As the comments on some of our articles will testify, IUD insertion is more painful for some women than for others. As more and more U.S. women are deciding that the gain is worth the pain, researchers and health care providers are looking for ways to make the insertion process more comfortable for all. A few of the better-known ways providers have tried are local anesthesia, a drug called misoprostol, and good old ibuprofen. The second of those options, misoprostol, may soon be officially off the table because of mounting evidence that it doesn’t make IUD insertion any easier for the patient or the provider.
Past studies about misoprostol for IUD insertion had sub-par methods and conflicting results—not so with a new study from the University of Utah. Women who had never had a child and wanted an IUD were eligible to participate in the study, which was double-blind and placebo-controlled. In plain English, that means neither the women nor their docs knew whether participants got actual misoprostol or an identical-looking placebo.
Women rated how uncomfortable they were before, during, and after the IUD insertion. There was only one difference between women who got misoprostol and women who got the placebo: women who got misoprostol were more likely to be uncomfortable before the IUD insertion. Misoprostol can cause cramps, nausea, or low fever. Using a pain scale from 0 to 10 (where 0 is nothing and 10 is the worst imaginable), the average woman in this study said the actual IUD insertion rated a 6. Despite that, three out of four participants said they’d go through it again for another IUD in the future.
Of course it’s possible that future research could find other benefits to taking misoprostol before an IUD insertion, but right now it’s looking like it may do more harm than good. Fingers crossed that other painkillers or local anesthesia prove to be better options.