Swiss gynecologists' opinions and perceptions concerning the use of intrauterine devices by nulliparous and multiparous women: an online survey study.
Objective: The aim of this study was to 1) evaluate the Swiss physicians' attitudes and beliefs on intrauterine device (IUD) use in multiparous and nulliparous women and 2) determine whether the woman's parity was a factor influencing the gynecologists' IUD practice. Material and methods: The Global Survey questionnaire investigating IUD use was modified and adapted to the Swiss guidelines. A link to the online questionnaire was sent to gynecologists practicing in the French- and German-speaking parts of Switzerland. We defined IUD use as frequent whenever it was prescribed by gynecologists for 25% or more out of all women consulting for contraception. Results: A total of 299/1,696 gynecologists completed the online questionnaire (17.6%). Frequent IUD prescription was found in 72.9% of multiparous and in 11.8% of nulliparous women. The most frequently reported barriers to IUD use in nulliparous women were as follows: concern over a painful insertion, difficulty of insertion, higher risk of perforation, pelvic inflammatory disease, changes in bleeding pattern, high cost, and risk of extrauterine pregnancy. The presence of such perceived obstacles was associated with less frequent IUD insertion in nulliparous women. Conclusion: The results of this study provide a valuable insight into the attitudes and opinions of Switzerland's gynecologists on the use of IUDs in nulliparous and multiparous women, showing that the women's parity is a factor influencing the physicians' attitudes and opinions. Further health education might help minimize the physicians' attitude discrepancies in IUD prescription to nulliparous and multiparous women.