Study of Pain Control With Hormonal IUS Insertion

Inclusion Criteria: * Nulliparous (i.e., no pregnancy \> 24 weeks) * Not currently pregnant * Not pregnant in the past 6 weeks * Willing to be randomized to a paracervical nerve block or sham paracervical block group * Interested in using an intrauterine system (IUS) * Able to read and provide written informed consent in English Exclusion Criteria: * An allergy, hypersensitivity, or absolute medical contra-indication to using lidocaine, other amino-amide local anesthetics, or to non-steroidal anti-inflammatory agents, such as ibuprofen * A history of epilepsy or peptic ulcer disease * Moderate to severe asthma that precludes non-steroidal anti-inflammatory drug (NSAID) use * Hepatic or renal failure * Moderate to severe cardiac disease * Previous use of an IUS or a history of a prior failed IUS insertion * Use of a narcotic or benzodiazepine in the past 24 hours * Positive pregnancy test or reasonable risk of pregnancy * Current cervicitis * Intrauterine infection in the past 90 days * Meet Centers for Disease Control Medical Eligibility Criteria (MEC) category 3 or 4 classification for IUS use * Currently breastfeeding