Pain — and Pain Relief for — IUD Insertion

There are new guidelines re IUD pain, which has always been a hot topic here at Corporette — we even had a reader guest post about her experience getting the Mirena IUD. But we haven't talked about it for far too long. How painful was IUD insertion or removal for you? Was your doctor understanding and compassionate if the pain was bad — or not? Which kind of IUD do you have?

New Guidelines for IUD Pain

Many of us have heard about — or have personally experienced — a common IUD experience: enduring moderate to severe pain without sufficient pain relief, maybe while being told that you must be exaggerating. Pain from IUD insertion (and removal!) has finally been getting more attention over the past couple of years, and we thought we'd have a timely open thread today about last week's New York Times story, “New Guidelines Call on Doctors to Take IUD Insertion Pain Seriously” [gift link].

The NYT reported that the American College of Obstetricians and Gynecologists (ACOG) has issued new guidelines for doctors that include the recommendation to “not underestimate the pain experienced by patients.” The bar is in hell, apparently.

{related: planning your career for babies}

Last fall, the CDC issued its own guidelines regarding IUD insertion pain that also included a mind-blowing recommendation to counsel patients about pain management before the procedure.

ACOG taking this step, the NYT reported, was “in part a response to a groundswell of complaints from patients on social media, in the news, and directly with physicians.”

Having women's pain downplayed or ignored is a maddeningly frequent occurrence — especially for Black women — and it's disappointing that the CDC and ACOG took THIS long to formally address the issue.

{related: the best birth control options — not a recent post, but the info still applies!}

(Check out the excellent podcast “The Retrievals” for especially disturbing examples of ignoring women's pain at Yale Fertility Center — yes, that Yale.)

By the way, if you've never had an IUD, here's an excerpt from a previous NYT story [gift link]: “Some women have described it as ‘the worst pain imaginable' or likened it to a ‘hot knife' slowly stabbing them.”

How to Prevent IUD Pain: ACOG's New Recommendations

1. Doctors should use an anesthetic cream, a spray, or an injected local anesthetic called a paracervical block (which can be uncomfortable itself for some patients).

2. Wait three minutes for anesthetic creams or sprays to take effect. (However, a doctor quoted in the story commented that this may lead to awkwardness, e.g., do you just lie there with a speculum sitting inside you while you wait?)

3. Special considerations for pain management should be given to patients who are particularly vulnerable, such as those with a history of chronic pelvic pain, sexual violence or abuse, or substance use disorder.

{related: guest post: reader B's experiences with an IUD}

Readers with IUDs, please share your experiences! How painful was IUD insertion or removal for you? Was your doctor understanding and compassionate if the pain was bad — or not? Which kind of IUD do you have?

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