I don't do IUD insertions, but pain management should be discussed and offered.I don't care what the studies say. Sometimes you just need to be a human and empathize with other humans. Medicine is as much an art as it is science.
I had an awful IUD experience, involving vomiting and fainting as a result of the pain level. I would rate my IUD insertion worse than passing a kidney stone or breaking bones. Im not alone with this experience. If you search IUD on TikTok or other female-dominated subreddits, youll see an abundance of women/ teenage girls who have also described the IUD pain as the worst pain in their life. Ive noticed a trend of increased pain particularly among nulliparous women.The Intensity of pain doesnt seem to be acknowledged by many medical providers though, as many patients are told it will be a slight pinch and arent properly informed about the pain involved. As a result, many of us did not properly prepare for the persisting pain by arranging a ride home from the appointment, a day off from work/school, or mental preparation for pain. Many providers both seem to acknowledge that extreme reactions to the insertion are normal, but the pain isnt enough to warrant preparation or pain medicationsI played rugby, basketball, football, and softball. Ive had many broken bones and torn ACLs. Ive also passed kidney stone. The IUD insertion pain was by far worse and longer than any of the aforementioned pain events. If I was offered pain medicine for all those events, why is nothing given for IUD insertions to reduce the associated pain and discomfort? Is there a specific reason?Edit- I should mention Im directing this question to medical professionals in the US.Edit 2- Ill admit I havent looked into any of the studies about this. We had one doctor chime in that studies show that extreme pain is not the norm, but the trend Im seeing in person and across social media appears contradictory to those findings. Would any medical professionals be willing to share the specific studies that are being referenced for care? Im a PhD student in a different area of public health research, but I wouldnt mind doing some critical review of the publications while I have the time. Update: so far I've only found a few relevant articles in my Uni's database. Most are about a decade or older and have really small sample sizes, like n=40 or less. The more recent articles are recognizing the pain of insertion as an issue, but I'm not finding a lot of resources so far. If anyone has a specific research study they reference when learning, I'd be thrilled to look at it.Edit 3 -I started to search for articles. This is the first abstract I found:"Concerns about pain during IUD insertion are a major barrier to use of IUDs among adolescent and young adult patients who may otherwise be interested in this method. Although few studies of pain control options have been conducted in this population, available data suggest that several pharmacologic interventions discussed in this chapter may be beneficial. Pre-procedure naproxen, ketorolac, or tramadol can help to reduce post-procedure discomfort. Paracervical nerve blockage with lidocaine-based anesthetics, topical lidocaine spray, or EMLA cream also appears to reduce pain with IUD insertion. Intravaginal 2% lidocaine gel may reduce pain with tenaculum and speculum placement. This chapter will discuss the complex nature of pain in gynecological procedures, including IUD placement, and the impact of anxiety and fear on pain perception. It will also review clinical guidelines to assist with pain control during procedures and describe evidence-based pharmacological pain control modalities that can be used during IUD procedures." Optimizing IUD Delivery for Adolescents and Young AdultsTho I don't have full access to the text, this abstract is making it apparent that pain management is a valid concern and there are options. Can doctors weigh in more on those options? If it is indeed a recognized problem in the medical community, why aren't these options considered?Update 4: I have 26 peer-reviewed articles to review. Slamming a coffee and Ill get you my quick-and-dirty lit review asap.