that clients are sufficiently informed about possible adverse reactions and followed-up accordingly. More research is needed that further investigates adverse reactions of the copper intrauterine device and the impact such reactions may have for clients.