{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,13]],"date-time":"2026-04-13T22:14:08Z","timestamp":1776118448387,"version":"3.50.1"},"reference-count":23,"publisher":"BMJ","issue":"2","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["J Fam Plann Reprod Health Care"],"accepted":{"date-parts":[[2013,3,5]]},"published-print":{"date-parts":[[2014,4]]},"abstract":"<jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>Many factors are suspected to influence the intrauterine device (IUD) insertion process. This study sought to examine the effects of a few key variables on IUD insertion tolerability, complications and follow-up issues.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>A retrospective chart review was undertaken of all IUD insertions over an 11-month period at an urban Canadian women's clinic. Linear regression analysis of 354 insertions assessed the effects of parity, age, local anaesthesia and other variables on insertion pain. Chi square (\u03c7<jats:sup>2<\/jats:sup>) and analysis of variance statistics were employed to evaluate differences in insertion complications by parity and age. A \u03c7<jats:sup>2<\/jats:sup> test was performed to compare follow-up expulsion or removal rates by parity.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Statistically significant differences were found, with nulliparous women and those who received local anaesthesia reporting more insertion pain. Age, IUD type and recent abortion status did not affect insertion pain. Nulliparous women did not experience significantly more insertion difficulty or complications, nor did they have higher rates of expulsion or removal at follow-up.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>These findings suggest that the practice of providing cervical anaesthesia at IUD insertion may cause slightly more pain, without any obvious additional benefit. The difference in insertion pain by parity, although statistically significant, is small enough to be of questionable clinical importance. Overall, these findings add to the growing body of evidence for IUDs being safe and well-tolerated in nulliparous women.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/jfprhc-2012-100383","type":"journal-article","created":{"date-parts":[[2013,6,15]],"date-time":"2013-06-15T20:09:40Z","timestamp":1371326980000},"page":"117-121","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":18,"title":["Intrauterine device insertions: which variables matter?"],"prefix":"10.1136","volume":"40","author":[{"given":"Windy Mary","family":"Brown","sequence":"first","affiliation":[{"name":"Family Physician, Station Fort Langley, Langley, British Columbia, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Konia","family":"Trouton","sequence":"additional","affiliation":[{"name":"Clinical Associate Professor, Department of Family Practice, Faculty of Medicine, University of British Columbia, Vancouver Island Women's Clinic, Vancouver, British Columbia, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2013,6,15]]},"reference":[{"key":"2025090511594309000_40.2.117.1","doi-asserted-by":"publisher","DOI":"10.1016\/0140-6736(92)91904-M"},{"key":"2025090511594309000_40.2.117.2","doi-asserted-by":"publisher","DOI":"10.1016\/0010-7824(95)00120-Y"},{"key":"2025090511594309000_40.2.117.3","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(00)02699-4"},{"key":"2025090511594309000_40.2.117.4","doi-asserted-by":"publisher","DOI":"10.1016\/j.contraception.2008.12.009"},{"key":"2025090511594309000_40.2.117.5","unstructured":"World Health Organization. Medical Eligibility Criteria for Contraceptive Use. 2008 Update. 2008. http:\/\/whqlibdoc.who.int\/hq\/2008\/WHO_RHR_08.19_eng.pdf [accessed 10 February 2013]."},{"key":"2025090511594309000_40.2.117.6","doi-asserted-by":"publisher","DOI":"10.1080\/02699200802253706"},{"key":"2025090511594309000_40.2.117.7","first-page":"206","article-title":"Comparative study of safety and efficacy of IUD insertions by physicians and nursing personnel in Brazil","volume":"29","author":"Lassner","year":"1995","journal-title":"Bull Pan Am Health Organ"},{"key":"2025090511594309000_40.2.117.8","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2006.08.022"},{"key":"2025090511594309000_40.2.117.9","first-page":"225","article-title":"Clinical performance of intrauterine devices in nulligravidae: is the length of endometrial cavity of significance","volume":"22","author":"Peterson","year":"1991","journal-title":"Acta Eur Fertil"},{"key":"2025090511594309000_40.2.117.10","doi-asserted-by":"crossref","first-page":"204","DOI":"10.1111\/j.1471-0528.1978.tb10482.x","article-title":"Copper intrauterine contraceptive devices in adolescent nulliparae","volume":"85","author":"Weiner","year":"1978","journal-title":"Br J Obstet Gynaecol"},{"key":"2025090511594309000_40.2.117.11","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1016\/0010-7824(95)00025-9","article-title":"Intrauterine contraception in nulligravid vs parous women","volume":"53","author":"Duenas","year":"1996","journal-title":"Contraception"},{"key":"2025090511594309000_40.2.117.12","doi-asserted-by":"crossref","first-page":"440","DOI":"10.1111\/j.1749-6632.1997.tb52174.x","article-title":"Intrauterine contraception in adolescent women. The GyneFix intrauterine implant","volume":"816","author":"Wildemeersch","year":"1997","journal-title":"Ann NY Acad Sci"},{"key":"2025090511594309000_40.2.117.13","doi-asserted-by":"crossref","first-page":"82","DOI":"10.3109\/13814780409044540","article-title":"Complications of the intrauterine device in nulliparous and parous women","volume":"10","author":"Veldhuis","year":"2004","journal-title":"Eur J Gen Pract"},{"key":"2025090511594309000_40.2.117.14","doi-asserted-by":"crossref","first-page":"195","DOI":"10.1016\/j.jpag.2012.01.005","article-title":"Retrospective review of intrauterine device in adolescent and young women","volume":"25","author":"Alton","year":"2012","journal-title":"J Pediatr Adolesc Gynaecol"},{"key":"2025090511594309000_40.2.117.15","doi-asserted-by":"crossref","first-page":"179","DOI":"10.1016\/0010-7824(86)90083-1","article-title":"Syncope and other vasovagal reactions at interval insertion of Lippes Loop D \u2013 who is most vulnerable?","volume":"33","author":"Chi","year":"1986","journal-title":"Contraception"},{"key":"2025090511594309000_40.2.117.16","first-page":"371","article-title":"Method of local anesthesia for IUD insertion","volume":"1","author":"Hepburn","year":"1980","journal-title":"Contracept Deliv Syst"},{"key":"2025090511594309000_40.2.117.17","doi-asserted-by":"publisher","DOI":"10.1783\/147118903101197854"},{"key":"2025090511594309000_40.2.117.18","doi-asserted-by":"crossref","first-page":"349","DOI":"10.4103\/0019-5359.100337","article-title":"Effect of lidocaine gel on pain from copper IUD insertion: a randomized double-blind controlled trial","volume":"64","author":"Mohammad-Alizadeh-Charandabi","year":"2010","journal-title":"Indian J Med Sci"},{"key":"2025090511594309000_40.2.117.19","doi-asserted-by":"publisher","DOI":"10.1016\/j.contraception.2011.01.016"},{"key":"2025090511594309000_40.2.117.20","doi-asserted-by":"publisher","DOI":"10.1016\/j.contraception.2012.06.004"},{"key":"2025090511594309000_40.2.117.21","doi-asserted-by":"crossref","first-page":"384.e1\u2013384.e6","DOI":"10.1016\/j.ajog.2012.09.018","article-title":"Cervical lidocaine for IUD insertional pain: a randomized controlled trial","volume":"207","author":"McNicholas","year":"2012","journal-title":"Am J Obstet Gynecol"},{"key":"2025090511594309000_40.2.117.22","doi-asserted-by":"publisher","DOI":"10.1016\/j.contraception.2012.01.005"},{"key":"2025090511594309000_40.2.117.23","doi-asserted-by":"crossref","first-page":"e5","DOI":"10.1016\/j.contraception.2011.05.010","article-title":"Duration of use of a levonorgestrel IUS amongst nulliparous and adolescent women","volume":"84","author":"Behringer","year":"2011","journal-title":"Contraception"}],"container-title":["Journal of Family Planning and Reproductive Health Care"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/jfprhc-2012-100383","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,5]],"date-time":"2025-09-05T19:08:14Z","timestamp":1757099294000},"score":1,"resource":{"primary":{"URL":"https:\/\/jfprhc.bmj.com\/lookup\/doi\/10.1136\/jfprhc-2012-100383"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2013,6,15]]},"references-count":23,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2014,3,19]]},"published-print":{"date-parts":[[2014,4]]}},"alternative-id":["10.1136\/jfprhc-2012-100383"],"URL":"https:\/\/doi.org\/10.1136\/jfprhc-2012-100383","relation":{},"ISSN":["1471-1893","2045-2098"],"issn-type":[{"value":"1471-1893","type":"print"},{"value":"2045-2098","type":"electronic"}],"subject":[],"published":{"date-parts":[[2013,6,15]]}}}