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Document Type
Poster
Description
An intrauterine device (IUD) is a highly effective, long-acting reversible contraceptive (LARC) option for patients from menarche until menopause. Pain associated with IUD insertion remains a significant barrier to IUD insertion use. Unrelieved pain during the procedure may lead to serious complications, such as vasovagal shock and cardiac arrhythmias, which may negatively impact patient experience and adherence to contraceptive methods. Oral nonsteroidal anti-inflammatory drugs (NSAIDs) are the most recommended medication for pain management; however, IUD insertional pain is unrelated to prostaglandin synthesis which is the primary target of NSAIDs. This literature review is to compare the efficacy of oral NSAIDs and topical anesthetics in pain reduction during IUD insertion considering the differences in mechanism of action and clinical implications. A review of peer-reviewed studies was conducted for oral NSAIDs versus topical anesthetics, such as lidocaine and lidocaineprilocaine mixtures, throughout different steps of the procedure. A data search of PubMed and Embase was conducted utilizing keywords; 11 studies met final inclusion criteria. Results shows that oral NSAIDs, such as ibuprofen and naproxen, are not effective for acute procedural pain during IUD insertion but are effective in post-procedural pain management. Topical anesthetics show greater efficacy in pain reduction for acute procedural pain. Given the limited efficacy of NSAIDs and the targeted pain relief offered by topical anesthetics during IUD insertion, clinicians should prioritize the use of topical anesthetics to improve patient comfort, outcomes, and satisfaction.
Department
Physician Assistant Studies
Degree Name
Master of Physician Assistant Studies (MPAS)
Date of Work
2025
Publication Date
Spring 5-2025
Disciplines
Medicine and Health Sciences
Recommended Citation
Ulven, Hannah, "Oral NSAIDs vs. Topical Anesthetics for Pain Management During IUD Insertion: A More Effective Standard of Care" (2025). Physician Assistant Scholarly Project Posters. 333.
https://commons.und.edu/pas-grad-posters/333