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IUD insertion: A pinch, a poke, or a serious ouch?

Just how painful does getting that little T have to be?

IUD insertion is different for everyone—some say it's not a big deal, but studies have shown that for between 10% and 20% of women, pain during insertion can be severe. Unfortunately, a 2013 study found that health care providers often underestimate how much pain their patients experience during insertion.

That's not to say that providers are insensitive to pain during IUD insertion. They've tried lots of tactics to relieve this discomfort, like having women take ibuprofen beforehand, using a drug called misoprostol that makes the cervix relax, and putting lidocaine, a numbing gel, inside the cervix. So far nothing has made a real difference. A numbing shot known as cervical block may help, but the scientific jury is still out on that one.

Painful periods and painful insertions?

A recent study found that among women without kids, painful periods were the only factor that meant pain during IUD insertion was more likely. Women who reported their period pain as severe were more than eight times more likely to report severe pain during an IUD insertion compared to women who reported mild or moderate period pain.

Blue pill, silver lining?

Call us optimists, but we're hoping this connection suggests a partial solution: treatments that get at the root of period pain may also help prevent painful IUD insertions. We know that painful periods are partly caused by compounds called prostaglandins, which make blood vessels smaller—so maybe treatments that counter these compounds and make blood vessels larger could help with insertion pain.

Guess which well-known drug does just that? Viagra. There's already been a small study that found that women with severe period pain who put Viagra in their vagina experienced reduced pain compared to women who used a placebo. Up next, Viagra for IUD insertion pain? There's a study idea that gets our motor running.

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