Background Understanding predictors of pain with gynaecological procedures may facilitate individualised counselling and pain management. We aimed to study the effect of dysmenorrhoea on intrauterine device (IUD) insertion pain. Methods This was a planned secondary analysis of a randomised trial evaluating self-administered lidocaine gel versus placebo for IUD insertion pain. We included those participants who reported menses in the past 3 months. We assessed dysmenorrhoea (in the past 3 months) and procedural pain using a 100 mm visual analogue scale (VAS). We categorised dysmenorrhoea as none/mild (<40 mm), moderate (40–69 mm) or severe (≥70 mm). We assessed participant pain scores at speculum insertion, tenaculum placement, IUD insertion, and overall. We compared median procedural pain scores by dysmenorrhoea group with three-way and post hoc pairwise analyses. Results We analysed 188 participants. Demographic characteristics were similar among the three dysmenorrhoea groups. Pairwise comparisons revealed higher median procedural pain scores in the severe dysmenorrhoea group compared with the none/mild dysmenorrhoea group at speculum insertion (25 mm vs 8 mm; p=0.007), tenaculum placement (51 mm vs 31 mm; p=0.04) and IUD insertion (74 mm vs 61 mm; p=0.04). Overall pain did not differ among the three groups (p=0.32). Conclusions Patients with severe dysmenorrhoea experienced increased pain with all aspects of IUD insertion, including speculum and tenaculum placement, compared with those with only mild or no dysmenorrhoea. Clinicians may consider this finding when providing individualised counselling and pain management for patients undergoing IUD insertion and other gynaecological procedures. Larger studies are needed to validate the effect of dysmenorrhoea severity on pain throughout IUD insertion. Data are available upon reasonable request. All data relevant to the study are included in the article.

中文翻译：

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痛经是宫内节育器插入疼痛的危险因素

背景 了解妇科手术疼痛的预测因素可能有助于个性化咨询和疼痛管理。我们旨在研究痛经对宫内节育器 (IUD) 插入疼痛的影响。方法 这是对一项随机试验的计划二次分析，该试验评估自我给药利多卡因凝胶与安慰剂治疗宫内节育器插入疼痛。我们包括那些在过去 3 个月内报告月经的参与者。我们使用 100 mm 视觉模拟量表 (VAS) 评估痛经（过去 3 个月内）和操作性疼痛。我们将痛经分为无/轻度（<40 mm）、中度（40-69 mm）或重度（≥70 mm）。我们评估了参与者在窥器插入、牵引器放置、宫内节育器插入和整体上的疼痛评分。我们将痛经组的中位手术疼痛评分与三因素和事后成对分析进行了比较。结果 我们分析了 188 名参与者。三个痛经组的人口统计学特征相似。两两比较显示，与无/轻度痛经组相比，在窥器插入（25 mm vs 8 mm；p=0.007）、悬钩放置（51 mm vs 31 mm；p=0.04）和宫内节育器插入（74 毫米对 61 毫米；p=0.04）。三组之间的总体疼痛没有差异（p=0.32）。结论 与仅有轻度痛经或无痛经的患者相比，重度痛经患者在放置 IUD 的各个方面（包括窥器和牵引器放置）都经历了更多的疼痛。临床医生在为接受宫内节育器插入和其他妇科手术的患者提供个性化咨询和疼痛管理时可能会考虑这一发现。需要更大规模的研究来验证痛经严重程度对宫内节育器整个插入过程中疼痛的影响。可根据合理要求提供数据。所有与研究相关的数据都包含在文章中。