Nonsteroidal anti-inflammatory drugs reduce bleeding and pain associated with IUD use. NSAIDs should be considered first-line therapy; if NSAIDs are ineffective, tranexamic acid may be considered as second-line therapy. Prophylactic ibuprofen administration with the first six menses after insertion appears unwarranted.
Naproxen sodium in uterine pain following intrauterine contraceptive device insertion.
In a double-blind parallel trial, repeated doses of naproxen sodium (550 mg initially, followed by 275 mg every 6 hours as needed) and placebo were administered to a group of intrauterine contraceptive device (IUD) users in whom dysmenorrhea and premenstrual uterine pain developed or increased following the insertion of the IUD. Seventeen subjects were treated with naproxen sodium and 16 received placebo. The study covered three episodes of uterine pain and/or cramping. Efficacy of pain relief was judged by: (1) the overall relief which the patients experienced during the treatment and (2) the changes in the pain intensity (measured on a 6 point scale). By both these criteria, naproxen sodium was statistically significantly superior to placebo (p = 0.02); consequently, naproxen sodium appears to offer a new treatment modality for pain associated with IUD usage.