IUD too often stands for pain.
Unfortunately, this experience is often coupled with intense pain if you are getting an IUD. Part of the reason for the pain is that the standard painkiller for an IUD insertion is Advil (ibuprofen), taken two hours before the procedure.
"We recommend Advil because it is an inexpensive painkiller that is easy to access and has no side effects," says Carol Scurfield, medical director of the Women's Health Clinic in Winnipeg.
Advil is adequate, in many cases, to cover the pain that comes with an IUD insertion. For some, the pain is more intense than ibuprofen can handle. An IUD insertion involves the T-shaped birth control device passing through the vagina, through the endocervix, into the uterus. There, it sits on the uterine lining and prevents egg implantation. While the exocervix has very few nerve endings, the endocervix, which is the small canal that connects the cervix to the uterus, is more sensitive. The pain experienced during IUD insertion results from the device brushing against the nerves of the endocervix. Bleeding is not uncommon after the procedure.
According to Maria Isabel Rodriguez, a clinical fellow in family planning at the University of California, some women, particularly those who have given birth, find the IUD insertion no more uncomfortable than undergoing a pap test. However, women who have not given birth, or those who have a history of heavy periods, are generally more likely to find the pain more severe.
This unpredictability can make choosing painkillers a challenging and subjective decision for this procedure. According to one report by Women's Health magazine, the pain during IUD insertion is usually rated as a three for women who've had vaginal births, while those who haven't rated the pain closer to a six on a pain scale of one to 10.
Still, not all women have the same pain threshold.
"I've had teenagers come in and get an IUD and feel fine. And I've also had women who've given birth to three children come in and feel a lot of discomfort," explains Scurfield.
Scurfield believes a factor contributing to the lack of dialogue about pain intensity during consultations is the conditioning of women patients to accept gynecological pain.
"There was actually a study comparing the amount of pain women felt during an abortion versus [pain felt during] a dental procedure in women," she notes. "The study found that women were willing to accept higher levels of pain during their abortions than they would allow during dental work. With this in mind, when women enter health clinics for their IUD consultations, they may be more unwilling to begin that conversation about stronger painkillers."
Scurfield emphasizes that a variety of pain alleviants are available and should be discussed, including naproxen, anti-anxiety medication and muscle relaxants.
Another option--though not yet widely offered--is a liquid freezing agent that numbs the endocervix.
Dr. Ellen Wiebe, medical director at the Willow Women's Clinic in Vancouver, says lidocaine, a freezing agent, is a viable option for those who are likely to experience high levels of pain during IUD insertion. Searching for a way to overcome the pain associated with IUD insertion, Wiebe found a study by Dr. Paul Blumenthal published in the August 2016 issue of the journal Obstetrics and Gynecology. She then recommended one of her patients insert 400 milligrams of lidocaine gel into her vagina 20 minutes before the procedure, and it was a success.
"She barely felt a thing," according to Wiebe.
Ultimately, making the experience as painless as possible comes down to finding a healthcare provider willing to discuss a variety of options for pain relief.
"It is important not to traumatize women with pain while they're getting an IUD inserted," Weibe emphasizes.
IUDs are an ideal form of birth control for many women. Taking the pain associated with this procedure out of the equation could make it appealing to a wider market.
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|Date:||Jan 1, 2017|
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