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Pharmacologic Approaches to Pain Management with IUD Insertion

  • Aletha Y. AkersEmail author
Chapter
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Abstract

Concerns about pain during IUD insertion are a major barrier to use of IUDs among adolescent and young adult patients who may otherwise be interested in this method. Although few studies of pain control options have been conducted in this population, available data suggest that several pharmacologic interventions discussed in this chapter may be beneficial. Pre-procedure naproxen, ketorolac, or tramadol can help to reduce post-procedure discomfort. Paracervical nerve blockage with lidocaine-based anesthetics, topical lidocaine spray, or EMLA cream also appears to reduce pain with IUD insertion. Intravaginal 2% lidocaine gel may reduce pain with tenaculum and speculum placement. This chapter will discuss the complex nature of pain in gynecological procedures, including IUD placement, and the impact of anxiety and fear on pain perception. It will also review clinical guidelines to assist with pain control during procedures and describe evidence-based pharmacological pain control modalities that can be used during IUD procedures.

Keywords

IUD Adolescent Young adult Pain management Lidocaine Non-steroidal anti-inflammatory drug (NSAID) Cervical block Pharmacologic Procedure 

Abbreviations

AYA

Adolescent and young adult

EMLA

Eutectic mixture of local anesthetics

IUD

Intrauterine device

NSAID

Non-steroidal anti-inflammatory agents

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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.The Craig Dalsimer Division of Adolescent Medicine, The Children’s Hospital of PhiladelphiaPhiladelphiaUSA

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