Stories of IUD trauma prove women’s pain is still sidelined

Traditionally, history has shown us that female-specific health needs have not been taken seriously by medical professionals, and it’s still happening today. A study recently found that it takes eight years on average for someone to receive an endometriosis diagnosis. Contraception methods have improved over the years (Google – or don’t – the torturous-looking Dalkon Shield device of the 70s), yet in 2021, there still isn’t a completely pain or side-effect free option.

A new dialogue about intrauterine devices (IUDs) and pain opened up this week. Speaking on Radio 5 Live, the BBC’s Naga Munchetty described the pain of getting her IUD fitted as “excruciating”, and that she fainted before bursting into tears of relief. “I felt violated, weak, and angry,” she said. Munchetty’s comments came after a piece by Caitlin Moran appeared in The Times, titled, “Why we all need pain relief when having an IUD fitted”. In it, she writes about a trainee fitting her contraceptive coil with considerable difficulty, and passing out from the pain repeatedly before being offered a Lucozade at the end by the doctor.

An IUD is a small T-shaped plastic and copper device that’s inserted into the womb by a doctor or nurse. They can either be hormonal or non-hormonal and, as far as protecting against unwanted pregnancies go, are around 99 per cent effective when fitted correctly. They can also offer protection from between five and ten years, making them a good choice for the long term.

Since Munchetty and Moran’s comments, however, thousands of women have been sharing their IUD insertion and removal experiences online. A petition started by Lucy Cohen calling for better pain management is littered with testimonies from women where passing out in pain is – terrifyingly – a common theme. One signee wrote that after suffering a painful insertion, a friend’s doctor said: “My private patients all get pain relief for this.” Another reports being told “no pain no gain” by a GP after asking for help managing the pain. Many women report being told or made to feel like their extreme pain was uncommon, although noting the sheer quantity of these stories, it is not.

Louise* tells Dazed that she found the insertion of her IUD “agony – it was possibly the most painful thing I’ve experienced as an adult”. She continues: “The doctor explained everything as she was doing it, and there was also a healthcare assistant present who was very nice and reassuring. But physically it was excruciating. I wasn’t offered any anaesthetic or pain relief. Afterwards I took cocodamol that I bought over the counter, as well as ibuprofen. To be honest, that didn’t really touch the sides – I ended up having to sit in the bath for ages when I got home. If they’d been unsuccessful with the insertion that day, there is no way I would’ve been able to go through it again – I would’ve had to find alternative contraception. I’m already dreading the removal if I ever want to try and get pregnant!”

For some people, though, the procedure can be relatively painless. The NHS website states that the process “can be uncomfortable”. But this seems like a large underestimation of most experiences. An article posted in response by the BBC, titled “Having coil fitted should not hurt, experts say”, rattled the countless people who say they have experienced extreme pain. “Were the experts men...?” one user tweeted.

Some patients describe being offered pain relief afterwards – often in the form of ibuprofen, and not realising that other forms of pain relief are available on request, including a local anaesthetic spray, injection, and gel. Mia* tells Dazed she was given the gel and “it worked, the procedure was uncomfortable but painless”. However, she describes the following events as “very traumatic. I fainted and vomited and cried later when I got back home. They had to get an oxygen tank in”.

In response to these testimonies earlier this week (June 22), the Faculty for Sexual and Reproductive Healthcare (FSRH) and the Royal College of Obstetricians and Gynaecologists (RCOG) issued a statement. “It saddens me to read these reports. No woman should endure severe pain when having their IUD fitted,” vice president of FSRH, Dr Diana Mansour, said. “I offer pain relief before and, where necessary, during an IUD placement including the use of local anaesthesia. I let women know that they are in control during the procedure and at any point additional pain relief can be given or other options explored such as having the IUD fitted under conscious sedation or general anaesthesia in the local hospital.”

Mansour goes on to explain that not all clinics or GP practices offer local anaesthesia. “Where this is the case, rapid referral to another service should be in place. Ultimately, I want to support women to choose a contraceptive that best suits them.”

“What is concerning to hear is that often women feel they need to endure this pain and stay silent, this should never be the case,” RCOG president Dr Edward Morris said. “If anyone is experiencing extreme pain during any procedure, then then they should feel empowered to ask for the procedure to stop, or request pain relief. Nobody should ever feel like they ‘have to’ go through with something, and should never have their concerns dismissed by a healthcare professional.”

What this new dialogue highlights is the vast array of experiences by women, as well as the alarming fact that – since many don’t know that pain relief is available to them – they aren’t being told. While medics say that most people have no problems with an IUD fitting, the response proves that, without being vocal about them, women’s health issues can easily get overlooked.

*Names have been changed