Cervical lidocaine for IUD insertional pain: a randomized controlled trial

Am J Obstet Gynecol. 2012 Nov;207(5):384.e1-6. doi: 10.1016/j.ajog.2012.09.018. Epub 2012 Sep 20.


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.

Publication types

  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Administration, Intravaginal
  • Adolescent
  • Adult
  • Anesthetics, Local / administration & dosage*
  • Female
  • Humans
  • Intrauterine Devices / adverse effects*
  • Lidocaine / administration & dosage*
  • Middle Aged
  • Pain / drug therapy*
  • Pain Measurement
  • Treatment Outcome
  • Young Adult


  • Anesthetics, Local
  • Lidocaine