Experiences with the levonorgestrel-releasing intrauterine system in Kenya: qualitative interviews with users and their partners

Eur J Contracept Reprod Health Care. 2018 Aug;23(4):303-308. doi: 10.1080/13625187.2018.1499892. Epub 2018 Sep 10.


Objectives: The levonorgestrel-releasing intrauterine system (LNG-IUS) is an underused contraceptive method in sub-Saharan Africa. A recent market assessment in Kenya found that if a more affordable version of the method were available it may increase demand and uptake of the method. We therefore aimed to examine attitudes and perceptions around the LNG-IUS and experiences of method use, including exploring attributes such as bleeding changes, contraceptive-related amenorrhoea and perceived non-contraceptive benefits.

Methods: Qualitative interviews were conducted among 29 women who were current or recent users of the LNG-IUS, and among a subset (n = 9) of their husbands/partners.

Results: Our findings indicate that women's main reason for choosing the LNG-IUS for contraception was their perception that the method had fewer side effects compared with other contraceptive methods. Women had favourable attitudes towards using the LNG-IUS. Husbands were also very positive about their partner's use of the method.

Conclusion: Understanding the motivations and experiences of early adopters of the LNG-IUS can help inform the development of demand creation and communication strategies to influence uptake and continuation of the LNG-IUS both in Kenya and perhaps more broadly. Communication efforts that emphasise the positive attributes of the LNG-IUS could help promote wider use of the method, especially if new, more affordable product(s) become available.

Keywords: Kenya; LARC; LNG-IUS; Mirena; levonorgestrel-releasing intrauterine system; long-acting reversible contraception; partner perspective.

MeSH terms

  • Adolescent
  • Adult
  • Attitude to Health
  • Contraception / economics
  • Contraception / methods
  • Contraception Behavior* / psychology
  • Contraception Behavior* / statistics & numerical data
  • Contraceptive Agents, Female / therapeutic use
  • Female
  • Humans
  • Intrauterine Devices, Medicated / statistics & numerical data*
  • Kenya / epidemiology
  • Levonorgestrel / therapeutic use*
  • Long-Acting Reversible Contraception* / economics
  • Long-Acting Reversible Contraception* / methods
  • Long-Acting Reversible Contraception* / psychology
  • Male
  • Needs Assessment
  • Sexual Partners / psychology*
  • Social Perception


  • Contraceptive Agents, Female
  • Levonorgestrel

Grant support

This work was financially supported from the Bill and Melinda Gates Foundation through FHI 360’s Contraceptive Technology Innovation Initiative.