A narrative review of the effectiveness of pain management strategies during intrauterine device insertion and endometrial biopsies.

Abstract

A variety of pain management techniques are currently used during gynecological procedures in outpatient settings to help improve patient comfort and satisfaction. The most common pharmacological methods include nonsteroidal anti-inflammatory drugs, lidocaine gel, lidocaine spray, and paracervical blocks. Moreover, noninvasive techniques such as transcutaneous electrical nerve stimulation and verbal analgesia have been shown to help reduce pain during intrauterine device (IUD) insertions and endometrial biopsies (EMB). More recently, Penthrox, an inhaled analgesic, is another promising new option for pain control in primary care practice. Despite the variety of available techniques, there are limited recent data evaluating the comparative efficacy of these pain management strategies during IUD insertions and EMB. Several factors play a significant role in pain perception. For example, parous women tend to have a higher tolerance for pain and report lower pain scores than nulliparous women who have not given birth and are more likely to experience cervical stenosis. This gap in evidence highlights the need for ongoing research and the development of accessible, evidence-based interventions in primary healthcare settings to enhance patient experiences and satisfaction with these common procedures. Patient education about the procedure, its benefits, and potential side effects, and providing additional counseling can help alleviate anxiety and contribute to better overall outcomes, and in turn, reduce pain.