Getting the contraceptive coil, also known as an IUD, is one of the worst pains Lucy Cohen has ever felt.
“After the procedure, I said to the receptionist: ‘Sorry if you heard me scream!’
“I laughed about it but when I got home I felt quite traumatised. I thought ‘this shouldn’t be happening’,” Lucy tells Metro.co.uk.
The Welsh entrepreneur has endometriosis, which makes it difficult to insert an IUD. She didn’t know about it until she went through the “excruciating pain” of the procedure.
Lucy was not offered pain relief when the doctor placed the IUD in her uterus. She was told to take painkillers, which Lucy describes as “stupid” because “over-the-counter drugs aren’t for acute pain.”
At the time, her experience was in line with NHS guidelines, although studies showed that ibuprofen was not effective in relieving pain during IUS insertion. In fact, experts say flush mounting shouldn’t hurt or cause pain.
Lucy’s procedure lasted 25 minutes and every second was agony, but unfortunately her experience is not unique.
When Lucy returned home after her procedure, she shared her story on Facebook and was shocked by the number of people affected. To gain more insight into the scale of the problem, she surveyed 15,000 people.
After the procedure, I said to the receptionist, “I’m sorry if you heard me scream!”
The response was overwhelming. Lucy said: “Some of them made me cry. They told me stories that they couldn’t drive home and that their husband came to pick them up… it just isn’t right.
“So many people thought they were an anomaly”
Lucy was thrilled and started a petition for pain relief — except she was told to take over-the-counter pain medications, which should be standard practice of health care professionals. It generated 30,000 signatures.
The issue gained more attention last year when BBC news anchor Naga Munchetty described the traumatic experience of having her IUD inserted, saying she felt “hurt, weak and angry”.
Many women started sharing their stories and Metro.co.uk spoke to women who felt they were not getting enough pain relief during their procedures.
Finally, the Faculty of Sexual and Reproductive Health (FSRH) and the Royal College of Obstetricians and Gynecologists (RCOG) issued a statement in July 2021 acknowledging their “concern” about the painful experiences of women who have received an IUD.
The FSRH has updated their guidelines by writing that everyone should receive adequate pain relief during an IUD placement.
The new FSRH guideline states that some forms of pain relief are more effective than painkillers.
One is a paracervical block, a nerve block. Another is an injection of a local anesthetic into the cervix. Finally, some medical professionals may use a numbing spray on the surface of the cervix.
The guidance was a step forward – but it’s not law and with the NHS as overburdened and underfunded as it is, some GP surgeries may not have access to paracervical blocks or lidocaine spray.
Emily Partner had her IUD inserted in April 2022 – almost a year after the new guidelines were introduced. When asked if she took painkillers, she laughed.
She tells Metro.co.uk: “I was told to go home and take paracetamol, which didn’t help.”
Like Lucy, Emily has endometriosis. She did research so she knew what to expect when she entered the operating room. It didn’t help.
The new guidelines are a step forward, but the NHS is overwhelmed and underfunded.
“The doctor couldn’t be less interested,” says Emily. She recalls that the doctor “barely spoke” and simply handed Emily a folder containing information she had already read online.
The procedure was so painful that Emily cried and passed out. The nurse supported her and offered her a compress and tissues, but the pain was “so sharp and deep” and wouldn’t go away.
She had pain during menstruation, during sex and every day. The bleeding didn’t stop and she had mood swings. In the end, she felt she had no choice but to have the oil removed.
And while some people choose to have the IUD removed and move on with their lives. For others, the trauma is felt outside of the procedure.
Ella Glover, 23, says the IUD triggered her vaginismus, which the NHS defines as the body’s automatic response to fear of some or all types of vaginal penetration.
This fear response causes the vaginal muscles to tense automatically when penetration is attempted. You have no control over it.
“It really pisses me off that I got vaginismus right when the IUD was put in. I was just protecting myself from pregnancy,” says Ella.
“No one prepared me for this. No one said it could happen and I had no support after it happened.”
Ella didn’t have to remove her IUD because she was afraid of the pain and had lost faith in medical professionals.
She says, “I don’t think they know enough about it or don’t care enough about that body part to take good care of it or help if they make a mistake.”
Dr. Nighat Arif has been using IUDs for eight years.
She says everyone will experience a different level of pain, meaning some will be no more than mildly uncomfortable, but claims it’s “by no means a painless procedure.”
“I tell every woman who chooses the IUD that the procedure is painful.
“The pain is on a spectrum[…] As a rule of thumb, it’s slightly more painful than a pap smear and less painful than having a baby,” she explains.
The pain usually arises from feeling the tenaculum (a surgical instrument used to grasp and hold parts) at the neck of the uterus, cutting the cervix to stabilize the cervix, and measuring the depth of the uterus before dilating the tube or slide with the coil. passed into the womb.
Historically, the cervix was medically thought to have “no or few pain fibers,” says Dr. Arif. That’s not true, but it’s one of the reasons women’s pain has been minimized for so long.
Dr. Arif says the reason discussions about pain are often kept to a minimum is because of concerns that they might startle or alarm people.
However, she also believes that “women’s pain in gynecological procedures or treatments is much nullified in society and medicine”.
She adds: “There’s an assumption that because women menstruate and give birth, they’re somehow better able to ‘endure’ pain, and we continue to medically pressure women into believing that they have the problem. are – which is completely wrong and something I pay close attention to. .”
Dr. Arif offers the cervical block – as recommended in the new FSRH guideline – but believes the spray, which they also suggest, works better. “It works in two minutes, no needles and tastes like bananas.”
It is believed that because women give birth, they are somehow better able to “endure” pain.
But: “The 10% xylocaine spray costs around £10 per bottle, so it’s not cheap. I think the cervical block is cheaper. Again, the range of practices is limited by things like cost and overhead.”
And Lucy says that despite the recent changes, some clinics “just don’t inform patients about what pain medications are available.”
“There is no uniform training for clinicians yet,” says Lucy. “Injecting pain medication is not part of the training of all IUD insertion clinicians. That limits where you can go.”
If your GP practice doesn’t offer all types of pain relief you should be referred elsewhere, but not everyone knows that. That’s why Lucy is committed to raising awareness, so people know to look around. She also suggests that sexual health clinics may be better than GPs.
Lucy “calls for a uniform experience” and general training for every medic, but warns that “any major overhaul of the NHS will take a while”.
For now, she just wants people to know what to expect so they can make a decision that’s right for them.
I am a highly experienced and well-connected journalist, with a focus on healthcare news. I have worked for several major news outlets, and currently work as an author at 24 news recorder. My work has been featured in many prestigious publications, and I have a wide network of contacts in the healthcare industry. I am highly passionate about my work, and strive to provide accurate and timely information to my readers.