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Women experience less pain during IUD insertion using a new method (opens in a new tab)

medicalxpress.com · 2026-09-17

Short answerEvidenceSource

Short answer

Mostly supported

Mostly supported.

The claims we could check match the study, but some claims were not covered by the evidence reviewed.

  • 6 supported
  • 1 not covered

Checked against the study summary. The full text wasn't available, so some details couldn't be settled either way.

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1
2

NewsLink checks it

Mostly supported

Every claim we could check holds up. Six of seven claims match the study. This overall rating is based only on the claims we could check. One claim the study doesn't address.

  • 6 supported
  • 1 not covered
Open claim evidence
3
Source paper

Source layer

The 2 papers the story cites

Source study separated from background citations.

The research anchor for the report.

  • The study this story reportspresented as the new finding

    Intrauterine Mepivacaine Instillation vs Placebo for Pain During IUD Placement

    JAMA · 2026

    Publisher (opens in a new tab)
  • The study this story reportspresented as the new finding

    Intrauterine Mepivacaine Instillation vs Placebo for Pain During IUD Placement

    JAMA · 2026

    Publisher (opens in a new tab)
Then inspect each claim

Evidence layer

Claim by claim

Each claim gets a verdict. Expand it to see the evidence directly below.

7 claims in this story

Showing all 7 claimsChoose a verdict to focus the list.

Claim 1 of 7Not coveredThe article says the findings are based on self-reported pain and that the anesthetic administration itself was usually only mildly painful.View evidenceHide evidence

Why this verdict

The self-reported pain component is supported because the primary outcome was pain on a 100-mm visual analog scale. However, the supplied abstract-level profile does not report whether administration of the anesthetic itself was usually only mildly painful, so the full claim is not verifiable at this evidence depth.

1

Study evidence

Intrauterine instillation of mepivacaine reduced mean pain scores during IUD placement compared with saline placebo.Mean difference 14.8 mm on 100‑mm VAS (95% CI, 10.0–19.6); P < .001. Clinician-adjusted mean difference 14.2 mm (95% CI, 9.7–18.6); P < .001.

“Multicenter, double-blind, randomized, placebo-controlled trial”
Claim 2 of 7SupportedA simple method involving local anesthesia in the uterus can reduce pain during IUD insertion, according to a new study from Karolinska Institutet, published in the journal JAMA.View evidenceHide evidence

Why this verdict

The abstract-profile evidence supports the main headline claim: this was a randomized, double-blind, placebo-controlled trial and intrauterine mepivacaine reduced pain during IUD placement versus saline placebo. The Karolinska attribution is not evidenced in the supplied profile, but the scientific claim about pain reduction is supported.

1

Study evidence

Intrauterine instillation of mepivacaine reduced mean pain scores during IUD placement compared with saline placebo.Mean difference 14.8 mm on 100‑mm VAS (95% CI, 10.0–19.6); P < .001. Clinician-adjusted mean difference 14.2 mm (95% CI, 9.7–18.6); P < .001.

“Multicenter, double-blind, randomized, placebo-controlled trial”
Claim 3 of 7SupportedThe method also increased the proportion of women who found the procedure tolerable.View evidenceHide evidence

Why this verdict

The profile reports a prespecified secondary tolerability outcome: tolerable pain was reported by 98.3% in the mepivacaine group versus 91.4% in the placebo group, with RR 1.08. Because this was randomized treatment assignment, the causal wording is supported for the mepivacaine-vs-saline comparison.

1

Study evidence

Higher proportion of participants reported tolerable pain with intrauterine mepivacaine versus placebo during IUD placement.RR 1.08 (95% CI 1.02–1.13); NNT 15 (95% CI 9–43)

“Prespecified secondary analyses included tolerability and overall experience.”
Claim 4 of 7SupportedIn the randomized study, researchers tested whether a small amount of local anesthetic introduced into the uterus via a thin plastic catheter a couple of minutes before the procedure could make IUD insertion less painful.View evidenceHide evidence

Why this verdict

The profile describes exactly this randomized test: 10 mL mepivacaine or saline was instilled intrauterinely via a hydrosonography catheter 2 minutes before IUD placement to assess whether mepivacaine reduced pain.

1

Study evidence

Intrauterine instillation of mepivacaine reduced mean pain scores during IUD placement compared with saline placebo.Mean difference 14.8 mm on 100‑mm VAS (95% CI, 10.0–19.6); P < .001. Clinician-adjusted mean difference 14.2 mm (95% CI, 9.7–18.6); P < .001.

“Multicenter, double-blind, randomized, placebo-controlled trial”
Claim 5 of 7SupportedThe study involved 370 women ages 18 to 31 who had not previously given birth and were randomly assigned to receive either mepivacaine or saline before IUD insertion, with neither participants nor staff knowing which treatment was given.View evidenceHide evidence

As stated370 women; ages 18 to 31; 91.4% to 98.3% tolerability; pain score 43.8 vs 58.6; around 15-unit reduction

Why this verdict

The profile supports the trial details: 370 participants, ages 18–31, nulliparous, randomized 1:1 to mepivacaine or saline, with participants, clinicians, and outcome assessors blinded. The profile uses 'nulliparous individuals' rather than specifically 'women,' but the main design and numeric details are supported.

1

Study evidence

Intrauterine instillation of mepivacaine reduced mean pain scores during IUD placement compared with saline placebo.Mean difference 14.8 mm on 100‑mm VAS (95% CI, 10.0–19.6); P < .001. Clinician-adjusted mean difference 14.2 mm (95% CI, 9.7–18.6); P < .001.

“Multicenter, double-blind, randomized, placebo-controlled trial”
2

Study evidence

Higher proportion of participants reported tolerable pain with intrauterine mepivacaine versus placebo during IUD placement.RR 1.08 (95% CI 1.02–1.13); NNT 15 (95% CI 9–43)

“Prespecified secondary analyses included tolerability and overall experience.”
Claim 6 of 7SupportedPain was reduced in the active-treatment group, with an average score of 43.8 versus 58.6 in the control group, and the share of participants who found the pain tolerable rose from 91.4% to 98.3%.View evidenceHide evidence

As statedaverage pain score 43.8 vs 58.6; reduction of around 15 units; tolerable 91.4% vs 98.3%

Why this verdict

The reported pain scores match the profile: 43.8 mm versus 58.6 mm on a 100-mm VAS, mean difference about 14.8 mm. The tolerability figures also match: 172/175, or 98.3%, versus 159/174, or 91.4%. The story does not mention confidence intervals, NNT, or missing tolerability denominators, but the stated findings are accurate.

1

Study evidence

Intrauterine instillation of mepivacaine reduced mean pain scores during IUD placement compared with saline placebo.Mean difference 14.8 mm on 100‑mm VAS (95% CI, 10.0–19.6); P < .001. Clinician-adjusted mean difference 14.2 mm (95% CI, 9.7–18.6); P < .001.

“Multicenter, double-blind, randomized, placebo-controlled trial”
2

Study evidence

Higher proportion of participants reported tolerable pain with intrauterine mepivacaine versus placebo during IUD placement.RR 1.08 (95% CI 1.02–1.13); NNT 15 (95% CI 9–43)

“Prespecified secondary analyses included tolerability and overall experience.”
Claim 7 of 7SupportedThe researchers said the study did not compare the method with other types of pain relief, so it is not possible to determine whether it is more effective than alternative treatments.View evidenceHide evidence

Why this verdict

The supplied profile describes a placebo-controlled comparison against saline, not a comparison with other active pain-relief methods. Therefore the statement that this trial cannot establish superiority over alternative treatments is supported by the comparator design, although the exact wording 'the researchers said' is not independently verifiable from the abstract profile.

1

Study evidence

Intrauterine instillation of mepivacaine reduced mean pain scores during IUD placement compared with saline placebo.Mean difference 14.8 mm on 100‑mm VAS (95% CI, 10.0–19.6); P < .001. Clinician-adjusted mean difference 14.2 mm (95% CI, 9.7–18.6); P < .001.

“Multicenter, double-blind, randomized, placebo-controlled trial”
Then look for missing context

Context layer

What the story left out

Important study details the story did not include.

  • Participants were nulliparous individuals aged 18–31 opting for IUDs with smaller-diameter placement tubes.

    The story reflects age and no previous birth, but it frames the group as women and does not mention the smaller-diameter placement-tube eligibility feature, which limits generalizability.

    From Multicenter double-blind randomized placebo-controlled trial

  • The randomized comparison found a mean pain reduction of about 14.8 mm, with clinician-adjusted mean difference 14.2 mm and statistically significant results.

    The story reports the approximate 15-unit reduction but does not mention the clinician-adjusted analysis, confidence intervals, or statistical significance.

    From Multicenter double-blind randomized placebo-controlled trial

  • Overall experience was listed as a prespecified secondary outcome, but the abstract profile provides no numeric outcome data for it.

    The story discusses pain and tolerability but does not address that overall experience was prespecified yet not reported numerically in the abstract-level profile.

    From Prespecified secondary patient‑reported outcomes in multicenter double‑blind randomized placebo‑controlled trial

5 things the story did carry across
  • The study was a multicenter, double-blind, randomized, placebo-controlled trial of intrauterine mepivacaine versus saline before IUD placement.
  • The intervention was 10 mL mepivacaine, 20 mg/mL, instilled intrauterinely via catheter 2 minutes before IUD placement, compared with saline.
  • Primary pain outcome was self-reported pain during IUD placement on a 100-mm visual analog scale; mean pain was 43.8 mm with mepivacaine versus 58.6 mm with placebo.
  • Tolerable pain was a prespecified secondary outcome, reported by 98.3% in the mepivacaine group versus 91.4% in the placebo group, with RR 1.08 and NNT 15.
  • The trial compared mepivacaine with saline placebo and did not compare it with other active pain-relief methods.
Then read the study layer

Study layer

Study at a glance

Scan the study first. Expand only the parts you want to inspect.

Pieces of work

2

Evidence read

study summary

Lead result

human in vivo

1Lead resulthuman in vivoDetermine whether intrauterine instillation of mepivacaine reduces pain during IUD placement in nulliparous individuals.Multicenter double-blind randomized placebo-controlled trialExpand

In plain English

Multicenter, double-blind, randomized, placebo-controlled trial in nulliparous individuals (aged 18–31) comparing intrauterine instillation of 10 mL mepivacaine (20 mg/mL) versus saline (9 mg/mL) 2 minutes before IUD placement. Primary outcome was pain during IUD placement measured on a 100-mm visual analog scale (VAS). Mepivacaine reduced mean pain scores versus placebo (mean difference ≈14.8 mm; P < .001) and increased the proportion reporting tolerable pain.

Key findings

  • Intrauterine instillation of mepivacaine reduced mean pain scores during IUD placement compared with saline placebo.Mean difference 14.8 mm on 100‑mm VAS (95% CI, 10.0–19.6); P < .001. Clinician-adjusted mean difference 14.2 mm (95% CI, 9.7–18.6); P < .001.
  • Mepivacaine increased the proportion of participants reporting tolerable pain during IUD placement.Relative risk 1.08 (95% CI, 1.02–1.13); NNT = 15 (95% CI, 9–43).
“Multicenter, double-blind, randomized, placebo-controlled trial”
2human in vivoAssess secondary patient-centered outcomes of mepivacaine vs placebo during IUD placement (eg, tolerability and overall experience).Prespecified secondary patient‑reported outcomes in multicenter double‑blind randomized placebo‑controlled trialExpand

In plain English

Prespecified secondary patient-reported outcomes included tolerability and overall experience. The abstract reports tolerable pain for 172/175 (98.3%) in the mepivacaine group versus 159/174 (91.4%) in the placebo group (reported effect estimates: RR 1.08, 95% CI 1.02–1.13; NNT 15, 95% CI 9–43). The abstract does not provide further detail on instrument/definition or timing for the tolerability or overall-experience measures.

Key findings

  • Higher proportion of participants reported tolerable pain with intrauterine mepivacaine versus placebo during IUD placement.RR 1.08 (95% CI 1.02–1.13); NNT 15 (95% CI 9–43)
  • Overall experience was listed as a prespecified secondary outcome but no outcome data are reported in the abstract.
“Prespecified secondary analyses included tolerability and overall experience.”
What this piece can’t prove

3 further details could not be confirmed from the summary.

Finally, the search trail

Method layer

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Open the paper in Tessa

Intrauterine Mepivacaine Instillation vs Placebo for Pain During IUD Placement

JAMA · 2026

Source record (opens in a new tab)

Why this one

Near certain

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Papers considered

The selected paper, plus nearby candidates.

Crossref, PubMed, Europe PMC · 38 candidate papers

And 32 more candidates considered.