title: Intrauterine contraception in nulliparous women: a prospective survey.
abstract: BACKGROUND
  Intrauterine contraception is a first-line option for young women, yet relatively few prospective studies have been performed in nulliparous women using currently available devices, and many providers are still reluctant to provide this option.
  
  
  METHODS
  Between January 2012 and June 2014, 109 nulliparous women, aged 18-30 years, who had an intrauterine device (IUD) placed at a student health clinic [88 levonorgestrel-intrauterine system (LNG-IUS) users and 21 Cu T 380A (IUD) users] were surveyed at 1, 6, 12 and 18 months after insertion.
  
  
  RESULTS
  Overall satisfaction was high; at follow-up survey 83% of 100 women (mean use 13.4 months) were 'happy' or 'very happy' with their IUD, and there were no differences in satisfaction between the two IUD types. Some 75% of participants stated that the insertion procedure went 'very well', despite 78% rating insertion pain as moderate to severe, and 46% experiencing vasovagal symptoms. The 12-month continuation rate was 89%, with discontinuations for expulsion (3%), side effects (6%), lack of anticipated benefit (1%) and pregnancy (1%). Users of the Cu T 380A were more likely to have heavy menses (74% vs 2%; p<0.0001) or moderate to severe cramping (68% vs 20%; p=0.0002) compared with LNG-IUS users. There were no uterine perforations or diagnoses of pelvic inflammatory disease. The rate of failed insertions during the study period was 6.2%.
  
  
  CONCLUSIONS
  Despite significant symptoms with insertion, intrauterine contraception is safe, effective and ultimately well tolerated in nulliparous women and should be provided to this population in both university and community health settings.
authors: Physician, University of Wisconsin - Stout Student Health Services, Menomonie, WI, USA Physician, Gannett Health Services, Cornell University, Ithaca, NY, USA (until June 2012).
authors: Alexandra M
authors: http://orcid.org/0000-0002-9805-6592
authors: AM
authors: Hall
authors: Nurse Practitioner, Gannett Health Services, Cornell University, Ithaca, NY, USA.
authors: Beth A
authors: BA
authors: Kutler
mesh_terms: D000328:Adult; D003271:Contraceptive Agents, Female / Q000008:administration & dosage* / Q000009:adverse effects; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007436:Intrauterine Devices, Medicated / Q000009:adverse effects / Q000706:statistics & numerical data*; D016912:Levonorgestrel / Q000008:administration & dosage* / Q000009:adverse effects; D010342:Patient Acceptance of Health Care / Q000523:psychology / Q000706:statistics & numerical data*; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D000292:Pelvic Inflammatory Disease / Q000209:etiology; D055815:Young Adult
chemical_list: D003271:Contraceptive Agents, Female; D016912:Levonorgestrel
keywords: intrauterine devices; intrauterine systems; long-acting reversible contraception