New Pain Management Strategies Improved IUD Placement
Researchers identified methods to reduce procedure-related pain, which can be a primary barrier to choosing an IUD.
Updated on Sept. 25, 2026 in Women’s Health
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Should patients be routinely offered more comprehensive pain management options during medical procedures?
Two recent studies published in JAMA have highlighted effective strategies for managing discomfort during intrauterine device (IUD) insertion. These findings offer new options for providers and patients to consider for improving the experience of this common contraceptive procedure.
Why it matters
Managing pain during IUD insertion is essential, as discomfort remains a significant barrier for many patients considering the procedure. These insights provide clinicians with evidence-based approaches that may increase patient comfort and accessibility.
A Swedish randomized trial of 370 women found that intrauterine mepivacaine significantly lowered average pain scores and the likelihood of severe pain compared to a placebo. Additionally, a review of 1,324 IUD placements in Massachusetts identified patient preferences for moderate sedation.
The players
JAMA
A peer-reviewed medical journal that publishes original research and clinical reviews across all medical specialties.
The details
To manage discomfort, researchers administered mepivacaine or saline into the uterus via a catheter, which helped reduce pain and the incidence of vasovagal reactions. Another study reviewed clinics that offered a combination of nonsteroidal anti-inflammatory drugs, paracervical lidocaine blocks, and moderate IV sedation using fentanyl and midazolam. Patients who opted for IV sedation often had histories of anxiety, depression, or pelvic pain, suggesting that tailored approaches may be necessary.
Timeline
Between 2021 and 2024, researchers conducted the study on 370 women in Sweden.
Between 2024 and 2025, researchers reviewed 1,324 IUD placements at clinics in Massachusetts.
Health Landscape
These studies provide a rigorous evaluation of pain management techniques for a procedure that has historically relied on limited standardized protocols. This evidence base helps evolve the standard of care for IUD insertion by identifying targeted interventions to reduce patient discomfort.
If you are considering an IUD but are concerned about pain, it is worth discussing available options like paracervical blocks or pharmacological support with your healthcare provider. Be sure to mention any history of pelvic pain or anxiety, as these factors may influence which management strategies are appropriate for you.
The takeaway
Effective pain management is a central component of high-quality gynecological care. Patients should feel empowered to discuss pain management protocols with their clinician well before their appointment to ensure the most comfortable experience possible.
Further reading
For more information on contraceptive choices and reproductive health, visit our Women’s Health section.
Source note: This article includes information reported by Medscape.
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Should patients be routinely offered more comprehensive pain management options during medical procedures?
