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Practical advice for avoidance of pain associated with insertion of intrauterine contraceptives

Lookup NU author(s): Dr Diana Mansour



This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License (CC BY-NC 4.0).


Few studies in the scientific literature provide clear direction on the prevention or management of pain associated with intrauterine contraceptive (IUC) placement. Those that have been published have studied small numbers of women and fail to provide definitive conclusions. There are also no guidelines available detailing recognised standard approaches to this problem. The consensus recommendations in this review focus primarily on non-pharmacological and often non-evidence-based interventions. This review includes general considerations, practical recommendations for both routine and more difficult cases and guidance on the optimal choice of instruments. General considerations, including pre-insertion counselling, the setting for the procedure, the confidence and technique of the provider and the interplay between the provider and assistant, can influence women's level of anxiety and, in turn, influence their perception of pain and their overall experience. Further studies are required to refine the optimal strategy for managing pain associated with IUC insertion.

Publication metadata

Author(s): Bahamondes L, Mansour D, Fiala C, Kaunitz AM, Gemzell-Danielsson K

Publication type: Review

Publication status: Published

Journal: Journal of Family Planning and Reproductive Health Care

Year: 2014

Volume: 40

Issue: 1

Pages: 54-60

Print publication date: 27/09/2013

Online publication date: 27/09/2013

Acceptance date: 30/07/2013

ISSN (print): 1471-1893

ISSN (electronic): 2045-2098



DOI: 10.1136/jfprhc-2013-100636