Differing Approaches to Pain Management for Intrauterine Device Insertion and Maintenance: A Scoping Review

Rahman M, King C, Saikaly R, et al. Differing Approaches to Pain Management for Intrauterine Device Insertion and Maintenance: A Scoping Review. Cureus. 2024;16(3):e55785. Published 2024 Mar 8. doi:10.7759/cureus.55785

Pain control and anxiety management during intrauterine device (IUD) insertion should be a highly prioritized aspect standard of care during the procedural treatment plan. In fact, pain perceived by females during intrauterine device insertion often limits the use of this effective contraceptive method. However, there is said to be a gap in the literature regarding official procedures for pain management during IUD implantation. This recently published systematic review sought to analyze pain control options during IUD insertion. Regarding pharmacological methods, local agents were significantly more effective in controlling pain than systemic agents including intramuscular naproxen, diclofenac, ketorolac, and prophylactic oral ibuprofen, none of which produced effective pain relief. This suggests that it is important to have a drug act directly in the vagina and on the cervix to manage pain during IUD insertion. Specifically, lidocaine administration via paracervical block appears to be most effective option and should be utilized more frequently by clinicians performing IUD insertion procedures.