title: Prophylactic ibuprofen does not improve pain with IUD insertion: a randomized trial.
abstract: OBJECTIVE
  To evaluate if ibuprofen 800mg reduces pain with intrauterine device (IUD) insertion among U.S. women.
  
  
  METHODS
  We conducted a randomized, double-blind, placebo-controlled trial of women undergoing IUD insertion approximately 2-6weeks following first-trimester uterine aspiration. Subjects were randomized to receive ibuprofen 800mg or placebo 30-45min prior to IUD insertion. A 100-mm visual analog scale (VAS) was administered to measure pain after speculum insertion (baseline) and immediately following IUD insertion.
  
  
  RESULTS
  A total of 202 women were enrolled, with 101 randomized to each group (ibuprofen or placebo). Sociodemographic characteristics and baseline VAS scores were similar between groups. The median pain score with IUD insertion was 41.5mm in the placebo group and 38.0mm in the ibuprofen group (p=.50). Mean and median pain scores did not differ between placebo and ibuprofen when nulliparous and parous women were analyzed independently. Overall, median pain scores were 17.5mm higher in nulliparous women than parous women (p=.004). Median pain scores did not differ by age, IUD-type, history of dysmenorrhea or time since aspiration.
  
  
  CONCLUSIONS
  Administration of ibuprofen 800mg prior to IUD insertion does not reduce pain associated with the procedure for U.S. women. Overall, nulliparous women report more pain with IUD insertion than multiparous women.
authors.affiliation: Department of Obstetrics and Gynecology, Oregon Health and Science University, Portland, OR, USA. Electronic address: bednarek@ohsu.edu.
authors.forename: Paula H
authors.initials: PH
authors.lastname: Bednarek
authors.affiliation: Department of Obstetrics and Gynecology, University of California, Davis, Sacramento, CA, USA.
authors.forename: Mitchell D
authors.initials: MD
authors.lastname: Creinin
authors.affiliation: National Abortion Federation, Washington, DC, USA.
authors.forename: Matthew F
authors.initials: MF
authors.lastname: Reeves
authors.affiliation: Department of Gynecology and Obstetrics, Emory University, Atlanta, GA, USA.
authors.forename: Carrie
authors.initials: C
authors.lastname: Cwiak
authors.affiliation: Department of Obstetrics and Gynecology, University of New Mexico, Albuquerque, NM, USA.
authors.forename: Eve
authors.initials: E
authors.lastname: Espey
authors.affiliation: Department of Obstetrics and Gynecology, Oregon Health and Science University, Portland, OR, USA.
authors.forename: Jeffrey T
authors.initials: JT
authors.lastname: Jensen
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D018712:Analgesics, Non-Narcotic / Q000008:administration & dosage*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007052:Ibuprofen / Q000008:administration & dosage*; D007434:Intrauterine Devices / Q000009:adverse effects*; D010146:Pain / Q000209:etiology / Q000517:prevention & control*; D059408:Pain Management / Q000379:methods*; D010147:Pain Measurement; D010298:Parity; D013525:Surgical Instruments / Q000009:adverse effects; D013997:Time Factors; D055815:Young Adult
chemical_list: D018712:Analgesics, Non-Narcotic; D007052:Ibuprofen
keywords: IUD; Ibuprofen; Intrauterine device; Pain