LOS ANGELES - A national organization is calling on doctors to offer pain relief options to patients undergoing an intrauterine device (IUD) insertion procedure.
What we know:
The American College of Obstetricians and Gynecologists (ACOG), the organization dedicated to providing nationwide guidance for practicing women's health care, published an updated guidance in May 2025 saying there is an "urgent need" for clinicians to look into pain management options for IUD insertion patients.
"These procedures are often painful or uncomfortable for patients but critically important for gynecologic health, heightening the need for better pain management options and patient counseling about the options available to them," the new guidance read. "There is an urgent need for clinicians to better understand pain management options and recognize and address patient pain, and for patients to have more autonomy over pain control options for their health care."
ACOG's guidance recommends clinicians to look into anesthetics such as lidocaine spray, lidocaine-prilocaine cream and paracervical block. Depending on the procedure, ACOG said in its guidance that clinicians can also consider looking into topical or injected anesthetics, NSAIDs, and miSOPROStol.
The backstory:
According to a report from The New York Times, ACOG in the past had acknowledged sharp pain during IUD insertions, but the organization had not formally recommended pain relief options for IUD patients in previously-published guidances.
ACOG's formal recommendation on May 2025 also comes months after the Centers for Disease Control and Prevention (CDC) had also addressed the painful side of IUD insertion procedures.
A doctor affiliated with ACOG issued a statement saying systemic racism and bias have "influenced" pain management considerations in the past.
"The way that pain is managed by health care professionals has been affected by a number of factors, including the fact that many of the pain management interventions had limited or conflicting evidence supporting their effectiveness," said Christopher M. Zahn, of ACOG, in the organization's press release. "Additionally, systemic racism and bias as to how pain is experienced and who experiences it also has, unfortunately, influenced pain management considerations. This guidance is an important step toward both identifying evidence-based approaches to pain management and reducing those biases by offering all patients more autonomy in deciding how to best approach the pain they experience. What I hope clinicians will take away from this guidance is the absolute importance of comprehensive pain management counseling -- not just for mitigating pain in the moment but also for improving trust with our patients and ensuring better access to gynecologic health care for every person."
A doctor who co-authored the new guidance also weighed in on the history of IUD insertion patients not getting chances to look into pain relief options.
"As a women's health nurse practitioner, I treat patients every day who express anxiety about pain related to common procedures like IUD placement. Unfortunately, many patients feel their pain has been diminished or dismissed by their clinicians, which data shows can lead to patient dissatisfaction and distrust. ACOG's new guidance provides critically important patient-centered recommendations on how to help our patients have better experiences and will help improve trust between patients and clinicians," said Genevieve Hofmann in a press release. "Though some clinicians have been able to offer some of these pain management options already, I am excited that this guidance will ensure more ob-gyns and clinicians are discussing pain management options with their patients, and, most importantly, that fewer people will have to endure pain to obtain procedures that are necessary for their health and well-being."