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This review includes general considerations, practical recommendations for both routine and more difficult cases and guidance on the optimal choice of instruments. General considerations, including pre-insertion counselling, the setting for the procedure, the confidence and technique of the provider and the interplay between the provider and assistant, can influence women's level of anxiety and, in turn, influence their perception of pain and their overall experience. Further studies are required to refine the optimal strategy for managing pain associated with IUC insertion.<\/jats:p>","DOI":"10.1136\/jfprhc-2013-100636","type":"journal-article","created":{"date-parts":[[2013,9,28]],"date-time":"2013-09-28T00:09:57Z","timestamp":1380326997000},"page":"54-60","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":35,"title":["Practical advice for avoidance of pain associated with insertion of intrauterine contraceptives"],"prefix":"10.1136","volume":"40","author":[{"given":"Luis","family":"Bahamondes","sequence":"first","affiliation":[{"name":"Professor of Gynaecology, Department of Obstetrics and Gynaecology, Faculty of Medical Sciences, University of Campinas (UNICAMP), Campinas, SP, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diana","family":"Mansour","sequence":"additional","affiliation":[{"name":"Consultant in Community Gynaecology and Reproductive Healthcare, Newcastle Hospitals, Community Health, New Croft Centre, Newcastle upon Tyne, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Fiala","sequence":"additional","affiliation":[{"name":"Director, Gynmed Clinic, Vienna, Austria and Department of Women's and Children's Health, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew M","family":"Kaunitz","sequence":"additional","affiliation":[{"name":"Professor and Associate Chair, Department of Obstetrics and Gynecology, University of Florida College of Medicine-Jacksonville, Jacksonville, FL, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristina","family":"Gemzell-Danielsson","sequence":"additional","affiliation":[{"name":"Professor of Obstetrics and Gynecology and Department Chair, Department of Women's and Children's Health, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2013,9,27]]},"reference":[{"key":"2025090510320596000_40.1.54.1","doi-asserted-by":"publisher","DOI":"10.1016\/j.contraception.2011.01.021"},{"key":"2025090510320596000_40.1.54.2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1110855"},{"key":"2025090510320596000_40.1.54.3","doi-asserted-by":"crossref","first-page":"367","DOI":"10.1016\/j.contraception.2010.01.010","article-title":"Use of the Mirena LNG-IUS and Paragard CuT380A intrauterine devices in nulliparous women","volume":"81","author":"Lyus","year":"2010","journal-title":"Contraception"},{"key":"2025090510320596000_40.1.54.4","unstructured":"National Institute for Health and Care Excellence. 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