title: IUDs at 1 year: predictors of early discontinuation.
abstract: OBJECTIVE
  To assess baseline dysmenorrhea and insertion-related pain as predictors of intrauterine device (IUD) removal within 1 year following insertion.
  
  
  METHODS
  System-wide medical record abstraction 1 year after IUD insertion to identify removals and comparison of baseline characteristics (dysmenorrhea, insertion pain) among women with a removal versus women who continued IUD use was used. Baseline data came from a randomized trial of pain control during insertion.
  
  
  RESULTS
  Among 199 insertions, we identified 21 removals and 7 expulsions, a continuation rate of 85.9%. Women with IUD removal had higher median dysmenorrhea scores before insertion than those who continued (42 vs. 25.5, p=.03). Insertion pain and other characteristics were not associated with removal.
  
  
  CONCLUSIONS
  Preexisting dysmenorrhea may predict IUD removal within 1 year.
authors.affiliation: Department of Obstetrics and Gynecology, University of Miami Miller School of Medicine, Miami, FL 33136, USA. Electronic address: kmaguire@med.miami.edu.
authors.forename: Karla
authors.initials: K
authors.lastname: Maguire
authors.affiliation: Department of Obstetrics and Gynecology, Division of Family Planning and Preventive Services, Columbia University Medical Center, New York, NY 10032, USA.
authors.forename: Sophie
authors.initials: S
authors.lastname: Joslin-Roher
authors.affiliation: Department of Obstetrics and Gynecology, Division of Family Planning and Preventive Services, Columbia University Medical Center, New York, NY 10032, USA; Department of Epidemiology and Heilbrunn Department of Population and Family Health, Columbia University Mailman School of Public Health, New York, NY 10032, USA.
authors.forename: Carolyn L
authors.initials: CL
authors.lastname: Westhoff
authors.affiliation: Department of Obstetrics and Gynecology, Division of Family Planning and Preventive Services, Columbia University Medical Center, New York, NY 10032, USA.
authors.forename: Anne R
authors.initials: AR
authors.lastname: Davis
mesh_terms: D000328:Adult; D003267:Contraception / Q000295:instrumentation / Q000523:psychology; D003268:Contraception Behavior / Q000523:psychology / Q000706:statistics & numerical data*; D004412:Dysmenorrhea / Q000209:etiology / Q000523:psychology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007433:Intrauterine Device Expulsion; D007434:Intrauterine Devices / Q000009:adverse effects / Q000706:statistics & numerical data*; D010146:Pain / Q000209:etiology / Q000523:psychology*; D010349:Patient Compliance / Q000523:psychology / Q000706:statistics & numerical data*; D013997:Time Factors; D055815:Young Adult
keywords: Discontinuation; Dysmenorrhea; IUD; Pain