Misoprostol and IUD Insertion

Misoprostol, a synthetic prostaglandin, causes cervical dilation and has multiple uses in obstetrics and abortion. Can misoprostol help with IUD insertion, as well?

Research has shown that misoprostol self-administered before IUD insertion in nulliparous women did not ease IUD insertion or reduce patient-perceived pain. In fact, several studies found that patients who received misoprostol before IUD insertion had significantly more pain, along with higher rates of other side effects (including shivering and headache).

Instead of misoprostol, clinicians can use “verbicain” to ease IUD insertion. Interpersonal techniques can prevent patients’ discomfort without misoprostol’s side effects.  

Resources

Non-Pharmacologic Pain Management

Postpartum IUD

Do You Underuse IUDs?

Methods to Reduce Pain With Insertions of Intrauterine Contraception

Sources

Al-Fozan H, Firwana B, Al Kadri H, Hassan S, Tulandi T. Preoperative Ripening of the Cervix Before Operative Hysteroscopy. Cochrane Database Syst Rev. 2015 April;(4):CD005998. doi:10.1002/14651858.CD005998.pub2.

Crane JMC, Craig C, Dawson L, O’Grady T, Bartellas E, Hutchens D. Randomized Trial of Oral Misoprostol Before Endometrial Biopsy. J Obstet Gynaecol Can. 2009 Nov; 31(11): 1054-1059. doi: 10.1016/S1701-2163(16)34351-1.

Swenson C, Turok DK, Ward K, Jacobson JC, Dermish, A. Self Administered Misoprostol or Placebo Before Intrauterine Device Insertion in Nulliparous Women: A Randomized Controlled Trial. Obstets Gyencol. 2012 August; 120(2 Pt 1):341-7. doi: 10.1097/AOG.0b013e31825d9ec9.

Zapata LB, Jatlaoui TC, Marchbanks PA, Curtis KM. Medications to Ease Intrauterine Device Insertion. A Systematic Review. Contraception. 2016 Dec; 94(6):739-759. doi:10.1016/j.contraception.2016.06.014. Epub 2016 June.  

Pharma-free

The Reproductive Health Access Project does not accept funding from pharmaceutical companies. We do not promote specific brands of medication or contraception. The information in the Contraceptive Pearls is unbiased, based on science alone.