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Benefit of self-administered vaginal lidocaine gel in IUD placement

While patient-administered lidocaine gel compared with placebo gel did not alter pain scores on IUD placement, the need for cervical dilation was considerably lower in treated women—a side benefit that warrants further study
OBG Management. 2016 December;28(12):32-33
November 30, 2016|OBG Management
Andrew M. Kaunitz, MD
Author and Disclosure Information

Dr. Kaunitz is University of Florida Research Foundation Professor and Associate Chairman, Department of Obstetrics and Gynecology, University of Florida College of Medicine–Jacksonville. He is the Medical Director and Director of Menopause and Gynecologic Ultrasound Services, UF Women’s Health Specialists–Emerson. Dr. Kaunitz serves on the OBG Management Board of Editors.

 

The author reports that he serves on advisory boards for Bayer and Medicines360 and consults for Allergan.

In this article

Pearls for practice

As this study showed, self-administered lidocaine vaginal gel did not alter the primary outcome (pain with IUD placement), but the reduced need for cervical dilation is a promising finding and warrants additional study.

Tip. Interestingly, the placebo-treated women experienced pain intensity with cervical tenaculum placement similar to that associated with IUD placement. This finding illuminates the fact that IUD placement is not the only action that can produce pain. For this reason, I use a finer, single-tooth tenaculum designed for use with sonohysterograms (Goldstein Grasp Cervical Stabilizer).2 This instrument appears to cause less pain and bleeding than conventional tenacula.

Related article:
How to identify and localize IUDs on ultrasound
 

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