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A potential deterrent to wider utilization of intrauterine devices (IUDs) is fear of pain during placement. Various strategies (intracervical lidocaine, oral or vaginal misoprostol, paracervical block, and nonsteroidal anti-inflammatory agents) have been unsuccessfully employed to minimize discomfort (e.g., NEJM JW Womens Health Sep 20 2012). But do providers have an understanding of the pain and discomfort experienced by women during IUD placement?
Researchers explored the differences between pain scores reported by patients versus those surmised by clinicians during IUD placement. Two hundred participants (age range, 18–45 years) were asked to use a 100 mm visual analog scale to record pain levels experienced during tenaculum placement, ut…