الفهرس 
IntroductionOnly 14 pages are availabe for public view
 |  | from | 136 |  |  |
| | | from | 136 | | |
Abstract
Intrauterine devices (IUDs) are one of the long-acting, safe and effective methods of contraception in women across the world [1]. The major advantage of long-acting reversible contraceptives (LARC) compared with other reversible contraceptive methods is that they do not require ongoing effort on the part of the patient for long-term and effective use. In addition, after the device is removed, the return of fertility is rapid [2]. in spite of that, it is used only in 7.6% of women in developed countries and 14.5% in developing countries [3]. This can be attributed to fears of pain and difficulty of insertion from both women and health care providers [4]. IUCD can elicit pain in several ways: use of the speculum to inspect the cervix; use of the tenaculum to grasp the cervix and straighten the uterus; trans-cervical procedures as measuring the uterine length by the sound, introducing the IUCD insertion tube; and placement of the IUCD inside the uterus [5]. The degree of pain during IUCD insertion is variable, the majority of women experience mild pain or discomfort during IUCD insertion, but some women may experience severe pain. Women who delivered only by cesarean section (CS) and women remote from vaginal delivery are expected to experience more pain during IUCD insertion [6]. Theoretically, reducing the pain during IUCD insertion by altering the pain pathways can be done by using prophylactic pharmacological agents for management of pain associated with IUCD insertion, including nonsteroidal anti-inflammatory drugs (NSAIDs), opioid analgesics and local anesthetics (gel, cervical and paracervical block). Moreover, prostaglandins, which may cause cervical ripening, may.