Abstract
Background
There is a significant need for research on treatments that provide pain relief during
intrauterine device (IUD) insertion. Misoprostol is frequently used before IUD insertion
but is not always necessary and its use may increase pain and side effects. This survey
evaluated how providers who perform IUD insertion in nulliparous women report using
misoprostol to facilitate the procedure.
Study Design
An anonymous Internet-based survey was distributed to members of three professional
organizations with family planning providers.
Results
Of 2211 survey respondents, 1905 (86%) reported providing IUDs to nulliparous women.
Of those providing IUDs to nulliparous women, 947/1905 (49.7%) reported using misoprostol,
and 380 (40%) of 947 of misoprostol users reported using the treatment empirically
with all nulliparous IUD insertions. There was wide variation reported in dose, route
and timing of misoprostol administration. Providers most commonly reported learning
of misoprostol use for IUD insertion by word of mouth rather than through the literature.
Conclusions
Despite conflicting published data, nearly half of survey respondents use misoprostol
before IUD insertion. Considerable variation in the timing of misoprostol use may
explain differences in perception of its effectiveness. Evidence-based information
about misoprostol for IUD insertion in nulliparous women, including pharmacokinetics,
efficacy and optimal dosing, is needed.
Keywords
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Article info
Publication history
Published online: May 12, 2011
Accepted:
March 15,
2011
Received in revised form:
March 11,
2011
Received:
January 22,
2011
Identification
Copyright
© 2011 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
