Location
Moultrie, GA
Start Date
17-4-2026 12:00 PM
End Date
17-4-2026 1:00 PM
Description
INTRODUCTION: The Committee on Clinical Consensus-Gynecology made an announcement establishing a standard of care for managing pain during in-office cervical and uterine procedures, which led to varying practices in management for patients.
OBJECTIVES: Determine if pain management strategies significantly different in rural versus urban areas.
METHODS: Data were obtained from the NIH All of Us Research Program Controlled Tier database, including de-identified health records, surveys, demographics, procedures, and medication data. The cohort included patients assigned female at birth who underwent intrauterine device (IUD) insertion, using the first recorded procedure date. Pain medications analyzed included NSAIDs, acetaminophen, opioids, local anesthetics, benzodiazepines, and misoprostol prescribed within one day of insertion. Urbanicity was classified by RUCA codes, and neighborhood deprivation index assessed socioeconomic disadvantage. Race was categorized as White, Black, or Other. Multivariable logistic regression estimated associations between residence, deprivation, race, and pain medication receipt, reporting adjusted odds ratios with 95% confidence intervals.
RESULTS: After adjusting for neighborhood deprivation, rural residency was associated with 0.599-fold lower odds of receiving pain medication at IUD insertion compared to their urban counterparts (OR 0.599940, 95% CI 0.359, 1.002). Race was included in the sensitivity analysis, classified as White, Black, and Other. White was used as the reference category in this analysis. Black race was associated with 1.45-fold odds (OR 1.45, 95% CI 1.229-1.727) and Other race was associated with 2.02-fold odds (OR 2.02, 95% CI 1.774-2.315) of receiving pain medication when compared to White patients. Among the patients who received pain medications at the time of IUD insertion +/- 1 day, NSAIDs were the most commonly used at 67.9%, followed by acetaminophen (50.2%) and local anesthetics (41.0%).
CONCLUSION: The analysis demonstrated a statistically significant difference in patients who reported using pain medication within one day of IUD insertion. Living in a rural area was associated with 0.599 lower odds of receiving pain medication at IUD insertion. The differences in socioeconomic status and race that may contribute to the results were also investigated. When compared to White patients, Black patients had 1.457 times higher odds of receiving pain medication at IUD insertion, while patients designated as “Other” had 2.027 times higher odds.
Embargo Period
5-28-2026
Included in
Pain Management for IUD Insertion in Urban and Rural Areas
Moultrie, GA
INTRODUCTION: The Committee on Clinical Consensus-Gynecology made an announcement establishing a standard of care for managing pain during in-office cervical and uterine procedures, which led to varying practices in management for patients.
OBJECTIVES: Determine if pain management strategies significantly different in rural versus urban areas.
METHODS: Data were obtained from the NIH All of Us Research Program Controlled Tier database, including de-identified health records, surveys, demographics, procedures, and medication data. The cohort included patients assigned female at birth who underwent intrauterine device (IUD) insertion, using the first recorded procedure date. Pain medications analyzed included NSAIDs, acetaminophen, opioids, local anesthetics, benzodiazepines, and misoprostol prescribed within one day of insertion. Urbanicity was classified by RUCA codes, and neighborhood deprivation index assessed socioeconomic disadvantage. Race was categorized as White, Black, or Other. Multivariable logistic regression estimated associations between residence, deprivation, race, and pain medication receipt, reporting adjusted odds ratios with 95% confidence intervals.
RESULTS: After adjusting for neighborhood deprivation, rural residency was associated with 0.599-fold lower odds of receiving pain medication at IUD insertion compared to their urban counterparts (OR 0.599940, 95% CI 0.359, 1.002). Race was included in the sensitivity analysis, classified as White, Black, and Other. White was used as the reference category in this analysis. Black race was associated with 1.45-fold odds (OR 1.45, 95% CI 1.229-1.727) and Other race was associated with 2.02-fold odds (OR 2.02, 95% CI 1.774-2.315) of receiving pain medication when compared to White patients. Among the patients who received pain medications at the time of IUD insertion +/- 1 day, NSAIDs were the most commonly used at 67.9%, followed by acetaminophen (50.2%) and local anesthetics (41.0%).
CONCLUSION: The analysis demonstrated a statistically significant difference in patients who reported using pain medication within one day of IUD insertion. Living in a rural area was associated with 0.599 lower odds of receiving pain medication at IUD insertion. The differences in socioeconomic status and race that may contribute to the results were also investigated. When compared to White patients, Black patients had 1.457 times higher odds of receiving pain medication at IUD insertion, while patients designated as “Other” had 2.027 times higher odds.
Comments
Winner of Research Day SGA 2026 Best Original Research.