{
    "abstract": "Fear of pain during intrauterine device (IUD) insertion remains a barrier to its adoption. In the absence of consensus on an optimal pharmacological strategy, it is crucial to determine the factors influencing this pain to reassure and improve the patient experience.\nIt was a prospective study conducted in Provence-Alpes-C\u00f4te d'Azur between August 2023\u00a0and 2024, interviewing adult patients and healthcare professionals during consultations for IUD insertion. The primary outcome studied was the pain experienced during IUD insertion, measured using a numerical rating scale from 0\u00a0to 10. After an univariate analysis, a multiple linear regression was performed to identify the factors associated with this pain.\nOf the 110\u00a0questionnaires analyzed, the average pain score at IUD insertion was 4.1\u00b12.7. Factors associated with pain included European origin, no history of vaginal delivery, apprehension and use of a tenaculum. In contrast, prior IUD insertion, the presence of dysmenorrhea, menstruation at the time of insertion, or premedication had no significant effect on pain. Prior bladder emptying and the use of equimolar mixture of oxygene and nitrous oxide (EMONO) could also be considered as strategies but require further studies.\nIUD insertion should be played down, given the moderate and temporary pain it causes. Physicians have a key role in identifying patients at risk of increased pain in order to provide them a personalized approach.",
    "authors": [
        {
            "affiliation": "D\u00e9partement de Gyn\u00e9cologie et Obst\u00e9trique, H\u00f4pital de La Conception, Assistance Publique H\u00f4pitaux de Marseille, 147, Boulevard Baille, 13005 Marseille, France; D\u00e9partement de Gyn\u00e9cologie et Obst\u00e9trique, H\u00f4pital Nord, Assistance Publique H\u00f4pitaux de Marseille, Chemin des Bourrely, 13015 Marseille, France. Electronic address: guerrychloe@outlook.com.",
            "firstname": "Chlo\u00e9",
            "initials": "C",
            "lastname": "Guerry"
        },
        {
            "affiliation": "D\u00e9partement de Gyn\u00e9cologie et Obst\u00e9trique, H\u00f4pital Nord, Assistance Publique H\u00f4pitaux de Marseille, Chemin des Bourrely, 13015 Marseille, France.",
            "firstname": "H\u00e9l\u00e8ne",
            "initials": "H",
            "lastname": "Piclet"
        },
        {
            "affiliation": "D\u00e9partement de Gyn\u00e9cologie et Obst\u00e9trique, H\u00f4pital de La Conception, Assistance Publique H\u00f4pitaux de Marseille, 147, Boulevard Baille, 13005 Marseille, France; Microbes, Evolution, Phylog\u00e9nie et Infection (MEPHI), Institut hospitalo-universitaire en maladies infectieuses de Marseille (IHU M\u00e9diterran\u00e9e Infection), Aix-Marseille Universit\u00e9, Marseille, France.",
            "firstname": "Florence",
            "initials": "F",
            "lastname": "Bretelle"
        },
        {
            "affiliation": "INSERM, IRD, ISSPAM, SESSTIM, Sciences Economiques & Sociales de la Sant\u00e9 & Traitement de l'Information M\u00e9dicale, Aix-Marseille Universit\u00e9, 13005 Marseille, France; BioSTIC, Biostatistique et Technologies de l'Information et de la Communication, H\u00f4pital Timone, Assistance Publique H\u00f6pitaux de Marseille, 13005 Marseille, France.",
            "firstname": "Julien",
            "initials": "J",
            "lastname": "Mancini"
        },
        {
            "affiliation": "D\u00e9partement de Gyn\u00e9cologie et Obst\u00e9trique, H\u00f4pital de La Conception, Assistance Publique H\u00f4pitaux de Marseille, 147, Boulevard Baille, 13005 Marseille, France; UFR de m\u00e9decine, Aix-Marseille Universit\u00e9, 27, bd Jean Moulin, 13005 Marseille, France.",
            "firstname": "Aubert",
            "initials": "A",
            "lastname": "Agostini"
        },
        {
            "affiliation": "D\u00e9partement de Gyn\u00e9cologie et Obst\u00e9trique, H\u00f4pital Nord, Assistance Publique H\u00f4pitaux de Marseille, Chemin des Bourrely, 13015 Marseille, France.",
            "firstname": "Mallaury",
            "initials": "M",
            "lastname": "Vitabile"
        }
    ],
    "conclusions": "IUD insertion should be played down, given the moderate and temporary pain it causes. Physicians have a key role in identifying patients at risk of increased pain in order to provide them a personalized approach.",
    "copyrights": "Copyright \u00a9 2025 The Authors. Published by Elsevier Masson SAS.. All rights reserved.",
    "doi": "10.1016/j.gofs.2024.12.007",
    "journal": "Gynecologie, obstetrique, fertilite & senologie",
    "keywords": [
        "Apprehension",
        "Appr\u00e9hension",
        "Contraception",
        "Dispositif intra-ut\u00e9rin",
        "Douleur",
        "Insertion",
        "Intrauterine device",
        "Pain",
        "Pose"
    ],
    "methods": null,
    "publication_date": "2025-01-20",
    "pubmed_id": "39826903",
    "results": "Of the 110\u00a0questionnaires analyzed, the average pain score at IUD insertion was 4.1\u00b12.7. Factors associated with pain included European origin, no history of vaginal delivery, apprehension and use of a tenaculum. In contrast, prior IUD insertion, the presence of dysmenorrhea, menstruation at the time of insertion, or premedication had no significant effect on pain. Prior bladder emptying and the use of equimolar mixture of oxygene and nitrous oxide (EMONO) could also be considered as strategies but require further studies.",
    "title": "[Factors influencing pain during intrauterine device insertion].",
    "xml": "<Element 'PubmedArticle' at 0x788506837d80>"
}