Practical Recommendations for Minimizing Pain and Anxiety with IUD Insertion

An evidence-based review of methods for reducing pain during IUD insertion. Many of these would probably work as well for other painful procedures. James W. Mold, MD, MPH

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Background: Intrauterine devices (IUDs) are one of the most effective, long-lasting, and convenient contraceptive methods available in the United States. Unfortunately, the anticipated pain and anxiety associated with an IUD insertion procedure deter many people from using this contraceptive method.

Methods: A literature review was conducted on PubMed by searching the terms “IUD insertion”, “pain management”, “anxiety”, “gynecologic procedures”. The Cochrane database was also searched for reviews about pain management methods during IUD insertions. Findings were summarized using the American Academy of Family Physicians’ Strength of Recommendation Taxonomy (SORT) scale.

Results: Pharmacologic methods that can be used to reduce pain with IUD insertion include naproxen, tramadol, lidocaine paracervical blocks, 10% lidocaine spray, lidocaine-prilocaine cream, and EMLA cream. Non-pharmacologic methods for reducing pain or anxiety during gynecologic procedures include pre-insertion counseling, “verbal analgesia”, lavender aromatherapy, distraction with music or television, using Valsalva maneuver instead of tenaculum during IUD insertion, and use of heating pad during procedure.

Conclusion: Moderately effective pharmacologic and non-pharmacologic methods exist for reducing pain and anxiety with IUD insertion. These treatment methods should be offered to create a more comfortable experience for patients. Additional research is needed to determine the comparative efficacy of these methods.

Author/s:

Viktoriya Ovsepyan, Petra Kelsey, Ann E Evensen

Topical Nonprescription Pain Medications for Adults

Erin Blanchette — Tue, 14 Nov 2023 20:48:41 +0000

Date Added:

November 14, 2023

Journal/Publication:

JAMA

Publisher:

American Medical Association

Publication Date:

November 3, 2023

URL:

Topical Nonprescription Pain Medications for Adults

Type:

Patient Education Materials

Format:

Article

DOI (1):

doi:10.1001/jama.2023.13813

Keywords

clinical pharmacy and pharmacology

PMID (1):

37921785

MeSH

Anti-Inflammatory Agents

Anti-Inflammatory Agents, Non-Steroidal

Nonprescription Drugs

Information for patients on three types of nonprescription topical analgesics. James W. Mold, MD, MPH

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This JAMA Patient Page describes the types of topical nonprescription pain medications and tips for using them.

Topical nonprescription pain medications are over-the-counter drugs applied to the skin to treat pain.

Topical pain medications can effectively treat pain caused by several acute and chronic conditions. Because they are applied directly to the skin, topical pain medications are easy to use and less likely to cause side effects or interact with other medications than oral pain medications. Pain relief typically occurs within several days of starting a topical pain medication.

Author/s:

Sarah E. Vordenberg