IUD Insertion Is Usually Painful—Can a New Tool Help?

Intrauterine devices have evolved into a widespread form of birth control, but it’s typical for women to convey pain during the placement process, and many individuals still avoid them out of anxiety. Now, a company called Aspivix has fabricated a new device developed to make IUD insertion less unfortunate. 

Before an IUD is inserted, healthcare providers generally grasp the cervix with a long scissor-like tool named a tenaculum, which specialists say can stick the cervix and spur bitter uterine squeezes. The new machine, dubbed Carevix, delivers an alternative to the tenaculum by utilizing suction to get the cervix. This “stops extreme pain and bleeding,” according to Aspivix. 

The machine was removed by the Food and Drug Administration last year, and Aspivix states it will be “known for commercialization in … the United States of America very soon.”

“Pain during IUD insertion is mainly driven by several aspects associated with the manipulation of the cervix and the uterus,” said Michal Yaron, MD, a gynecologist at Geneva University Hospitals who conducted a study on Carevix offered at the American College of Obstetricians and Gynecologists (ACOG) Annual Clinical and Scientific Meeting in May.

By potentially relieving pain during IUD insertion, Carevix “handles critical barriers to IUD adoption,” Yaron told Health.

What the Research Shows

The new instrument is still being tested. Still, some investigations have shown favorable outcomes.

For the analysis offered in May, which hasn’t yet been peer-reviewed, Yaron and her colleagues gathered data from about 300 operations conducted across 11 healthcare centers in Europe and the U.S., 88% of which were IUD insertions.

About 76% of healthcare providers said successfully used Carevix at first, and 89% stated they achieved it after using it in 10 systems.

As for pain, most patients interviewed said it was painless, and the procedure was “comfortable.” 

For another investigation issued last July, led by Yaron and supported by Aspivix, students haphazardly set a hundred women suitable for IUD insertion to have the system using either the suction machine or a tenaculum. Overall, players whose operations included suction said less pain than those in the other company.

The group saw the most important distinction in pain decrease written by patients who had never given birth, a group that manages to share more pain during an IUD insertion because their cervixes have never been widened. (One study discovered that 80% of women who had never given birth conveyed intense pain during their IUD insertion.)

Yaron said that using suction rather than a clamp could decrease the risk of uterine squeezes that result from manipulation of the cervix.

Carevix may also help to underestimate stab injuries, Katrina Heyrana, MD, PhD, an OB-GYN at Cedars-Sinai in Los Angeles who is not concerned with the investigations, told Health. “In my knowledge, most patients sense pain most powerfully at the point of time that the tenaculum pierces the cervix,” she stated.

Not a ‘Total Alternate’

The device does have some rules, Lisa Bayer, MD, an associate professor of o.b. and gynecology at the Oregon Health & Science University School of Medicine who is not concerned with Carevix research, told Health.

It doesn’t handle the discomfort that happens when doctors estimate the height of the cervix, which needs testing the cervix and inserting a measuring instrument that connects the bottom of the uterus. “Anytime something goes via the cervix, it can be bitter,” she said. “Then you’re feeling the top of the uterus, and there are a lot of nerves there, which can generate pain.”

That’s often the most important origin of pain for patients, Heyrana counted.

It’s also conceivable that some patients won’t be capable of using it—about 5% of players were banned from the printed study because the device was too big to be operated on their cervix.

Carevix is also a disposable instrument, which would donate to the already sizable issue of healthcare destruction, Bayer counted.

“It doesn’t look like it’s a total relief” of a tenaculum, she stated.

A Growing Concern

According to a report published by the Centers for Disease Control and Prevention in 2023, about a quarter of U.S. women aged 15 to 49 who have ever had sex with men use long-acting reversible birth control, which doesn’t have condoms or surgical sterilization such as a hysterectomy. Of those, more than 80% have used an IUD.6

Bayer said more individuals are likely suffering pain from insertion because IUDs are evolving more favored among women who’ve never given birth.

“IUD users have varied over the last one to two decades,” Bayer stated. “Traditionally it was ladies who got them after they had infants. But that has reversed; we see them typically in younger ladies and individuals who have never been expectant.”

A key issue donating to the concern is that there “is a release of women’s pain during gynecological operations,” Bayer said. The American College of Obstetricians and Gynecologists, the governing association for OB/GYNs, does not have advice on the best way to handle pain during an IUD insertion, she counted. 

“They believe that studies haven’t shown an effective method to mitigate this pain, but they don’t tell somebody somebody what to do rather,” she said. “That has gone a lot of individuals thinking there aren’t interventions that are useful.”

Pain Relief Alternatives

Bayer said that many ladies aren’t given anything to relieve pain during the procedure, despite the availability of alternatives.

“Research has shown that ibuprofen isn’t the best remedy for this, but other NSAIDs are practical,” she said.

A paracervical block—local anesthesia helped to the cervix and uterus—can also be useful, Bayer counted.

Acquiring an IUD while under full anesthesia can also be required for some individuals. “A lot of people haven’t felt about that because the standard review is this is just going to be a little twitch,” she stated.

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