Virtual Reality (VR) Use During Intrauterine Device (IUD) Procedures: A London Experience 

Aims & Objectives

The primary aim was to evaluate the feasibility, acceptability, and impact of VR on anxiety, and overall experience during IUD procedures. 

Objectives included:

• Assessing patient and clinician perceptions of VR
• Measuring changes in anxiety using VR
• Comparing experience with VR to previous procedures
• Evaluating the effect of VR on appointment duration and workflow.
• Identifying facilitators and barriers to VR uptake and implementation.

Outcomes & Measured Impact

Of 235 patients offered VR, 177 (75%) accepted, and this evaluation represents the largest single-site dataset and the first UK sexual health centre to introduce VR into clinical practice, strengthening the reliability and applicability of findings compared to previous smaller-scale, non-NHS trials. Among VR users, 87% reported reduced anxiety (33% “significantly,” 54% “somewhat”), and 86% of those with prior IUD experience found VR superior to previous procedures. 93% would use VR again, and 96% would recommend it. Overall, 87% rated VR 4/5 or 5/5 stars.

Survey feedback from clinicians was received from 9/13 (69%) IUD fitters and 6/6 (100%) chaperones. All respondents felt VR was helpful in clinic, reduced patient anxiety, improved patient care and generated increased positive patient feedback. Most perceived that VR helped them perform their job better (80%), rated it highly (80%) and all endorsed continued use. Respondents reported VR increased chaperone availability (67%) and generated the same (53%) or fewer (40%) staff–patient interactions.

Clinician feedback was therefore positive: all respondents felt VR was helpful, reduced patient anxiety, improved care, and increased positive feedback. Appointment durations remained comparable between pre-VR and VR periods, demonstrating that VR could be integrated without prolonging procedures. The evaluation showed VR was feasible, well-accepted, and improved patient and clinician experience.

Overall the service evaluation demonstrated that use of VR as a non-pharmacological adjunct during IUD procedures was well accepted by clinicians and patients. Most patients reported that VR decreased their anxiety, were willing to reuse VR and recommend it and the majority reported a superior experience compared to previous procedures. These outcomes were achieved without significant prolongation of the appointment time.

Key Enablers

• High baseline patient anxiety, making VR a welcome intervention.
• Chaperones offering and setting up VR, with quick and easy setup.
• Portability and availability of multiple headsets.
• Staff training and troubleshooting tips.
• Content options including breathing exercises and calming scenes.
• Reassurance that patients accepting VR could still communicate with clinicians and remove the headset at any time.

Key Challenges/Barriers

• Claustrophobia and motion sickness for some users.
• Anxiety about being distracted or sensory overload.
• Technical issues: device charging, image quality, headset comfort (especially for spectacle wearers or those with certain hairstyles).
• Chaperone shortages and logistical barriers.
• Ensuring content duration matched procedure length and volume was appropriate.

Image: VR choices

Demographics, Settings & Referral Routes

Demographics: The project targeted young adults (18–25), and working-age adults (26–64) undergoing IUD procedures. 

Settings: The intervention can be delivered in acute hospitals, primary care (GP surgeries, health centres), and community health hubs, focusing on sexual and reproductive health and menopause/gynaecological health.

Referral Routes: : Participants were recruited via self-referral and/or GP referral to secondary care sexual health professionals The offer of VR was embedded into routine clinical pathways for IUD procedures.

Evaluation Methods

Evaluation included routine monitoring data (participant numbers, demographics, attendances and consultation durations. Both patients and clinicians provided feedback through structured questionnaires, and the project adhered to ethical standards for consent and safeguarding.

The evaluation demonstrated that VR is a feasible, acceptable, and effective adjunct for reducing anxiety during IUD procedures, with high uptake and satisfaction among patients and clinicians. 

Participant & Stakeholder Feedback

Patient feedback was overwhelmingly positive, with comments highlighting the value of distraction, relaxation, and reduced anxiety. Many noted that VR helped them focus on breathing, masked anxiety triggers, and provided a superior experience compared to previous procedures. Clinicians reported that VR improved patient care, reduced anxiety, and made their roles easier.

Comments included:

• Good to take away the hospital environment and to not think about what instrument is being used next
• Loved it. Audiovisual distracted me. I get anxious when I see the equipment so having headset stopped this from triggering my anxiety
• This was a good distraction and soothing. It was good to not see instruments but was still guided as to what was happening which was helpful
• This definitely should be offered. Helped me to distract. Also allowed an element of masking which was helpful for someone who is autistic
• Positive experience - I was able to distract myself from the pain by focussing on the visuals and breathing instructions which I felt helped me breathe through the pain/discomfort
• Really excellent distraction and it reduced my anxiety significantly
• It was nice to be in your own world with your eyes closed rather than looking at bright doctor office lights or complete darkness
• It really helped to take my mind off the procedure and gave me something to focus on. I had an unpleasant coil fitting in the past and so was a bit nervous about today
• It was very helpful to relax and distract yourself. It should be offered more widely.
• Pleasant experience. Hope can be used for other procedures to reduce anxiety

Alignment with National Strategy &  System Learning

The project aligns with NHS priorities for digital technology, planning and commissioning, evidence and impact, health inequalities, self-management, and health and care settings. It demonstrates how digital innovation can be embedded into clinical practice to improve patient experience and reduce anxiety, supporting wider system learning and service redesign.

Image: VR scene