What is included in patient education about intrauterine devices (IUDs)?

Updated: Nov 29, 2018
  • Author: Sarah Hagood Milton, MD; Chief Editor: Christine Isaacs, MD  more...
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All patients who express interest in an IUD should be counseled regarding alternative forms of contraception. Following this conversation, informed consent should be obtained from the patient. Both the levonorgestrel-releasing intrauterine systems and the copper T380A IUD have patient information included within IUD packaging; this should be provided to the patient, ideally at a visit prior to IUD insertion.

An essential part of preinsertion counseling involves clear communication regarding expectations with IUD placement and continued use. This counseling has been proven to decrease interval IUD removal rate. [19, 20]

Inform the patient that mild pain with insertion is common. With the levonorgestrel-releasing intrauterine systems, many women experience cramping for days to weeks following insertion. Additionally, levonorgestrel-releasing IUD users should be informed that although daily spotting may occur following insertion, periods usually become lighter. Further, amenorrhea has been reported in as many as 70% of women after 2 years of use. [21] With the copper T380A IUD, bleeding may initially increase and periods should continue owing to the nonhormonal mechanism of action. [22]

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