Prophylactic ibuprofen does not improve pain with IUD insertion: a randomized trial

Abstract Objective To evaluate if ibuprofen 800 mg reduces pain with intrauterine device (IUD) insertion among U.S. women. Study design We conducted a randomized, double-blind, placebo-controlled trial of women undergoing IUD insertion approximately 2–6 weeks following first-trimester uterine aspiration. Subjects were randomized to receive ibuprofen 800 mg or placebo 30–45 min 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 41.5 mm in the placebo group and 38.0 mm 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 17.5 mm 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 800 mg 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.