Purpose of Review <p>Intrauterine devices (IUDs), while safe, effective, and increasingly popular, can be associated with significant pain during the insertion procedure. There is not yet one consistently recommended pain management strategy; this review explores the pharmacologic and nonpharmacologic pain management options.</p> Recent Findings <p>Most patients report some amount of pain during the IUD insertion procedure, and fear of the pain associated with IUD insertion can be a barrier to this otherwise desirable form of contraception. Thus, the CDC has advocated for all patients to be counseled on potential pain prior to IUD insertion and has issued several recommendations regarding pain control medications.</p> Summary <p>A total of 67 articles were included in the final analysis. 16 articles analyzed prostaglandin analogues, 28 looked at local anesthetics, 17 looked at analgesics, and 14 examined other methods of pain control. Lidocaine-prilocaine cream and lidocaine sprays applied cervically were both found to significantly reduce pain at IUD insertion. Intracervical or paracervical lidocaine blocks had mixed evidence, with studies reporting variable efficacy and potential increases in pain. Five studies examining dinoprostone demonstrated a reduction in pain during IUD insertion, while those assessing misoprostol showed mixed evidence. Two alternative methods of IUD insertion were effective in pain reduction. There exists high quality evidence to support several pain control methods for IUD insertion. Namely, we recommend consideration for the use of vaginal dinoprostone, cervical lidocaine-prilocaine cream, or lidocaine spray. Further study should be directed towards other approaches, including alternative IUD insertion techniques.</p>