Prescribing Practices for Pre- and Post-Procedural Analgesia During Intrauterine Device Insertion: A National Survey of Providers in the United States.

BACKGROUND

The intrauterine device (IUD) is an effective contraceptive, but insertion pain is a significant concern and barrier, especially for nulliparous patients.

OBJECTIVE

To evaluate differences in practice patterns for pre- and post-procedural analgesia during IUD insertion.

STUDY

DESIGN

A cross-sectional national web-based survey of 652 IUD providers examined demographics and their likelihood of prescribing analgesia to nulliparous and multiparous patients. Linear regression models and 1-way analysis of variance (ANOVA) tests assessed differences in analgesia recommendations by provider demographics.

RESULTS

Pre-procedurally, 75.9% of providers for nulliparous and 66.2% for multiparous patients frequently prescribed non-steroidal anti-inflammatory drug (NSAIDs). Post-procedurally, 76.5% for nulliparous and 65.4% for multiparous patients frequently prescribed NSAIDs. Providers with 30+ years of experience and cisgender male providers prescribed NSAIDs and anxiolytics less frequently.

CONCLUSIONS

NSAIDs were the most common analgesic pre- and post-IUD insertion. Prescribing practices varied by gender and years in practice. Providers should adopt patient-centered prescribing to reduce IUD insertion pain.