Medications to ease intrauterine device insertion: a systematic review

Zapata, Lauren B.; Jatlaoui, Tara C.; Marchbanks, Polly A.; Curtis, Kathryn M.

doi:10.1016/j.contraception.2016.06.014

Cited by 31 publications

(11 citation statements)

References 47 publications

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“…Evidence for misoprostol from two systematic reviews, including a total of 10 randomized controlled trials, suggests that misoprostol does not improve provider ease of insertion, reduce the need for adjunctive insertion measures, or improve insertion success (Level of evidence: I, good to fair, direct) and might increase patient pain and side effects (Level of evidence: I, high quality) (115,116). However, one randomized controlled trial examined women with a recent failed IUD insertion and found significantly higher insertion success with second insertion attempt among women pretreated with misoprostol versus placebo (Level of evidence: I, good, direct) (117).…”

Section: Provision Of Medications To Ease Iud Insertionmentioning

confidence: 99%

“…Limited evidence on nonsteroidal antiinflammatory drugs (NSAIDs) and nitric oxide donors generally suggested no positive effect; evidence on lidocaine with administration other than paracervical block was limited and inconclusive (Level of evidence for provider ease of insertion: I, good to poor, direct; Level of evidence for need for adjunctive insertion measures: I, fair, direct; Level of evidence for patient pain: I, high to low quality; Level of evidence for side effects: I, high to low quality) (115,116).…”

Section: Provision Of Medications To Ease Iud Insertionmentioning

confidence: 99%

See 1 more Smart Citation

U.S. Selected Practice Recommendations for Contraceptive Use, 2016

Curtis

Jatlaoui²,

Tepper³

et al. 2016

MMWR Recomm. Rep.

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313

333

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The 2016 U.S. Selected Practice Recommendations for Contraceptive Use (U.S. SPR) addresses a select group of common, yet sometimes controversial or complex, issues regarding initiation and use of specific contraceptive methods. These recommendations for health care providers were updated by CDC after review of the scientific evidence and consultation with national experts who met in Atlanta, Georgia, during August 26-28, 2015. The information in this report updates the 2013 U.S. SPR (CDC. U.S. selected practice recommendations for contraceptive use, 2013. MMWR 2013;62[No. RR-5]). Major updates include 1) revised recommendations for starting regular contraception after the use of emergency contraceptive pills and 2) new recommendations for the use of medications to ease insertion of intrauterine devices. The recommendations in this report are intended to serve as a source of clinical guidance for health care providers and provide evidence-based guidance to reduce medical barriers to contraception access and use. Health care providers should always consider the individual clinical circumstances of each person seeking family planning services. This report is not intended to be a substitute for professional medical advice for individual patients. Persons should seek advice from their health care providers when considering family planning options.

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Section: Provision Of Medications To Ease Iud Insertionmentioning

confidence: 99%

Section: Provision Of Medications To Ease Iud Insertionmentioning

confidence: 99%

U.S. Selected Practice Recommendations for Contraceptive Use, 2016

Curtis

Jatlaoui²,

Tepper³

et al. 2016

MMWR Recomm. Rep.

Self Cite

313

333

View full text Add to dashboard Cite

show abstract

“…54 The evidence did not show the insertion was easier, neither a reduction in the need for techniques to dilate the uterine cervix, nor higher success rates (A). 54 Only a study with women who underwent a failed insertion procedure showed higher success rates in the group that used misoprostol prior to the procedure compared with the placebo group (A). 55 The use of diclofenac plus 2% intracervical lidocaine also showed no positive effect on insertion (A).…”

Section: Medications To Facilitate Iud Insertionmentioning

confidence: 99%

Long-Acting Reversible Contraception

Machado

Monteiro

Magalhães³

et al. 2017

Rev Bras Ginecol Obstet

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Unwanted pregnancy is a major public health problem both in developed and developing countries. Although the reduction in the rates of these pregnancies requires multifactorial approaches, increasing access to long-acting contraceptive methods can contribute significantly to change this scenario. In Brazil, gynecologists and obstetricians play a key role in contraceptive counseling, being decisive in the choice of long-acting reversible methods, characterized by intrauterine devices (IUDs) and the contraceptive implant. The vast scope due to the reduced number of situations to indicate long-acting methods should be emphasized in routine contraceptive counseling. On the other hand, gynecologists and obstetricians should adapt the techniques of insertion of long-acting methods, and engage in facilitating conditions to access these contraceptives through public and private health systems in Brazil. This study is part of a project called ( from the Portuguese acronym). It aims to review the main characteristics of long-acting contraceptives and critically consider the current situation and future prospects to improve access to these methods, proposing practical recommendations of interest in the routine of gynecologists and obstetricians.

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“…To this day, several systematic reviews on the use of IUD in adolescents and nulliparous women have been conducted. Among those published in the recent years, the main topic became the IUD insertion procedure and pain management in this specific population [22][23][24]. They indicated higher rates of difficulties in insertion, insertion failure and pain during insertion in nulliparous, but at the same time, highlight the existence of potentially helpful interventions, such as cervix preparation with the use of misoprostol or lidocaine anesthesia [22][23][24].…”

Section: Introductionmentioning

confidence: 99%

“…Among those published in the recent years, the main topic became the IUD insertion procedure and pain management in this specific population [22][23][24]. They indicated higher rates of difficulties in insertion, insertion failure and pain during insertion in nulliparous, but at the same time, highlight the existence of potentially helpful interventions, such as cervix preparation with the use of misoprostol or lidocaine anesthesia [22][23][24]. Other available summaries demonstrated high level of safety and encouraging continuation rates of IUDs in young women [25][26][27].…”

Section: Introductionmentioning

confidence: 99%

Levonorgestrel-Releasing Intrauterine System as a Contraceptive Method in Nulliparous Women: A Systematic Review

Zgliczyńska

Kocaj

Szymusik

et al. 2020

JCM

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The aim of this review was to summarize the available evidence about the use of levonorgestrel-releasing intrauterine system (LNG-IUS) as a contraceptive method in nulliparous women. For this purpose, studies evaluating the efficacy, safety, bleeding pattern, satisfaction and discontinuation of the levonorgestrel-releasing intrauterine system in nulliparous women were analyzed. Only original research articles published in English between 1990–27th March 2020 were considered eligible. Reviews, book chapters, case studies, conference papers, opinions, editorials and letters were excluded. The systematic literature search of PubMed/MEDLINE, Scopus, Embase and Cochrane Library databases identified 816 articles, 23 of which were analyzed. The available evidence indicates that LNG-IUS is an effective and safe contraceptive method for nulliparous women that achieves high levels of satisfaction among patients. Moreover, nulliparous women seem to experience fewer expulsions than parous ones. Bleeding pattern is acceptable for the majority of patients, and bleeding disorders mainly occur in the first months after the insertion. More in-depth, long-term prospective studies are needed in this patient group to determine risk factors for the occurrence of side effects and associated discontinuations, which should not, however, delay the wider use of the method in this group, given the number of advantages.

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Medications to ease intrauterine device insertion: a systematic review

Cited by 31 publications

References 47 publications

U.S. Selected Practice Recommendations for Contraceptive Use, 2016

U.S. Selected Practice Recommendations for Contraceptive Use, 2016

Long-Acting Reversible Contraception

Levonorgestrel-Releasing Intrauterine System as a Contraceptive Method in Nulliparous Women: A Systematic Review

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