• Paula H Bednarek, Mitchell D Creinin, Matthew F Reeves, Carrie Cwiak, Eve Espey, Jeffrey T Jensen, and Post-Aspiration IUD Randomization (PAIR) Study Trial Group.
• Department of Obstetrics and Gynecology, Oregon Health and Science University, Portland, OR, USA. Electronic address: bednarek@ohsu.edu.
• Contraception. 2015 Mar 1;91(3):193-7.

ObjectiveTo evaluate if ibuprofen 800mg reduces pain with intrauterine device (IUD) insertion among U.S. women.Study DesignWe conducted a randomized, double-blind, placebo-controlled trial of women undergoing IUD insertion approximately 2-6weeks following first-trimester uterine aspiration. Subjects were randomized to receive ibuprofen 800mg or placebo 30-45min 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.ResultsA 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 41.5mm in the placebo group and 38.0mm 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 17.5mm 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.ConclusionsAdministration of ibuprofen 800mg 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.Copyright © 2015 Elsevier Inc. All rights reserved.

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