Factors associated with early intrauterine device discontinuation among French women aged 18–50: a multicentre exploratory cross-sectional study

This study aimed to compare the characteristics of French women aged 18–50 who discontinued their intrauterine device (IUD) less than one year after insertion with those who retained it for over one year. A secondary objective was to explore self-reported discontinuation reasons by IUD type and duration of use. A retrospective, cross-sectional multicentre study was conducted in France from February to June 2024. A 31-question survey was distributed in healthcare settings and via digital platforms. Socio-demographics, IUD insertion details, and self-reported reasons for discontinuation were collected from women who had a copper or levonorgestrel IUD discontinued within the last 10 years. Descriptive analyses, as well as univariate and adjusted logistic regressions, were performed. Of 380 respondents, 26% discontinued their IUD within one year. Obesity (OR = 2.7 [1.3–5.8]), a history of miscarriage (OR = 3.8 [1.5–10.4]), and insertion by a midwife (OR = 2.0 [1.2–3.4]) or general practitioner (OR = 3.0 [1.1–7.8]), compared with a gynaecologist, were associated with early discontinuation after adjustment for recruitment source. Common self-reported reasons included pain, heavy or irregular bleeding, and mood changes. Women with copper IUDs more often reported heavy bleeding, while those with levonorgestrel IUDs more often reported spotting, mood disorders and weight gain. In this exploratory, self-selected sample of women who had discontinued an IUD, obesity, prior miscarriage, and insertion by a non-gynaecologist were associated with earlier discontinuation within the first year. These findings should not be interpreted as causal or predictive and may not be generalisable to all IUD users, particularly as women with higher educational and socio-professional backgrounds were over-represented. The differences in self-reported reasons for discontinuation according to timing and IUD type may help inform counselling and warrant further prospective investigation.