Alleviating Pain with IUD Placement: Recent Studies and Clinical Insight

AbstractPurpose of ReviewThe pain associated with intrauterine device placement (IUD) may decrease uptake of this highly effective form of contraception. The purpose of this review is to present recently studied methods and techniques employed by clinicians to reduce pain with IUD placement.Recent FindingsParacervical and intracervical lidocaine blocks are effective options for pain control during IUD placement. Lidocaine blocks are particularly effective in nulliparous patients during IUD placement. Topical or vaginal lidocaine are not effective in decreasing pain with IUD placement.SummaryBased on the existing published literature and our clinical experience, we recommend clinicians use several modalities to decrease pain associated with IUD placement. For nulliparous women, we recommend an intracervical or paracervical lidocaine block prior to IUD placement. Misoprostol use should be limited to when a patient had a prior unsuccessful IUD placement attempt or known cervical stenosis. NSAIDs can help with post-procedure pain but do not help with pain during the placement.

Source: Current Obstetrics and Gynecology Reports - February 12, 2022 Category: OBGYN Source Type: research