The Lived Experiences of Long-Term Users of Copper-T Intrauterine Devices: A phenomenological Qualitative Study among women at Kawempe National Referral Hospital in Uganda

Abstract Background: The Copper-T intrauterine device (Cu-T IUD) is a highly effective, non-hormonal, long-acting reversible contraceptive that can protect against pregnancy for up to 12 years, with a failure rate under 1%. Despite its clinical efficacy, early discontinuation remains a substantial challenge in Uganda, where discontinuation is approximated at 29% within the first year of use. Understanding the experiences of women using the Cu-T IUD is important to predict factors associated with discontinuation and to inform practice. Methods: Between September and November 2025, we conducted twenty in-depth interviews with women of reproductive age (15-49 years) who had used a Cu-T IUD for at least two years, recruited from the family planning clinic of Kawempe National Referral Hospital, Kampala, Uganda. Data were analysed thematically, guided by the Social-Ecological Model and Lazarus and Folkman's Transactional Model of Stress and Coping. Results: Long-term Cu-T IUD users reported both positive and negative experiences shaped by individual, interpersonal, and community factors. Two themes were identified at the individual-level domain: experiences during insertion and post-insertion experiences. Negative experiences, particularly heavy menstrual bleeding, anxiety, and abdominal pain, were common and distressing. Participants employed coping strategies, including taking painkillers, using home remedies, and resting, to manage these challenges with Cu-T IUD use. Conclusions: Negative experiences of Cu-T IUD are common among long-term users; women's coping strategies such as taking painkillers lead to continued use. Client-centred pre-insertion counselling addressing both anticipated side effects and common misconceptions, alongside accessible follow-up services, may facilitate long-term Cu-T IUD use. Keywords: copper-T IUD; lived experiences; coping mechanisms; long-term use; Uganda