title: Characteristics associated with discontinuation of long-acting reversible contraception within the first 6 months of use.
abstract: OBJECTIVE
  To measure discontinuation within 6 months among users of the levonorgestrel intrauterine system, copper intrauterine device (IUD), and etonogestrel implant and identify baseline characteristics associated with early discontinuation.
  
  
  METHODS
  This was an analysis of the Contraceptive CHOICE Project, a cohort study of 9,256 participants provided with no-cost contraception and followed with telephone interviews at 3 and 6 months. We used logistic regression to investigate characteristics associated with early discontinuation of the two IUDs and implant and described reasons for discontinuation.
  
  
  RESULTS
  A total of 6,167 participants were eligible for this analysis. Follow-up data were available for 5,928 participants; 5,495 (93%) were using their method at 6 months and 433 (7%) had discontinued. Discontinuation rates were 7.3%, 8.0%, and 6.9% for the levonorgestrel intrauterine system, copper IUD, and implant, respectively. After adjusting for age, race, marital status, low socioeconomic status, and history of sexually transmitted infection, we found that unmarried women were slightly more likely to discontinue compared with married women (adjusted odds ratio [OR] 1.26, 95% confidence interval [CI] 1.01-1.59 and adjusted OR 1.62, 95% CI 1.11-2.37, respectively). No other baseline characteristics, including younger age (14-19 years), were associated with early discontinuation. The most common reason given for discontinuation was cramping among IUD users and irregular or frequent bleeding among implant users.
  
  
  CONCLUSIONS
  Rates of discontinuation of long-acting reversible contraception at 6 months is low and not increased in adolescents and young women. Intrauterine devices and the implant should be considered as first-line contraceptive options among all women to reduce unintended pregnancy.
  
  
  METHODS
  : II.
authors.affiliation: Division of Clinical Research, Department of Obstetrics and Gynecology, Washington University in St. Louis School of Medicine, St. Louis, Missouri.
authors.forename: Danielle S
authors.initials: DS
authors.lastname: Grunloh
authors.forename: Teya
authors.initials: T
authors.lastname: Casner
authors.forename: Gina M
authors.initials: GM
authors.lastname: Secura
authors.forename: Jeffrey F
authors.initials: JF
authors.lastname: Peipert
authors.forename: Tessa
authors.initials: T
authors.lastname: Madden
mesh_terms: D000293:Adolescent; D000328:Adult; D001741:Black or African American; D003085:Colic / Q000209:etiology; D004343:Drug Implants / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007435:Intrauterine Devices, Copper / Q000009:adverse effects* / Q000706:statistics & numerical data; D007436:Intrauterine Devices, Medicated / Q000009:adverse effects* / Q000706:statistics & numerical data; D017533:Marital Status; D008796:Metrorrhagia / Q000209:etiology; D011446:Prospective Studies; D012923:Social Class; D013997:Time Factors; D016312:Treatment Refusal / Q000706:statistics & numerical data; D044465:White People; D055815:Young Adult
chemical_list: D004343:Drug Implants