Abstract
A psychological factor associated with pain during intrauterine device insertion: emotional reactivity
Highlights
The intrauterine device (IUD) can be an ideal, reliable and reversible method for women who require long-term reversible contraception as this approach offers high efficacy [1], low expulsion rate [2], and a lifespan between 5 and 10 years
Body mass index (BMI), occupational status and lactational status were similar among the participants, previous IUD insertion experience was higher in women with mild pain (p = 0.001)
Anticipated mean visual analogue scale (VAS) pain scores, mean VAS pain scores at IUD insertion and emotional reactivity (ER) were higher in the patients with moderate-severe pain (p = 0.001)
Summary
The intrauterine device (IUD) can be an ideal, reliable and reversible method for women who require long-term reversible contraception as this approach offers high efficacy (total pregnancy rate of 1.7 per 100 women for the first 3 years of use) [1], low expulsion rate (first-year expulsion rates of the IUD are commonly quoted as 2%–10% ) [2], and a lifespan between 5 and 10 years. Several studies have investigated the main barriers to IUD insertion and concluded that fear, pain during insertion and anxiety were the most common obstacles to its use [4, 5]. Nulliparity, not currently breast feeding, older age, history of dysmenorrhea, and lengthier time since last pregnancy are factors reported to be associated with more significant pain [6, 7, 8]. A recent study by us demonstrated that experience of cesarean delivery and pre-procedure anxiety were associated with higher pain scores during IUD insertion, and the presence of negative perceptions of IUDs was the most significant predictor of pain during IUD insertion in parous women [9]. Higher pre-procedure anxiety and higher expected pain during IUD insertion were associated with greater pain in other studies [10, 11]
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