Pain-free fitting

Insertion of the hormonal IUS should be as painless as possible for all patients. This is particularly true for women who have not yet had a vaginal birth. Three very effective strategies can achieve this:

  • Cervix priming:  Medicinal preparation of the cervix is very effective and described in a separate section.
  • Conical dilators instead of Hegar needle holders: Due to the conical shape, the dilatation can be dosed much better compared to parallel-shaped dilators like the Hegar. This induces less pain. A further advantage is the lower risk of infection, as only a single insertion through the cervix is necessary instead of repeated stretching with Hegar needle holders of different sizes. This allows a faster procedure, which is also less stressful for the patient. Suitable are Denniston Dilators or the Hamann cervicometer, specially developed for inserting an IUS or IUD:
  • Intra-cervical local anaesthesia: If pain occurs in the cervical canal during the insertion of an IUD/IUS, local anaesthesia is a very effective way of reducing pain. A few small applications of local anaesthetic (2-3 ml) in the area of the outer and inner cervix are usually sufficient for this.

In some cases, a very brief general anaesthetic is also a good option for a pain-free insertion, e.g. for young women. The anaesthesia can be brief and superficial because minimal pain is induced during the very short dilatation.

Video on hormonal IUS insertion from the company Bayer: