Misoprostol Prior to Intra-Uterine Device (IUD) Insertion in Nulliparous Women

IUDs are an excellent method of contraception but are underutilized in the U.S. IUD use is
expanding in the U.S. and is now routinely recommended for nulliparous women. The cervix
of a nulliparous woman has a smaller diameter and can lead to more difficult and
uncomfortable IUD insertions. Because of misoprostol's known ability to cause cervical
dilation, some family planning providers use this drug to facilitate insertion. While there
is a wealth of data on the use of misoprostol prior to many procedures requiring cervical
dilation there is minimal objective evidence assessing its effect on provider ease of
insertion or patient comfort during IUD insertion in nulliparas. The goal of this project is
to evaluate whether misoprostol relative to placebo prior to IUD insertion in nulliparous
women eases insertion and decreases pain. The results of this trial will be contributed to a
prospective meta-analysis on the subject.