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August 1, 2014

Can the Discomfort Felt During IUD Placement Be Alleviated?


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IUDs are quickly becoming an acceptable form of artificial birth control. However, the pain associated with the insertion of the device can be troublesome to some women. In the past, there have been several methods used to try to alleviate the pain and discomfort but none of them have been proven to be successful.

Now, researchers at Columbia University Medical Center have conducted trial to see if something else might help alleviate IUD insertion discomfort. This trial involved the use of intracervical lidocaine to decrease pain experienced at IUD insertion. A total of 200 women who sought IUDs were randomized into one of two groups: following speculum insertion and tenaculum placement, a sterile Q-tip that contained either 2% lidocaine gel or a visually similar sterile lubricant was placed in the area for 1 minute. Afterward, using a 100-mm visual analogue scale, patients rated their pain after placement of the tenaculum, during sounding of the uterus, immediately following IUD insertion, and following removal of the speculum. A pain score reduction of 20 mm was considered indicative of clinically significant pain relief.

While the study showed that the lidocaine had no effect on the discomfort felt during IUD insertion, it did provide other insights into the discomfort associated with the entire process such as; uterine sounding was found to be the most painful aspect of the procedure followed by the IUD insertion.

Maguire K et al. Intracervical lidocaine gel for intrauterine device insertion: A randomized controlled trial. Contraception 2012 Sep; 86:214. Published in Journal Watch Women’s Health September 20, 2012

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