Major differences in the characteristics of users of the copper intrauterine device or levonorgestrel intrauterine system at a clinic in Campinas, Brazil

Abstract

Highly effective long-acting reversible contraceptives (LARCs), including intrauterine devices (IUDs) and implants, can be an excellent contraceptive choice for women wishing to avoid unplanned pregnancies. However, the method mix of IUDs, including the copper IUD (Cu-IUD) and the 52-mg levonorgestrel intrauterine system (LNG-IUS), is reported to be pitifully small (less than 5%) in 63 countries and only 5%-9% in a further 32 countries. 1 Compared with other contraceptives, LARC methods have lower contraceptive failure, are safe, and have fewer adverse effects. 2 The reported contraceptive failure rate of the TCu380A IUD is 1 per 100 women-years, with up to 12 years of effective protection. 3 For the LNG-IUS, failure is between 0.1 and 0.2 per 100 women-years and 0.3 per 100 womenyears up to the sixth year of use, 4 providing effective contraception for up to 6 years. 5,6

Profiles of copper intrauterine devices and levonorgestrel intrauterine systems users in France in 2019: A national observational population‐based study

“…A recent Brazilian monocentric study has only showed that users of Cu-IUDs were less likely to be nulliparous compared to users of LNG-IUSs, but it was not focused on the postpartum period. 19 In the present study, the LNG-IUS appeared to be prescribed according to French professional recommendations. The National College of French Gynecologists and Obstetricians recommends the use of LNG-IUS in absolute/relative hyperestrogenic environments, endometriosis, adenomyosis, and endometrial hyperplasia.…”

“…In the present study, women who had a pregnancy history in the year before dispensation of a device were more likely to get a Cu‐IUD rather than a LNG‐IUS. A recent Brazilian monocentric study has only showed that users of Cu‐IUDs were less likely to be nulliparous compared to users of LNG‐IUSs, but it was not focused on the postpartum period 19 …”

Female body mass index and the selection of a long‐acting reversible contraception for the first time

“…Users presented with high rates of satisfaction with high continuation rates and also reported non‐contraceptive benefits of the method. The number of users of this device in our service has increased in recent years 22 . Also, the benefit regarding bleeding control in women with heavy menstrual bleeding could be a reason for this choice among women with a high BMI, including after bariatric surgery 23,24 .…”

“…The number of users of this device in our service has increased in recent years. 22 Also, the benefit regarding bleeding control in women with heavy menstrual bleeding could be a reason for this choice among women with a high BMI, including after bariatric surgery. 23,24 Furthermore, the ENGimplant was more commonly chosen by women with normal weight, a group in which the younger women were concentrated, and it was less commonly chosen by women with obesity.…”

What Have We Learned? Implementation of a Shared Learning Agenda and Access Strategy for the Hormonal Intrauterine Device

“…26 Table 2 provides a summary of the designs of the studies conducted in both public and social marketing sectors, and Table 3 lists the learning agenda questions that were addressed in countries where research was conducted (i.e., Kenya, Madagascar, Nigeria, and Zambia). Additional research was published on hormonal IUD use in LMICs during this period (2015-2021) [27][28][29] ; however, those results are not summarized here.…”