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The following is a summary of “Efficacy of NSAIDs in reducing pain during intrauterine device Insertion: A systematic review,” published in the March 2025 issue of European Journal of Obstetrics and Gynecology and Reproductive Biology by Martingano et al. 

Intrauterine devices (IUDs) were highly effective, but insertion pain discouraged many, with no established gold standard for analgesia despite common non-steroidal anti-inflammatory drugs (NSAID) use.  

Researchers conducted a retrospective study to assess the effectiveness of NSAIDs in reducing pain during IUD insertion.   

They systematically searched in PubMed, Embase, Web of Science, Scopus, and Cochrane Library using the terms (intrauterine device* OR IUD*) AND (NSAIDs OR non-steroidal anti-inflammatory drugs). The primary outcome measured was pain reported during IUD insertion. Each study was assessed for bias using the Centre for Evidence-Based Medicine Critical Appraisal Tool for Randomized Control Trials (CEBM).   

The results showed that the search identified 6,529 studies, from which 29 full texts were reviewed, and 20 met the inclusion criteria. Limited evidence supported that prophylactic NSAIDs provided clinically significant pain relief for most individuals. Various NSAID types and dosages were included in the analysis and 6 studies and reported a statistically significant reduction in pain compared to placebo (P < 0.05).   

Investigators concluded that prophylactic NSAIDs exhibited limited effectiveness in reducing IUD insertion pain in most studies, emphasizing a need for standardized approaches. 

Source: htejog.org/article/S0301-2115(25)00186-1/abstract