New Monash University study highlights factors behind IUD insertion pain in Australian women

Monash University

A national study published in the Australian and New Zealand Journal of Obstetrics and Gynaecology has revealed that while nearly half of Australian women experience minimal discomfort during intrauterine device (IUD) insertion, one in five report "severe" pain.

The research, conducted by Monash University’s SPHERE Centre of Research Excellence in collaboration with Jean Hailes for Women’s Health, identifies mental health, pregnancy history, and "self-perceived knowledge" of IUDs as key factors associated with how pain is experienced during the procedure.

The study analysed data from 347 women using hormonal or copper IUDs as part of the 2024 Australian National Women’s Health Survey, conducted by Jean Hailes.

While IUDs are more than 99 per cent effective at preventing pregnancy, Australia has low uptake of these methods compared to international peers, with fear of insertion pain cited as a primary barrier.

Key findings:

Pain levels: Pain levels vary for individual women. Approximately 50% reported mild or no pain during insertion, 30% reported moderate pain and 19% experienced severe pain.
Mental health link: Women reporting a current mental health condition that restricts everyday activities reported significantly higher levels of pain.
The "Knowledge" Paradox: Higher self-perceived knowledge about IUDs was associated with more reported pain. Researchers suggest this may be due to exposure to negative information or "fear-inducing" anecdotal accounts on social media and online platforms.
Pregnancy history: Women who had been pregnant more than once reported higher pain levels compared to those who had never been pregnant.

"These findings highlight that pain perception is a multifactorial phenomenon," Professor Danielle Mazza AM, Director of SPHERE and Head of Monash University’s Department of General Practice, said.

"It isn't just about the physical procedure; it's about a complex interplay of factors including a woman's mental health, her past experiences, and the quality of information she has accessed beforehand."

The researchers are calling for healthcare providers to prioritize individualized pain management strategies and to address misinformation before the procedure. By improving the patient experience, the study suggests Australia could see a more positive discourse around LARCs (long-acting reversible contraception) and a potential increase in uptake.

"Educational initiatives must provide accurate, evidence-based, and balanced messaging," Professor Mazza said.

"Ensuring women feel supported and correctly informed is essential to reducing avoidable distress."

Read the research paper: https://doi.org/10.1111/ajo.70125

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