title: Motivation and experience of nulliparous women using intrauterine contraceptive devices.
abstract: OBJECTIVE
  Use of an intrauterine contraceptive device (IUD) has not been recommended to nulliparous women in the past. There is now good evidence that there is no increased risk of pelvic inflammatory disease or infertility in nulliparas who use IUDs and the recommendations have changed. Our objective was to understand more about the motivations and experience of nulliparous women using IUDs.
  
  
  METHODS
  This was a mixed method study. First, we asked 44 nulliparous women who had had an IUD inserted within the previous six months about their reasons for seeking the IUD, their history with other forms of contraception, their perception of the insertion experience, and their feelings after insertion. Questionnaires were then distributed to 154 nulliparous women presenting for IUDs, asking about their past experience with hormonal contraception.
  
  
  RESULTS
  The main theme arising from the interviews was a desire to avoid hormonal contraception. Other reasons for choosing the IUD were greater contraceptive effectiveness than other methods, convenience of use, and lower cost. Responses to the questionnaire indicated that 138 women (89.7%) had used hormonal contraception in the past and, of those, 98 (63.0%) complained of mood side effects, 64 (41.6%) of sexual side effects, and 64 (41.6%) of physical side effects.
  
  
  CONCLUSIONS
  The most important motivation for nulliparous women in this study to choose IUDs was to avoid the potential or actual side effects of hormonal contraception. Despite experiencing some discomfort at the time of insertion, this group of nulliparous women was very positive about using IUDs for contraception.
authors.affiliation: Department of Family Practice, Faculty of Medicine, University of British Columbia, Vancouver BC.
authors.forename: Ellen Ruth
authors.initials: ER
authors.lastname: Wiebe
authors.affiliation: Department of Family Practice, Faculty of Medicine, University of British Columbia, Vancouver BC.
authors.forename: Konia Jane
authors.initials: KJ
authors.lastname: Trouton
authors.affiliation: Faculty of Medicine, University of British Columbia, Vancouver BC.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Dicus
mesh_terms: D000328:Adult; D002170:Canada; D005260:Female; D006801:Humans; D007434:Intrauterine Devices; D009042:Motivation; D010298:Parity; D057240:Patient Preference; D017060:Patient Satisfaction; D011247:Pregnancy; D011795:Surveys and Questionnaires