Details:

Alternative Title:
Contraception
Personal Author:
Whiteman, Maura K. ; Tyler, Crystal P. ; Folger, Suzanne G. ; Gaffield, Mary E. ; Curtis, Kathryn M.
Whiteman, Maura K. ; Tyler, Crystal P. ; Folger, Suzanne G. ; Gaffield, Mary E. ; Curtis, Kathryn M. Less -
Description:
Background

Intrauterine device (IUD) insertion during menses may be viewed as preferable by some providers, as it provides reassurance that the woman is not pregnant. However, this practice may result in unnecessary inconvenience and cost to women. The objective of this systematic review is to evaluate the evidence for the effect of inserting IUDs on different days of the menstrual cycle on contraceptive continuation, effectiveness and safety.

Study Design

We searched the MEDLINE database for peer-reviewed articles published in any language from database inception through March 2012 concerning the effect of inserting copper IUDs (Cu-IUD) or levonorgestrel-releasing IUDs (LNG-IUDs) on different days of the menstrual cycle on contraceptive continuation, effectiveness, and safety. The quality of each individual piece of evidence was assessed using the United States Preventive Services Task Force grading system.

Results

We identified eight articles that met the criteria for review. Each study examined the Cu-IUD; no studies were identified that examined the LNG-IUD. Overall, these studies suggest that timing of Cu-IUD insertion has little effect on longer term outcomes (rates of continuation, removal, expulsion, or pregnancy) or on shorter term outcomes (pain at insertion, bleeding at insertion, immediate expulsion). Specifically, there was no evidence to suggest that outcomes were better when Cu-IUD insertions were performed during menses. Limitations of the studies include small sample sizes for insertions performed during later days of the menstrual cycle and non-randomized assignment to timing of insertion.

Conclusions

There is fair evidence (body of evidence grading: II-2, fair) indicating that timing of Cu-IUD insertion has little effect on contraceptive continuation, effectiveness or safety.


Subjects:
[+]
Female Humans Intrauterine Devices Menstrual Cycle
Keywords:
[+]
Insertion Intrauterine Devices Menstruation Systematic Review
Source:
Contraception. 87(5):666-673
Pubmed ID:
22995537
Pubmed Central ID:
PMC4578632
Document Type:
Journal Article
Funding:
CC999999/ImCDC/Intramural CDC HHSUnited States/
Collection(s):
CDC Public Access
Main Document Checksum:
[+]
urn:sha256:edb722513688493168bc7ab947e58d2fc38159fb250528aad9a05ba050616b49
Download URL:
https://stacks.cdc.gov/view/cdc/34430/cdc_34430_DS1.pdf
File Type:

Supporting Files

• nihms723283.nxml

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