QuestionDoctor,
My girlfriend is considering having a Paragard IUD inserted, due to very severe emotional side effects with combination birth control pills. As she has not given birth to children, and has a small frame, she is worried that she is at greater risk for expulsion of the IUD and of being unable to cope with the pain of insertion. She has no health problems or STIs, and we are in a monogamous relationship.
Our question is whether it is possible or advisable either to undergo general anaesthesia or to have an epidural during the insertion. If neither of these options is viable, are there any choices beyond ibuprofen for pain relief? Also, she wonders whether taking a smooth muscle relaxant such as dicyclomine (prescribed to me for IBS) might help with cramping.
Thank you for your help.
AnswerHi Will,
I would not recommend general or epidural anesthesia. If she desires, a local anesthetic can be given which will make the insertion almost painless. It's called a paracervical block, and most OB/GYN's are very experienced in using them. The other 2 things are for the IUD to be inserted during a period, when her cervix will be a little bit open, and to take ibuprofen 800 mg about an hour before. Since she has not given birth, she may have cramping and pain for a while after insertion, but hopefully it won't be too bad or last too long. I've never heard of using a smooth muscle relaxant. It sounds promising, but I just don't have any experience with it. I hope it goes well for her.
