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Pain reduction during and after insertion of an intrauterine contraceptive device

  • Published:
Advances in Contraception

Abstract

The intrauterine contraceptive device (IUD) is an establshed method of fertility regulation despite certain problems. The major problems relating to IUD use are unwanted pregnancy, excessive bleeding, genital infection, occasional uterine perforation, device translocation, and pelvic pain. All fertility regulation personnel are aware that a very large number of potential IUD acceptors are concerned about the possibility of pain before, during and after device insertion.

Pain is recognized as one of the major reasons for termination of the use of the IUD. Despite this, and unlike other IUD problems, IUD-related pain has been very poorly studied. At a recent workshop on intrauterine contraception there was not one presentation on this topic [1]. The reason for this is that IUD-related pain is difficult to study, requiring careful analysis of subjective rather than objective data. Nevertheless a thorough understanding of the mechanisms, causes, prevention and treatment of IUD-related pain is important for fertility regulators in both developed and developing countries.

Resumé

Malgré certains problèmes, la pose d'un dispositif contraceptif inter-utérin (DIU) est une méthode établie de régulation de la fertilité. Les principaux problèmes liés à l'utilisation des DIU sont les suivants: grossesses involontaires, saignements excessifs, infections génitales, parfois perforations utérines, déplacement du dispositif et douleurs pelviennes. Les responsables de la régulation de la fertilité sont tous conscients du fait qu'un très grand nombre de femmes qui accepterainent éventuellement d'utiliser un DIU sont préoccupées par la possibilité de douleurs avant, pendant et après la mise en place d'un dispositif.

Il est admis que l'abandon d'un DIU est déterminé dans la plupart des cas par les doulers qu'il occasionne. Pourtant, au contraire d'autres problèmes liés aux DIU, les douleurs qu'ils peuvent causer ont été fort peu étudiées. A des journées de travail sur la contraception interutérine tenues récemment, aucune communication à ce sujet n'a été présentée [1]. Cette lacune provient de ce qu'il est difficile de mener une étude sur les douleurs liées à l'utilisation des DIU, celle-ci nécessitant une analyse de données subjectives plutôt qu'objectives. Il est néanmoins essentiel, pour les responsables de la régulation de la fertilité, aussi bien dans les pays développés que dans les pays en développement, de compre à fond les mécanismes, les causes, la prévention et le traitement des douleurs liées à l'utilisation des DIU.

Resumen

Pese a ciertos problemas, el dispositivo anticonceptivo intrauterino (DIU) es un método reconocido para la regulación de la fertilidad. Los mayores problemas relacionados con el uso de DIU son: embarazo no deseado, sangrado excesivo, infección genital, perforación uterina ocasional, dispositivo cambiado de sitio y dolor pelviano. El personal que regula la fertilidad tiene conciencia que a un gran número de potenciales aceptantes de DIU les preocupa la posibilidad de dolor antes, durante y después de la inserción del dispositivo.

El dolor está reconocido como una de las mayores razones para la terminación del uso de DIU. Pese a esto, y a diferencia con otros problemas conectados con los DIU, el dolor relacionado con ellos ha sido muy poco estudiado. En una reciente reunión de trabajo sobre anticoncepción intrauterina, no hubo ninguna presentación sobre este tópico [1]. La razón de esto es que el dolor relacionado con los DIU es difícil de estudiar y requiere un cuidadoso análisis de datos subjetivos más que objetivos. Sin embargo, la comprensión absoluta del mecanismo, las causas, la prevención y el tratamiento del dolor relacionado con los DIU es importante para la regulación de la fertilidad, tanto en los países desarrollados como en aquellos en desarrollo.

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  1. Department of Obstetrics and Gynaecology, Johannesburg Hospital and University of the Witwatersrand, Johannesburg, South Africa

    N. D. Goldstuck

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Goldstuck, N.D. Pain reduction during and after insertion of an intrauterine contraceptive device. Adv Contracept 3, 25–36 (1987). https://doi.org/10.1007/BF01849250

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  • DOI: https://doi.org/10.1007/BF01849250

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