revalidation

Misoprostol (Cytotec) for IUD insertion: Does this medication make IUD placement easier?

Though IUD is an effective form of contraception, there is concern about the pain some patients experience during its insertion. This article aims to explore the role of misoprostol in IUD insertion.

image showing intrauterine device (IUD)

Key takeaways

  • IUDs are an effective form of contraception for women of childbearing age. They are up to 99% effective in preventing pregnancy.
  • Misoprostol is used in IUD insertion because it may increase the ease and success of the insertion.
  • Misoprostol use is mostly recommended for patients who have had previous IUD insertion failures. 

IUD, or intrauterine device, is a contraception inserted in the uterus. It is a long-acting and reversible form of birth control commonly used by women of childbearing age to prevent pregnancy.

Misoprostol, on the other hand, is a medication used to prevent or treat stomach ulcers, induce labor, and induce medical abortion.

IUD is known for its effectiveness and is regarded as one of the most effective forms of birth control. Other benefits of IUD include its safety, reversibility, ease of use, and patient satisfaction. 

However, despite the numerous benefits of IUD, it is less frequently used when compared to other contraceptives. Patient's preference for other forms of contraceptives over IUDs has been linked to the technicalities involved in their insertion and the pain or discomfort some people using them experience. 

Since most patients experience pain and discomfort during the insertion of an IUD, experts have conducted some studies to find effective ways of reducing the pain and allowing ease of insertion.

Due to the effectiveness of misoprostol in causing cervical ripening and dilation of the cervix, it may be useful in IUD insertion to reduce pain and discomfort.

Does misoprostol facilitate IUD insertion in people with tight cervix?

Yes. Misoprostol helps facilitate IUD insertion in people with a tight cervix.  

Because misoprostol effectively dilates the cervix, it may help with the easy insertion of an IUD into the uterus. 

Does misoprostol help relieve pain during IUD placement?

Yes. A 2022 study showed that giving misoprostol vaginally before inserting an IUD makes the process easier and reduces pain.

However, not all patients experience pain during IUD insertion. 

Who may benefit from misoprostol IUD pre-medication?

Research shows that different groups of patients are more likely to benefit from misoprostol use in IUD insertion.

These groups include:

  1. People with previous IUD insertion failure - These are patients whose first attempt at IUD insertion was unsuccessful.
  2. People who have undergone a prior cesarean section - Patients who have previously given birth through a C-section.  

Possible side effects of taking misoprostol prior to IUD placement

Although there are benefits to using misoprostol for IUD insertion, there are also some associated risks. 

Some possible side effects to expect when taking misoprostol before IUD insertion include:

Before using misoprostol to ease IUD insertion, you should be aware of these side effects and discuss them with your doctor.

What dosage of Cytotec is approved for use by the FDA?

The FDA approves a dosage of 200 mcg of Cytotec (misoprostol) given four times a day to prevent or treat stomach ulcers. However, the dose that has been found effective in relieving the pain of IUD insertion is 600 mcg.

Tips on how to make IUD insertion easier and less painful

Aside from the use of misoprostol, some tips on making IUD insertion easier and less painful include:

  1. Consider the right timing. Scheduling your appointment for a few days after your menstruation is best, as your cervix will be more open during this period.
  2. Book an experienced healthcare provider. Inserting an IUD is a technical process, and not everyone can handle it properly. To avoid going through a painful process, ensure you book an experienced healthcare provider.
  3. Take some pain relief medications. Taking a common painkiller like ibuprofen can help make the process less painful. 

Summary

IUD insertion has long been associated with pain and discomfort during its insertion. However, misoprostol use during the procedure helps relieve this pain and discomfort.

Using misoprostol to ease IUD insertion has been proven safe and effective in several individuals. However, before you decide to use misoprostol to ease IUD insertion, you should speak to a doctor to understand the pros and cons.

References

  1. Lanzola EL, Ketvertis K. (2023). Intrauterine Device.
  2. Zapata LB., et al. (2022). Misoprostol for intrauterine device placement.  
  3. Ahmed TM., et al. (2020). Efficacy and safety of misoprostol for intrauterine device insertion in women with no previous vaginal delivery: a systematic review and meta-analysis of randomized controlled trials
  4. Sameh Salama., et al. (2022). Role of vaginal misoprostol  prior to levonorgestrel-releasing IUD insertion.
  5. Bahamondes MV., et al. (2015). Effect of vaginal administration of misoprostol before intrauterine contraceptive insertion following previous insertion failure: a double blind RCT.
  6. Tassi A., et al. (2020). Misoprostol administration prior to intrauterine contraceptive device insertion: a systematic review and meta-analysis of randomised controlled trials.