Factors Associated With Pain Related to Insertion of a Contraceptive Intrauterine Device: Findings of a National Survey

BACKGROUND: A prominent barrier to broader intrauterine device (IUD) uptake is the fear of pain and discomfort associated with insertion of the device. AIM: To examine the pain level perceived during IUD insertion and identify factors associated with perceived pain during the insertion procedure. MATERIALS AND METHODS: We conducted a secondary analysis of nationally representative survey data from Australian women using IUDs. We explored self-reported pain perception during IUD insertion retrospectively. We asked women about pregnancy history, mental health and their perceived knowledge about the IUD method they were using at the time of the survey. Ordinal logistic regression was employed to analyse associations between these factors and pain perception. RESULTS: A total of 347 respondents were using an IUD and reported on pain perception during IUD insertion. One in five women reported experiencing severe pain during IUD insertion and approximately one in two women reported experiencing mild or no pain during this procedure. Having a current mental health condition, having more than one previous pregnancy and higher self-perceived knowledge about IUD groups were associated with more perceived pain. CONCLUSIONS: These findings highlight the need for healthcare providers to consider the complex interplay of factors affecting pain perception during IUD insertion, prioritise individualized pain management strategies and address perceived knowledge surrounding IUDs, particularly in women with mental health conditions. Exploring ways to improve the experience of women during IUD insertion may contribute to positive discourse around IUDs and to encourage others to select an IUD as a contraceptive approach.