Original research
Advance information improves user satisfaction with the levonorgestrel intrauterine system

https://doi.org/10.1016/S0029-7844(01)01764-1Get rights and content

Abstract

OBJECTIVE:

To evaluate parameters associated with and the impact of advance information given in a regular outpatient setting on user satisfaction with the levonorgestrel-releasing intrauterine system.

METHODS:

A questionnaire was sent to 23,885 women in Finland who had had a levonorgestrel intrauterine system inserted between 1990 and 1993. The number of returned questionnaires was 17,914 (response rate 75%). Cumulative logistic regression analysis was based on the five-grade scale of satisfaction as a dependent variable.

RESULTS:

Most users of the levonorgestrel-releasing intrauterine system (74%) were very or fairly satisfied with it, although over 70% of them had chosen it because of dissatisfaction with their previous method of contraception. User satisfaction increased with age and was associated with the amount of information about different symptoms (menstrual, greasiness of hair/skin, pregnancy, pelvic inflammatory disease, and missed periods) regardless of whether the symptom in question was actually experienced. The women who received information about the possibility of absence of menstruation were more satisfied than the less informed women (odds ratio 5.0, 95% confidence interval 4.1, 5.9).

CONCLUSION:

Information received at the insertion visit is strongly associated with increased user satisfaction among the users of the levonorgestrel intrauterine system. The association between high user satisfaction and advance information was strongest regarding the possibility of missing periods.

Section snippets

Materials and methods

The levonorgestrel-releasing intrauterine system (Mirena, Levonova, Turku, Finland) was launched in Finland in 1990. Simultaneously, all women who had had their levonorgestrel-releasing intrauterine system inserted between April 1990 and December 1993 were asked to participate in an epidemiologic study. A consent form was filled in. The women were asked to fill in their identity number (unique for every Finnish citizen) and to consent for further collection of data by signing their initials.

Results

Table 1 shows age and age-adjusted demographic variables: education, contraception just before the insertion of the levonorgestrel-releasing intrauterine system, parity, and marital status by user satisfaction.

The majority of the women (74%) were very or fairly satisfied with the levonorgestrel-releasing intrauterine system. The number of fairly or very dissatisfied users was 1425 (8.3%). Of the 11,177 current users of the levonorgestrel-releasing intrauterine system, 91% were very or fairly

Discussion

We conclude that user satisfaction is strongly associated with information given at the time the levonorgestrel-releasing intrauterine system is inserted. User satisfaction increased with advance information with all six symptoms (bleeding problems, possibility of pregnancy, mood changes, greasiness of hair and/or skin, pelvic inflammatory disease, and total or occasional absence of menstruation) regardless of whether the symptom in question was experienced. The adjustment of symptoms

References (30)

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This study has been sponsored by an unrestricted grant by Leiras Oy, Finland. Three of the authors also received some financial support from the company.

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