A Needle-Free Anesthetic Just Made IUD Insertion Significantly Less Painful
If you've ever put off getting an IUD because of the horror stories, you're not alone. Fear of pain during insertion is one of the biggest reasons women skip this contraceptive option, even though it's one of the most effective, long-acting forms of birth control available.
Right now, the standard IUD insertion process involves no pain relief at all. Sometimes women are offered a numbing injection into the tissue around the cervix, which can be its own uncomfortable experience. This is why researchers at the Karolinska Institutet in Sweden have been developing a needle-free option for reducing IUD pain insertion, and their work was just published in JAMA1. Keep reading to learn more about this promising innovation.
What the study looked at
The researchers wanted to know if a small amount of local anesthetic delivered directly into the uterus, without a needle, could make IUD insertion less painful. They developed a method where physicians introduce the anesthetic mepivacaine to the uterus through a thin plastic catheter just a couple of minutes before the IUD is placed.
To test its efficacy, the team ran a randomized, double-blind trial with 370 women between the ages of 18 and 31 who had never given birth and needed IUDs placed. Half the group received the anesthetic during the procedure, and half received a saline solution instead.
The study was conducted across eleven gynecological clinics and youth health centers in Sweden. Neither the participants nor the healthcare providers knew who received which treatment, which reduces the risk of bias in the results.
The results were meaningful, not just marginal
The women who received the anesthetic reported notably less pain. On a 0-to-100 pain scale, the treatment group averaged a score of 43.8, compared to 58.6 in the group that got saline, a difference of about 15 points.
That drop in pain also translated into a better overall experience. The share of women who described the procedure as tolerable rose from 91.4% in the control group to 98.3% in the treatment group. More than half of the women who received the anesthetic said the procedure was easier than they expected, compared to only about a third of women in the control group.
Plus, women didn't report much additional discomfort during the administration of the anesthetic itself. Most participants rated that step as only mildly painful.
Why this is a big deal
IUDs are a great option for women who want reliable birth control they don't need to worry about on a daily basis, especially because hormonal oral contraceptives have many side effects. But a lot of women avoid IUDs because they fear the pain will be unbearable and they're unsure what to expect. If this method can measurably improves both the pain itself and how tolerable the whole experience feels, it could remove a real barrier for people considering long-acting birth control.
The ease of the method is also part of the appeal. "It is a simple method that does not require needles and is easy to use in everyday clinical practice," said Karin Elgemark, a PhD student at the Karolinska Institutet, and the study's lead author, in a press release.
What the study doesn't tell us yet
The researchers compared this method against no active treatment (saline), not against other existing pain-relief options for IUD insertion, like the cervical injection method already in use. That means it's still an open question whether this needle-free approach beats, matches, or falls short of other options.
However, even if the method doesn't reduce pain as effectively as the cervical injection, the lack of needles will make it more appealing for many women who are already nervous about the procedure.
The pain measurements were also self-reported, which means they reflect each participant's personal experience and threshold rather than an objective clinical measure. The researchers acknowledge more studies are needed to prove the efficacy of this method, but they are hopeful it could be a game-changer when it comes to women's contraception.
The takeaway
This method isn't necessarily available at your provider's office yet, since it's still relatively new research. But it's a good reminder that pain-relief options for IUD insertion do exist and are actively evolving, and it's worth asking your provider what's available before your appointment.
If pain has been the thing holding you back from getting an IUD, ask your provider about it directly. Your doctor may be able to offer you other numbing options, whether it be a topical numbing treatment, or the injectable version, and can educate you on what to expect from each. You deserve to feel informed and as comfortable as possible going into the procedure. (If you frequently experience pelvic or vaginal pain, that's worth bringing up with your doctor, too, whether or not you are interested in an IUD).