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N/A N=24 Randomized Quadruple-blind Prevention

The Effect of Nitroglycerin on the Intrauterine Device (IUD) Insertion Experience in Nulliparous Women

Contraception · Pain

Enrolled (actual)
24
Serious AEs
0.0%
Results posted
Apr 2019
Primary outcome: Primary: Patient-reported Pain at Passage of Insertion Device Through Cervix, as Measured on a 100 mm VAS — 55.8; 53.9 mm

Study Design & Population

Study type
Interventional
Phase
N/A
Interventions
Insertion of nitroglycerin ointment (Drug); Insertion of placebo ointment (Drug)
Age
Adult · 18+ yrs
Sex
Female
Sponsor
Oregon Health and Science University
Primary completion
Nov 2012

Outcome Measures

OutcomeResultp-value
PRIMARY
Patient-reported Pain at Passage of Insertion Device Through Cervix, as Measured on a 100 mm VAS
55.8; 53.9
SECONDARY
Provider Ease With Intrauterine Device Insertion Measured on a 100 mm VAS
29.4; 22.8

Summary

Increasing ease of access of long-acting birth control methods, like intrauterine devices (IUDs), is an important way to reduce the risk of unintended pregnancy. Unfortunately, fear of IUD insertion in women who have not had children is common among health care providers and women alike, and this limits IUD use. To increase acceptance of this highly effective birth control method, there is a need to explore new, low cost, and easily applied methods to improve the insertion experience. This is a pilot study to evaluate the effectiveness and acceptability of nitroglycerin ointment applied vaginally to improve the IUD insertion experience for both patient and provider. The investigators hypothesis is that nitroglycerin ointment will decrease the pain associated with IUD insertion.

Eligibility Criteria

Inclusion Criteria

  • age 18-45 years,
  • generally healthy,
  • requesting a LNG-IUS for contraception as the primary indication

Exclusion Criteria

  • Previous pregnancy beyond 20 weeks;
  • previous IUD placement or attempted IUD placement;
  • previous cervical cold knife cone (CKC) or loop electrosurgical excision procedure (LEEP);
  • contraindication to LNG-IUS (including pregnancy, fibroids that distort the uterine cavity, exam consistent with PID, allergy to any component of the LNG-IUS, etc);
  • concurrent use of any form of nitrate therapy or medications that interact with nitroglycerin (such as phosphodiesterase V inhibitors);
  • known allergy to nitroglycerine or common topical ointment ingredients;
  • known renal or hepatic impairment;
  • history of hypertensive or hypotensive disorder;
  • history of migraine, cluster headaches, or vascular headaches;
  • history of myocardial infarction;
  • uncontrolled congestive heart failure;
  • unstable angina;
  • tobacco or alcohol amblyopia;
  • congenital optic atrophy;
  • blood pressure less than 90/55 or greater than 150/100 in office prior to speculum exam
View full record on ClinicalTrials.gov →

Data sourced from ClinicalTrials.gov (NCT01490073). Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication.

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