Postinsertion medical symptoms and removal of the IUD in the Taiwan IUD follow-up study.

5 medical symptoms associated with IUD usage were analyzed from data obtained in the Second Taiwan IUD Acceptors Follow-Up Survey having a probability sample of 4648 women representing a total of 205000 IUD users between January 1964 and June 1966. Discomfort was reported by 63% (2909) with the major complaints being bleeding spotting abdominal pain lumbago and increased menstrual flow. The removal rate was high among those with discomfort (25.9/100 at 6 months 36.7/100 at 12 months) compared with those without discomfort (1.9/100 at 6 months 4.6/100 at 12 months). Removal rates for specific medical symptoms were high: 69.2/100 at 6 months and 76.6/100 at 12 months for bleeding. Spotting and increased menstrual flow also resulted in high removal rates. This study confirmed findings that removal for medical reasons is the most important cause. Boosting womens motivation through education can improve IUD retention.