Vaginal dinoprostone may reduce pain during IUD placement

Women who receive prophylactic treatment with 3-mg dinoprostone vaginally appear to experience less pain during insertion of copper intrauterine device (IUD), increasing their satisfaction as a result, as shown in a study.

A total of 160 multiparous women requesting copper IUD insertion were randomized to receive 3-mg dinoprostone (n=80) or placebo (n=80) vaginally. Pain scores were assessed using a 100-mm visual analogue scale.

There were no significant between-group differences in anticipated pain score (p=0.41), pain during tenaculum placement (p=0.22), and pain during sound insertion (p=0.07).

However, pain scores during IUD insertion were much lower in the dinoprostone group than in the placebo group (mean, 34.8 vs. 57.8), as were pain scores 15 minutes after insertion (mean, 20.6 vs 29.6).

Dinoprostone was also associated with easier IUD insertion (mean, 43.6 vs 64.7) and higher satisfaction among women (mean, 83.9 vs 63.0). Fewer women in the active treatment than in the placebo group required additional analgesics in (p=0.01).

The drug was well tolerated, with side-effects similar to that with placebo.