Evaluation of Gynecologists and Patients Experience, Anxiety and Pain Perception During Intrauterine Device Insertion Containing Levonorgestrel (ELA 52 Study)

Abstract

Ricardo Ribeiro, Albertino Chaves, Lina Fernandes, Mariana Novais, Paula Caetano, Fátima Faustino, Cristina Nogueira-Silva, and Daniel Pereira da Silva

Objective: To characterize patient’s and obstetricians-gynecologist’s (ob-gyns) experience in insertion of a 52 mg levonorgestrel�?� releasing intrauterine device (LNG-IUD).

Materials and Methods: A non-interventional, prospective and multicentric study was conducted in 583 patient of reproductive age who had insertion of Levosert® following routine clinical practice. Questionnaires were used to collect information on obgyns’ and patient’s experiences associated with IUD insertion. Pain and anxiety were rated, and possible predictors such as age and parity were evaluated.

Results: Before IUD insertion, 50.8% of the participants felt minimal anxiousness and 44.9% predicted moderate pain. Twohundred and sixteen (37.0%) patient reported mild pain with insertion and 227 (38.9%) reported moderate pain. Ob-gyns were aware of the patient’s insertion pain experience and 84.2% considered LNG-IUD insertion “Easy” or “Very Easy”. The vast majority of patient (88.2%) were also “Satisfied” or “Very Satisfied” with LNG-IUD insertion, considering the procedure less or at least equally painful as they expected.

Conclusions: Given the strong link between anxiety and expected pain and the lack pain management strategies effectiveness, the implementation of interventions that may mitigate both anxiety and pain during IUD insertion are crucial. LNG-IUD is associated with high satisfaction rates by patient and considered easy to apply by ob-gyns.

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