The intrauterine device (IUD) has become an increasingly popular choice for women seeking long-term, low-maintenance contraception. In 2018, 18% of women aged 15 to 44 who used contraception relied on either an IUD or an implant, compared to only 1.5% in the 1990s. This method is often selected and celebrated for its effectiveness and convenience, lasting between three and ten years with over 99% efficacy. However, as IUD adoption rises, there has been increased scrutiny about women’s experiences while undergoing the insertion process.
Routinely touted as a quick and painless procedure, IUD insertion is often described as causing no more than a minor pinch, comparable to an ear piercing; patients are typically instructed to take ibuprofen before their visit to mitigate the discomfort. However, this is not always the case for women who choose this form of contraception. A study conducted in 2015 found that among women who never gave birth, 42% rated the procedure as severely painful, while 35% described it as moderately painful, and 23% reported mild pain. While having her IUD placed, Ashley Stewart recalls, “I screamed, crawled up the table, blacked out, and then when I woke up, I projectile-vomited.” Stewart’s experience was so traumatic they scheduled a hysterectomy but was informed by their provider that they could have another IUD placed while under general anesthesia. Stewart opted for another IUD. Like Stewart, many others have taken to social media to share and document their painful experiences.
In response to these concerns, the CDC now recommends providers adopt a more patient-centered approach. The agency urges practitioners to prioritize clear communication about expectations and offer enhanced pain management, ensuring that each patient is fully informed and supported throughout the process. Despite being the most effective reversible contraception, some women opt not to get an IUD. “Barriers to IUD use include patient concerns about anticipated pain with placement and provider concerns about ease of placement,” the CDC recommendations say. To address these barriers and mitigate pain, some providers are now using lidocaine to numb the area before insertion.
Thanks to women speaking out, despite studies showing that women’s pain is often ignored or dismissed by doctors, more attention is being paid to the patient experience. This shift in awareness could lead to changes in how the procedure is performed, with a greater focus on pain management and patient comfort becoming the standard of care.
SOURCES
https://www.yalemedicine.org/news/intrauterine-devices-iud
https://www.cnn.com/2019/02/04/health/iud-trump-election-study/index.html