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Higher discontinuation rate with a standard-sized compared to a small-sized ‘gold standard’ copper intrauterine device: a case-control review
  1. Hannat Akintomide1,
  2. Pam Barnes1,
  3. Nataliya Brima2,
  4. Diana Mansour1
  1. 1 Sexual Health Services, New Croft Centre, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
  2. 2 School of Population Health & Environmental Sciences, Faculty of Life Sciences & Medicine, King's College London, London, UK
  1. Correspondence to Dr Hannat Akintomide; h.akintomide{at}


Background T-shaped intrauterine devices (IUDs) with a copper surface area of 380 mm2 and copper bands on the transverse arms are the most effective types of copper-containing IUDs. A small-sized ‘gold standard’ IUD is available but there has been little research to compare the effects of this small-sized IUD to its standard-sized counterpart.

Aim To determine discontinuation rates and reasons for discontinuation at 1 year of the small-sized Mini TT380 Slimline IUD compared with the standard-sized TT380 Slimline.

Methods The clinical records of women fitted with Mini TT380 Slimline (‘mini’) IUDs were compared with those of women fitted with standard-sized TT380 Slimline (‘standard’) IUDs over a 3-year period (2013–2016).

Results Clinical records were available for 67 women fitted with a mini IUD (mean age 23 years, 64% nulliparous) and 63 women fitted with a standard IUD (mean age 25 years, 39% nulliparous). At 1 year, twice as many standard IUD users (32%, n=20) had discontinued their IUD use compared with mini IUD users (15%, n=10). Complaints of pain and bleeding were more than double (70%, n=14) in those women who discontinued standard IUD use compared with those who discontinued using the mini IUD (30%, n=3). These differences were statistically significant and were unrelated to parity.

Conclusions More women using a standard-sized ‘gold standard’ IUD rather than its smaller counterpart complained of pain and bleeding, leading to higher discontinuation at 1 year. More research on the association between size and discontinuation of these IUDs is needed.

  • copper intrauterine contraceptive device
  • discontinuation
  • size
  • pain and bleeding

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  • Contributors HA undertook the planning of the study (including patient and public involvement and obtaining approvals), data collection and initial data analysis, literature searches, writing and revision of the manuscript. PB was involved in initial data analysis, literature searches and writing and revision of the manuscript. NB performed data analysis, and writing and revision of the manuscript. DM was involved in the planning of the study (including obtaining approvals), and writing and revising the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; internally peer reviewed.

  • Data availability statement Data are available upon reasonable request.

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