WHEP Scholar Jessica Titherington
Drexel University College of Medicine, Class of 2024

The IUD is one of the most effective long-acting reversible contraceptive options on the market, with failure rates comparable to those of tubal ligation. However, the fear of pain or discomfort with IUD insertion has been identified as a potential barrier in its use among women. Various analgesic options have been suggested to reduce pain during IUD insertion, including non-steroidal anti-inflammatory drugs (NSAIDs), prostaglandins, nitrates and lidocaine preparations. These analgesic agents have been studied extensively over the years with inconsistent findings reported. Additionally, there is currently no standard practice for managing pain during IUD insertion.

This review summarizes the current literature on the pain management options for IUD insertion and provides a brief analysis of the factors that may contribute to the inconsistent results, such as anticipated pain and parity. The amount of pain experienced appears to vary significantly among women, and it is the responsibility of the health care provider to assess patient risk factors and hold a patient-centered discussion about analgesic options. The primary goal of this review is to provide a better understanding of the available analgesic options so that health care providers can provide the best pain management plan for each individual patient.