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Practical Recommendations for Minimizing Pain and Anxiety with IUD Insertion
Viktoriya Ovsepyan1, Petra Kelsey2, Ann E Evensen2
1From the University of Wisconsin School of Medicine and Public Health - Department of Family Medicine and Community Health Madison, Wisconsin (VO, AEE); One Medical Austin, Texas (PK). vovsepyan@wisc.edu.
Journal of the American Board of Family Medicine : JABFM
|March 21, 2025
Summary
Effective pain and anxiety management strategies exist for intrauterine device (IUD) insertions. Offering these pharmacologic and non-pharmacologic options can improve patient comfort during IUD procedures.
Area of Science:
- Reproductive Health
- Contraception
- Pain Management
Background:
- Intrauterine devices (IUDs) are highly effective, long-acting contraceptives.
- Fear of pain and anxiety during IUD insertion discourages use.
Purpose of the Study:
- To review pharmacologic and non-pharmacologic methods for managing pain and anxiety during IUD insertion.
- To summarize findings on pain and anxiety reduction techniques for gynecologic procedures.
Main Methods:
- Conducted a literature review using PubMed and Cochrane databases.
- Searched terms included "IUD insertion", "pain management", and "anxiety".
- Summarized findings using the American Academy of Family Physicians' Strength of Recommendation Taxonomy (SORT) scale.
Main Results:
- Pharmacologic options: naproxen, tramadol, lidocaine blocks/sprays, lidocaine-prilocaine cream.
- Non-pharmacologic options: pre-insertion counseling, verbal analgesia, aromatherapy, distraction, Valsalva maneuver, heating pad.
- Both approaches demonstrated moderate effectiveness in reducing pain and anxiety.
Conclusions:
- Moderately effective pharmacologic and non-pharmacologic methods are available for IUD insertion pain and anxiety.
- Offering these methods can enhance patient comfort during the procedure.
- Further research is needed to compare the efficacy of different methods.
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