Cervical lidocaine for IUD insertional pain: A randomized controlled trial

Colleen P. McNicholas, Tessa Madden, Qiuhong Zhao, Gina Secura, Jenifer E. Allsworth, Jeffrey F. Peipert

Research output: Contribution to journalArticlepeer-review

47 Scopus citations


Objective: Anticipated pain with intrauterine device (IUD) insertion may be a barrier to widespread use. Our objective was to evaluate the efficacy of intracervical 2% lidocaine gel for pain relief with IUD insertion. Study Design: We performed a double-blind, randomized controlled trial of women undergoing IUD insertion. Participants were randomly assigned to 2% lidocaine or placebo gel. Study gel (3 mL) was placed 3 minutes prior to IUD insertion. Pain scores were measured at various time points using a 10-point visual analog scale. Results: Of the 200 participants randomized, 199 completed the study. Pain scores among lidocaine and placebo arms were similar at tenaculum placement (lidocaine and placebo: median, 4; range, 0-10; P =.15) and with insertion (lidocaine: median, 5; range, 1-10; placebo: median, 6; range, 0-10; P =.16). These results did not differ by parity. Conclusion: Topical or intracervical 2% lidocaine gel prior to IUD insertion does not decrease pain scores.

Original languageEnglish
Pages (from-to)384.e1-384.e6
JournalAmerican journal of obstetrics and gynecology
Issue number5
StatePublished - Nov 2012


  • intrauterine device
  • lidocaine gel
  • pain


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