Pain medication finally recommended in U.S. for IUD use. What about Canada?

Newly released guidance in the United States is now recommending pain management for the insertion of an intrauterine device or IUD, which can be an unpleasant experience for some women.

The Centers for Disease Control and Prevention (CDC) updated its guidance on Thursday for contraceptive use, saying that lidocaine, which is a local anesthetic agent, “might be useful” in reducing patient pain for IUD placement.

To numb the cervix area, doctors may use this anesthesia in a topical ointment form or via injection.

The previous CDC guidance from 2016 did not specifically address pain management for IUD insertions.

The Society of Obstetricians and Gynaecologists of Canada (SOGC) has previously said when it comes to IUD use, “an appropriate pain management plan” should be developed “when it is needed.”

“Some patients may experience more pain or discomfort than others during IUD insertion including those who have a history of trauma, chronic pelvic pain, sexual pain, or painful periods, as well as those who are post-partum, have difficulty with or have never had speculum exams, and those who are anxious about the procedure,” the SOGC said in statement in December 2022.

1:55 The Canadian Pediatric Society says IUDs should be the first-line birth control option for teens

The SOGC also lists lidocaine as a local anesthetic option for IUD pain management, recommending its use prior to the procedure.

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Oral analgesics that could be considered for use are ketoprofen, ketorolac, naproxen and tramandol, the SOGC says.

“Most patients find that oral medications meet their pain management needs, but (these) options … have been shown to be effective and should be discussed with patients, as appropriate.”

In addition to IUD pain management, the CDC also on Thursday updated its recommendations for treating bleeding irregularities during implant use.

It said that hormonal treatment, antifibrinolytic agents, nonsteroidal anti-inflammatory drugs or NSAIDs and selective estrogen receptor modulators may be considered as treatment options.

Experts say IUD is one of most effective forms of contraception, with less than one per cent chance of getting pregnant.

Global News is awaiting a response from Health Canada about the new CDC guidance for IUD pain management.