(13) Adolescent Levonorgestrel Intrauterine Device Experience and Satisfaction

Background: In adolescents, the first line contraception method recommended by the American College of Obstetricians & Gynecologists (ACOG) is long-acting reversible contraception (LARC) such as an IUD, yet they are rarely utilized. In numerous studies providers have reported hesitation due to patient’s lack of parity and age. This study aimed to explore the experience and satisfaction of adolescents with levonorgestrel IUDs, as well as compare between the available brands (Skyla, Kyleena, and Mirena).

Methods: A retrospective chart review was performed to attain patients meeting inclusion criteria (females 10-21 with IUD insertion between 2011-2021). Patients were emailed a survey obtaining age at insertion, IUD brand, reason for IUD insertion, side effects, device continuation, rate of satisfaction (1-10), et cetera. Results were used to determine satisfaction rates, overall and specific, and if satisfaction varied between IUD brands/types. Descriptive statistical analysis was performed.

Results: A total of 102 individuals were surveyed. Overall satisfaction was not statistically different (p = 0.2004) between levonorgestrel IUDs, with individuals overall satisfied with their IUD experience. In this study there was a statistically significant difference in the proportion of individuals experiencing significant post-insertion pain among the three IUD brands (p = 0.0282). Kyleena has the highest percentage of individuals experiencing significant post-insertion pain (65.12%), followed by Skyla (62.50%) and Mirena (54.17%).

Conclusions: LARCs are the first-line recommendation for contraception in adolescents. Adolescents who have levonorgestrel IUDs placed have an overall positive experience and are satisfied with their decision. There is no significant difference in satisfaction between levonorgestrel IUDs.