Strategies for reducing the pain of IUD insertions and removals

Intrauterine devices (IUDs) are a highly effective form of reversible contraception preferred by many.

However, the pain during the insertion and removal process can vary widely from user to user: all the way from mild discomfort to extremely painful.

Accordingly, the Vancouver Island Women’s Clinic has some strategies and tools we can use to make your experience as comfortable as possible.

Our providers each have the experience of inserting hundreds of IUDs each year, and we think this experience gives you the best chance of a successful and comfortable process.

Your provider will discuss your options for pain control with you before your in-clinic appointment to come up with a customized plan that works for you.

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Planning your procedure

Before your in-clinic appointment, you’ll likely have a phone call with your physician.

You’ll have a chance to chat about any past experiences you’ve had with an IUD, any concerns you have, and come up with a customized insertion plan that works for you.

You’re in control: we want you to have all of the information you need to make the most informed decision you can.

During the procedure, the physician can proceed as slowly or as quickly as you’d like.

Some patients want the physician to describe every step and check in frequently, and others are happy for the physician to just proceed quickly.

The choice is yours. In all cases we’re sure to check in and make sure you are comfortable with the process as it unfolds.

Some Options to Consider

  • Oral Analgesics

    Oral analgesics, such as ibuprofen or acetaminophen, are commonly recommended to manage pain associated with IUD insertion and removal. These medications are effective in reducing general discomfort and inflammation.

    Taking an oral analgesic about an hour before the procedure can help minimize cramping and pain during and after the insertion or removal.

  • Cervical Block (Freezing with Lidocaine)

    A cervical block involves injecting a local anesthetic, such as lidocaine, directly into the cervix. This method effectively numbs the cervix, and can significantly reduce pain during the IUD insertion or removal.

  • Benzocaine Spray on the Cervix

    For those who prefer a non-invasive option, Benzocaine spray can be applied directly to the cervix. This topical anesthetic provides a temporary numbing effect, easing discomfort during the procedure.

    While it is less invasive than an injection, it may not offer the same depth of numbness as the cervical block but is an excellent option for those with needle anxiety.

    We use a product called "HurriCaine" which is a 20% Bensocaine spray.

  • Inhaled Anesthetic Gas (Penthrox)

    Methoxyflurane, an inhaled anesthetic, offers a quick and effective way to manage both pain and anxiety during IUD procedures. This gas is administered through a hand-held, single-use inhaler, allowing patients to self-administer and control their dosage.

    Methoxyflurane works rapidly to relieve pain while also providing a calming effect, which can make the procedure more tolerable.

    If you are interested in discussing Penthrox as an option for pain control, please let us know at the time of booking so we can book you sufficient time.

  • Oral benzodiazepine (Ativan)

    Oral Ativan (lorazepam) is a benzodiazepine that can be taken prior to the procedure to alleviate anxiety. While it does not directly relieve pain, reducing anxiety can help patients manage discomfort better. Ativan is particularly useful for patients who experience significant nervousness about the procedure.