Effects of age, parity and device type on complications and discontinuation of intrauterine devices

摘要

To the Editor: We read the study by Aoun et al, and we would like to express some concerns and make some comments. As evidenced in many recent articles (hat have appeared in journals worldwide, many young women experience problems during intrauterine device (IUD) use, particularly nul-liparous women. This is not surprising-researchers have demonstrated the great disparity between uterine cavities, particularly the transverse dimensions of the cavity, which were found to be on average only about 2.5-2.7 cm in the fundal area in nulliparous women and only marginally wider in women who had given birth. Paragard and Mirena are 3.2-cm wide, and, therefore, will not fit in many uterine cavities. Several authors conclude that side effects (eg, bleeding, pain) are the consequence of disproportion between the IUD and the endometrial cavity, which leads to early discontinuation.