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Despite sparse safety and efficacy data, off-label misoprostol use is common for cervical ripening during labor and office-based procedures such as endometrial biopsy, hysteroscopy, and abortion. Researchers evaluated whether prophylactic misoprostol before first-time intrauterine device (IUD) placement alleviated pain and eased insertion in 40 nulliparous women (age range, 18–45). Participants could choose a levonorgestrel-releasing or copper IUD and were randomized to receive 400-µg buccal misoprostol or placebo 90 minutes before placement. Using a visual analog scale (VAS; range, 0–100 mm), women reported their pain at specific points before, during, and after their procedures; providers also used a 0-to-100–mm VAS to rate ease of insert…