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Anticipated Pain During Intrauterine Device Insertion.

Tegan A Hunter1, Sarita Sonalkar2, Courtney A Schreiber2

  • 1University of Miami Miller School of Medicine, Miami, Florida.

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|September 30, 2019
PubMed
Summary

Anticipated pain during intrauterine device (IUD) insertion is higher for Black adolescent women. This increased anticipated pain correlates with greater perceived pain, suggesting a need for targeted support to improve IUD use.

Keywords:
AdolescentContraceptive devicesIntrauterine devicesPain

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Area of Science:

  • Reproductive Health
  • Pain Management
  • Adolescent Gynecology

Background:

  • Intrauterine devices (IUDs) are highly effective reversible contraceptives.
  • Pain perception during IUD insertion can be a barrier to use, particularly among adolescents.
  • Predictors of anticipated pain require further investigation to optimize patient experience.

Purpose of the Study:

  • To identify factors predicting anticipated pain during IUD insertion in adolescents and young women.
  • To explore the relationship between anticipated pain and perceived pain during the procedure.

Main Methods:

  • A randomized trial involving 93 adolescent and young adult women aged 14-22 years at three academic family planning clinics.
  • Linear regression analysis was used to assess demographic, sexual/gynecologic history, and mood covariates.
  • Anticipated pain was measured using a visual analogue scale (VAS) before IUD insertion.

Main Results:

  • Race was a significant predictor of anticipated pain, with Black or African American participants reporting higher median scores than White participants (P=.012).
  • Higher anticipated pain scores were significantly associated with increased perceived pain throughout the IUD insertion procedure.
  • No significant difference in perceived pain was found between the lidocaine and sham paracervical block groups.

Conclusions:

  • Black adolescent women experience greater anticipated pain during IUD insertion.
  • Anticipated pain is a strong predictor of perceived pain, highlighting its importance in the IUD insertion experience.
  • Targeted counseling and clinical interventions may be beneficial to mitigate anticipated pain and reduce barriers to IUD utilization in this population.