Abstracts from the International Pelvic Pain Society (IPPS) annual scientific meeting on pelvic pain 2022

Abstract

System—Gynecology section Introduction: The intrauterine device (IUD) is an efficacious, long-acting, reversible contraceptive method that can be used to treat dysmenorrhea and heavy menses. Studies have shown that women experience moderate levels of pain at the time of IUD insertion and that they may decline IUD insertion due to fears of pain. Previous investigations regarding the efficacy of oral analgesics for IUD insertion pain have conflicting results. We hypothesize that a multidose ibuprofen regimen given 24-hours before the insertion of IUD can provide pain relief. Methods: This is a prospective, triple-blind, placebo-controlled study that assesses pain levels with a 10-point visual analog scale (VAS) during speculum insertion, tenaculum insertion, IUD insertion, and 24 hours after insertion. Pain methods used 24 hours after insertion were also assessed. We performed an interval analysis of 27 patients who have completed the trial, without breaking the randomization sequence as enrollment is still ongoing. Results: There is a significant difference in IUD insertion pain scores between multidose ibuprofen group and a placebo group (Group A mean 6.8, SD 1.7, Group B mean 4.3, SD 2.9, P 5 0.01). There was no difference in pain scores at any other time point. Despite a higher pain score at the time of insertion, more women in Group A than in Group B used no pain medications after insertion ( P 5 0.03). Conclusions: There is a difference in pain scores at the time of IUD insertion; however, due to ongoing randomization, we do not know whether it is less in women who took ibuprofen or placebo. Disclosure: Any of the authors