BELLEVUE, Wash.—February 2, 2026—Truveta today announced the publication of a new Truveta Research study in Contraception, a leading peer-reviewed journal in reproductive health. The study leverages real-world data to examine trends in pain management during intrauterine device (IUD) insertion and evaluates adherence to updated clinical guidelines—offering important insights
The study, “Evaluating changes in lidocaine and opioid administration on the day of IUD insertion, 2018–2025,” analyzed electronic health record data from more than 286,000 IUD insertion procedures performed in the United States between 2018 and mid-2025. Researchers assessed the documented use of pain-relief medications—specifically lidocaine and opioids—on the day of the procedure and evaluated changes following updated Centers for Disease Control and Prevention (CDC) guidance issued in 2024.
Overall, the study found that documented use of pain-relief medications during IUD insertion increased modestly over time but remained uncommon. In 2025, 95% of patients undergoing IUD insertion had no documented lidocaine or opioid administration on the day of the procedure. Following the 2024 CDC guidance, the odds of receiving lidocaine increased by 18%, and the odds of receiving an opioid increased by 22%, though overall utilization levels remained low.
The study also observed that IUD insertion procedures performed by male providers were associated with a 10% lower likelihood of documented pain relief. Researchers also noted an increase in opioid use following the CDC guidance, despite opioids not being commonly recommended for procedural pain management in this setting.
“These findings highlight how practice patterns can vary across clinical contexts and patient populations,” said Karen Gilbert Farrar, PhD, Senior Research Analyst at Truveta Research and study co-first author. “Real-world data allow us to examine where clinical guidance appears to influence care and where additional evaluation or implementation support may be needed. The results also underscore the role of patient–provider communication in shaping how pain management options are discussed and documented during procedures like IUD insertion.”
The analysis also identified differences in pain management patterns across patient and provider characteristics. Younger patients ages 15–24 were more likely to receive documented pain medication, which may reflect increased awareness and patient engagement around pain during IUD insertion. Patients with endometriosis were also more likely to receive pain relief, potentially reflecting clinician recognition of higher baseline pelvic pain risk or differences in patient-provider communication.
“This research contributes to a growing body of evidence examining how pain is addressed in women’s health care,” said Nina Masters, PhD, MPH, Senior Applied Scientist at Truveta Research and study co-first author. “Even after updated CDC guidance encouraging pain management, we found that many patients had no documented pain medication use on the day of IUD insertion. These findings highlight the importance of understanding how clinical guidance translates into practice and how patients are informed about available options.”
The results are particularly relevant as professional organizations continue to update recommendations related to procedural pain management. In May 2025, the American College of Obstetricians and Gynecologists (ACOG) updated its guidance to emphasize advance counseling about pain management options, discussion of local anesthetic approaches, and individualized, patient-centered decision-making.
Truveta Research is committed to generating timely, high-quality evidence that reflects real-world care and supports better health outcomes for all. This publication builds on Truveta’s growing body of peer-reviewed research focused on women’s health, health equity, and the use of data to improve clinical decision-making.
The full study, “Evaluating changes in lidocaine and opioid administration on the day of IUD insertion, 2018–2025,” is available online in Contraception.
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