Research highlighted: association between bleeding and cramping patterns in LARC methods and satisfaction

12 December 2022|By Titus Health Care

The vast majority of users of long-acting reversible contraception (LARCs) is satisfied with their method at 3 and 6 months, despite differences in bleeding and cramping patterns. Women differ in basic characteristics and are likely to find an appropriate contraceptive with appropriate counselling, ensuring this satisfaction. This is shown in a prospective cohort study of Diedrich (2015). The study is part of the Contraceptive CHOICE Project.

Target research

In a prospective cohort study, Diedrich looked at the different bleeding and cramping patterns that occur when using different LARC methods. These include the hormone IUD, the copper IUD and the implantable rod. She then looked at user satisfaction with these methods at 3 and 6 months after insertion.

Set up

Participants received a counselling session on contraception at the start of the study. Women who chose a LARC method and completed the analyses at 3 and 6 months were included. 5001 women were included in the 3-month analysis and 4235 women in the 6-month analysis.

There were differences in baseline characteristics of women who chose a copper IUD, hormone IUD or implantable rod after counselling. Women who chose a copper IUD were less likely to have dysmenorrhoea symptoms while women who chose a hormone IUD were more likely to have well suffered from dysmenorrhoea. Women who opted for an implantable rod were younger, single, low-skilled and more likely to have a short or irregular menstrual cycle.

At follow-up after insertion, participants were asked about the amount and frequency of blood loss and cramps and how satisfied they were with the method.


With the copper IUD, an increase in cramps and amount of blood loss usually occurred at 3 months. After 6 months, less than 50% of women still reported this. With the hormone coil and implantable rod, no change or decrease in frequency and amount of blood loss was usually reported. Finally, after both 3 and 6 months after insertion, ≥90% of women were satisfied with the LARC method. This was true for all methods.

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