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IUD insertions and analgesia
  1. Sheila E Brown, MBChB, FFSRH
  1. Senior Clinical Medical Officer, Birmingham Reproductive and Sexual Health Clinics, Birmingham, UK; sheila.brown{at}

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I am pleased to note on reading Dr Duncan's letter1 in the January 2013 issue of the Journal that I am not the only person who waits a full 3 minutes after using local anaesthetic gel prior to fitting an intrauterine device/system. I totally agree that this makes a difference to the pain experienced by women. I have been fitting ‘coils’ for almost 30 years and when I started was totally reliant on a good ‘vocal local’ to get the women relaxed, an experienced nurse was then my assistant. Over the years I have had to explain to many nurses and now health care assistants how vital this role is, but now adding local anaesthetic gel for 3 minutes I find that there is hardly ever an occasion when ‘fail to fit’ occurs. I totally agree with Margaret Duncan that this is of benefit to women but wait with interest to see if Entonox® will help further.


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  • Competing interests None.

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