Women who received the injection had lower mean pain levels at tenaculum placement [ 12.3 mm ( S.D. 17.4 mm ) versus 36.6 mm ( S.D. 23.0 mm ) , p < .001 ] but higher mean pain levels with study drug application [ 20.4 mm ( S.D. 19.4 mm ) versus 5.9 mm ( S.D. 8.6 mm ) , p < .001 ] .