Assessment of pain and ease of intrauterine device placement according to type of device, parity, and mode of delivery: The European Journal of Contraception & Reproductive Health Care: Vol 0, No 0

Purpose

We compared the pain and ease of insertion of two different types of intrauterine devices (IUDs; the levonorgestrel intrauterine system 52 mg (LNG-IUS 52 mg) and the copper-bearing IUD [TCu380A]) in nulligravidas and parous women with and without caesarean delivery.

Method

A cross-sectional study evaluated women’s perceived pain and ease of insertion of two IUD models. We applied a visual analogue scale (VAS) to assess pain, while ease of entry was defined by healthcare professionals.

Results

We analyzed 1076 women, including 334 nulligravidas and 566 parous women who had at least one caesarean delivery and 176 women with a history of vaginal delivery only. Regarding IUD insertion pain, 26 (2.5%) women reported no pain, 167 (16.4%) mild pain, 319 (31.3%) moderate and 506 (49.7%) severe pain. The highest score for pain was reported by nulligravidas (67.2%, p= 0.001), while the average pain score was higher in the LNG-IUS 52 mg group. Difficulties reported by health care providers were more frequent among nulligravidas (21.2%) and women with a previous caesarean delivery (16.9%).

Conclusions

Our findings suggested differences between the two IUDs tested, with higher pain associated with the LNG-IUS 52 mg, and highlight the need for pain management, mainly in nulligravidas and women with history of caesarean delivery.

• SHORT CONDENSATION

• Acute insertion pain was more associated with nulligravida than parous women and more pain with insertion of LNG-IUS 52 mg IUDs than with TCu380A IUDs. However, our results confirm that the ease of IUD insertion is between 80% to 90% of all insertions, which is more common in parous women without a previous caesarean delivery.