Let’s just say it: many gynecologic procedures hurt.

IUD insertions, endometrial biopsies, vulvar biopsies and other in-office procedures can cause real pain and anxiety. For a long time, women were often told to expect “a little pinch” and simply get through it.

We don’t practice that way.

At Kultivate Women’s Health, we take women’s pain seriously. We also know there isn’t one pain-management plan that works for everyone. We have a lot of tools in our tool purse—and we’re not afraid to use them. That's why we offer individualized pain-management options for IUD insertion and other in-office gynecologic procedures at our Beachwood office.

Pain management starts with a conversation.

Before your procedure, we want you to understand what to expect, what may be uncomfortable, and what options are available to you.

Depending on the procedure and your individual needs, your pain and anxiety plan may include:

• Anti-inflammatory medication such as ibuprofen

• Local numbing medication, including lidocaine or a paracervical block

• Medication to help with anxiety when appropriate

• Pro-Nox™ nitrous oxide during the procedure

• A combination of approaches

Not every option is appropriate for every patient or every procedure.

That’s why we talk about it first.

We want you to understand your choices, ask questions, and make an informed decision about what feels right for you.

And consent doesn't end when you sign a form. You can ask questions, change your mind, or ask us to pause or stop at any point.

Now we have another tool: Pro-Nox™

Pro-Nox™ is a 50/50 mixture of nitrous oxide and oxygen, sometimes called “laughing gas.”

You breathe it yourself during the procedure, so you control when you use it. You remain awake and able to communicate with your provider.

Pro-Nox™ can help with anxiety, relaxation, and discomfort. It doesn't guarantee a pain-free procedure, but for some patients it can make the experience much more manageable.

And because different types of discomfort respond to different things, Pro-Nox™ doesn't necessarily replace the other tools we use. It can be one part of a broader pain-management plan.

Yes, medicine is finally talking about this too.

In 2025, the American College of Obstetricians and Gynecologists (ACOG) issued guidance specifically addressing pain management for in-office gynecologic procedures. The message was clear: patients should be counseled about pain, offered appropriate options, and included in deciding what works for them.

We couldn't agree more. We've always believed women's pain deserves to be taken seriously.

When is Pro-Nox™ available?

Pro-Nox may be available for select in-office procedures, including:

• IUD insertion and replacement

• Endometrial biopsy

• Vulvar biopsy

• Other procedures when appropriate

Your provider will help you understand your options and make a plan before your procedure. Our goal isn't to promise you'll feel nothing. It's to make sure you know what to expect, understand your options, and feel heard and supported before we ever start.

Do You Have an Upcoming Procedure?

Worried about pain or anxiety? Tell us. Seriously.

Send us a message through the patient portal before your appointment so we can talk about your options and make a plan.

→ CLICK HERE TO MESSAGE US IN THE PATIENT PORTAL

Curious About Nitrous?

Visit the Pro-Nox website for additional information and frequently asked questions.

→ CLICK HERE FOR PRONOX FAQs