‘All women should be offered pain relief for coil fitting’

[mrsgrealish69]

I’ve just read a news story about a lot of women finding coil fittings painful and traumatic (certainly was the case for me a decade ago) I think naga munchetty said on the radio or in an interview somewhere that it was an excruciating experience for her.
I’ve seen an NHS response that apparently guidelines state women are offered appropriate pain relief for a fitting. Does anyone know what they mean by this?

I was advised to take a paracetamol beforehand, is this what they are referring to?

It definitely isn’t to do with having a high pain threshold or better tolerance. I tried to have it fitted with no pain relief but it was impossibly painful. I returned a second time having had paracetamol but had an equally bad experience. I was then told that my cervix is very small hence why the pain was very bad. Eventually I went to hospital to get sterilised because I wanted a permanent solution but the consultant there convinced me to have a coil fitted under general anaesthetic instead. That was great and I woke up in no pain at all. Roll on 7 years, I went to get it removed in hospital but because my periods had become erratic, the doctor decided to take a biopsy of my cervix at the same time with no pain relief at all. This was horrendous and extremely traumatic. I think I actually have a high pain threshold in general but I was screaming and in tears when the biopsy was done. It took me a few days to put it behind me. I agree that more care should be taken over procedures like these. It can be a really horrible experience when it doesn’t need to be.

@toastantea it wasn't a problem for me either but I'm not sure why that's a problem! Should I complain and say it hurt when it didn't? I took a paracetamol before and one 4 hours later and that was it. I've had 2, maybe if I have another it'll be horrendous but I can only give my opinion on what it was like for me! I shouldn't be made to feel bad just because it was ok. I'd never deny a woman pain relief for the coil but I'm a bit pissed off you feel woman who don't feel pain are part of the problem 🤷🏼‍♀️

Just been to have mine removed and replaced this afternoon. The GP had a good rummage but couldn't find it. It was painful, so she gave up and has referred me to another clinic where they can do an ultrasound to try and locate it. She was nice and reassuring and seemed very experienced, so I don't think it was down to her technique, it's just a horrible invasive procedure.

I have been given local anaesthetic for coil fittings at other clinics in the past, but wasn't offered it this time. Maybe if I had been anaesthetised, I could have let her carry on a bit longer to try and find it rather than now having to wait for another appointment to go through it all again.

[quote WeWantAMackerelNotASprat]@toastantea it wasn't a problem for me either but I'm not sure why that's a problem! Should I complain and say it hurt when it didn't? I took a paracetamol before and one 4 hours later and that was it. I've had 2, maybe if I have another it'll be horrendous but I can only give my opinion on what it was like for me! I shouldn't be made to feel bad just because it was ok. I'd never deny a woman pain relief for the coil but I'm a bit pissed off you feel woman who don't feel pain are part of the problem 🤷🏼‍♀️[/quote]

I only feel those are part of the problem when they jump on a thread to minimise the experience of others. Not finding it sore in itself isnt what I was talking about. Mine were not sore either, as I have said, but simply posting 'it didn't hurt' etc isn't helping get basic pain relief as an option, quite the opposite

It does feel very much like it’s a case of moderate pain (with high failure rate at achieving even that) as an acceptable outcome in women’s health.

The The Royal College of Obstetricians and Gynaecologists (RCOG) and the Faculty for Sexual and Reproductive Healthcare (FSRH) have released a joint statement on this.

“No woman should endure severe pain”

“We believe that unbearable pain during any gynaecological procedure is unacceptable”

“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”

I found a study which said that “small proportions of nulliparous (∼17%) and parous (∼11%) women experience substantial pain” and a claim here that “almost 90% of women report moderate to severe pain during procedures using a cervical tenaculum”. A tenaculum is the forceps used to grip the cervix. They have sharpen ends designed to pierce the cervix.

It has been known for a while that women are often in a lot of pain for these procedures. The “concern” seems to be that women are not happy to accept it.

Iv been lucky. 3 iud and each time dr numbed my cervix

My first one was painful. Second worse. Had general anaesthetic for third. I finally decided just to have it out and be done with it but after being mucked around by the NHS, decided to pay to see a gynaecologist privately - fully expecting to pay thousands to have it done under GA again.

BUT she said: well we could do that but let's try increasing your oestrogen first and see where we are in a couple of months. Turns out that as women get older, lack of oestrogen causes atrophy but upping oestrogen levels reverses that. She was right by the way and I just had normal pain relief for the procedure.
Am I wrong to think that women's issues are underfunded and women's pain is ignored?

@TheSockMonster

It does feel very much like it’s a case of moderate pain (with high failure rate at achieving even that) as an acceptable outcome in women’s health.

The The Royal College of Obstetricians and Gynaecologists (RCOG) and the Faculty for Sexual and Reproductive Healthcare (FSRH) have released a joint statement on this.

“No woman should endure severe pain”

“We believe that unbearable pain during any gynaecological procedure is unacceptable”

“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”

I found a study which said that “small proportions of nulliparous (∼17%) and parous (∼11%) women experience substantial pain” and a claim here that “almost 90% of women report moderate to severe pain during procedures using a cervical tenaculum”. A tenaculum is the forceps used to grip the cervix. They have sharpen ends designed to pierce the cervix.

It has been known for a while that women are often in a lot of pain for these procedures. The “concern” seems to be that women are not happy to accept it.

Clinical lead gynae told me it’s policy to try to insert awake with instillagel as a first line - despite me having vaginismus and previous surgery to vulva at nineteen . Also told coil was first line treatment for all endometriosis and dysmenorrhea, couldn’t try anything else without trying a coil .

Meant I went to an appointment thinking I was discussing coil; told there and then they’d try it and to get my trousers down so she could get it and done .

I’m ASD and didn’t feel able to say no, stop . Thought I’d someone’s a doctor you do what they say and don’t complain .

She forced and forced for ten minutes despite me sobbing and biting my mouth - stopped and said I was being ridiculous and silly and ‘it doesn’t hurt anyone else’

Walked out and left me so I had to hobble back to complete a 12 hour shift - ended up flooding and thrush, GP examined and found a laceration inside that she said was inevitably gynaecology’s doing.

When I complained - ‘we’re very sorry this happened; you’ll learn to live with these experiences however’

My GP said this is happening dozens and dozens of times to women needing internal procedures and examinations .

My GP funnily enough had one within six weeks of me and said she went home with bruises on her hand from gripping couch so hard - she was 45 and two big babies - said she was in agony too .

I really wish I’d complained about my experience.

I was feeling really fragile and vulnerable at the time having just been really ill in hospital and in truth I was just totally blindsided my the fact this ‘lunchtime procedure’ had left me in agony and passing out. The GP suggested I ‘go and treat myself to some cake’ on my way back to work

I've had 3 - the first was soon after having DS so didn't really hurt much as I'm assuming everything was still a bit 'soft'.

2nd one was moderately painful being put in and pretty bad the rest of the day.

3rd one was terrible. It hurt a lot both during and after, in fact I was shaking and white in the face walking out. I was very glad I had DP at the time to give me a lift home and that I wasn't working that day as I honestly couldn't have done anything.

Each time I was advised to take paracetamol which I did, before and after. Did absolutely nothing for the pain, I had to just wait for it to wear off.

I'm due to have a new one in 2023 and I'm absolutely dreading it as they seem to be getting worse each time. I will still have it as it really works for me in general but I'm already afraid of the pain 😞😭

I wish there were clinics where you could have gas and air

I've had two copper IUDs, and it's time to replace the second. I've never given birth, and I won't have a smear test. I chose the coil because I don't get on with hormones and I don't trust condoms.

The first coil was very painful to insert and the cramps lasted about two days. That was nothing compared to having it taken out. Having it taken out was agony, and they couldn't get the replacement in. I was freaked out, despite them having given me diazepam to take earlier, and I was deeply upset when it wore off. Fortunately, one of the Doctors at the local surgery is nationally well-known as an expert in women's issues. She kindly got me sent to a hospital sexual health clinic, where I got the re-insertion under GA. If that's an option for the next replacement, I'm definitely taking it.

I've always felt a bit ashamed that what seemed like such a small thing was such a problem, and that I was pathetic. This thread is enlightening and definitely helping me feel better

What pain relief do you think should be administered that would be effective for what IME is a minority of patients that a HCP would be happy to administer to someone who didn't need it and which a patient would be happy to receive if they didn't need it? In PP's words, what pain relief would touch the sides that wouldn't be inappropriate to administer when someone didn't need it?

Surely there has to be more appropriate choice than ‘2 paracetamols beforehand’ when so many women just on this thread are reporting they found the experience painful, some even excruciating and distressing. Not sure I see the logic in ‘well some women only experience mild discomfort so we shouldn’t offer pain relief’ which means a great deal of women endure pain and trauma. Some PPs have said a colonoscopy was similar in terms of pain and discomfort yet sedation is routinely offered for those, even though statistically some patients may not really need it as much as others.

Oh my goodness, I didn't even feel my one being put in, am now doubting I even had it done! I don't for a minute think that my experience is the same as everyone else's though, I know it causes an awful lot of pain to most women and it's appalling that there is nothing in place to combat this. I'm on the waiting list to have mine changed and am dreading it now!

I think women should have a wider range of pain relief offered for any vaginal procedure. My coil didn’t hurt but having pessaries and gel when I was induced was extremely painful, one lovely nurse gave me G&A and it was so much easier.

Didn’t feel a thing when I had mine fitted.

Mind you, I made sure I was royally off my tits on prescription codeine beforehand .

Getting an embedded one removed with no pain relief was pretty horrific.

I nearly hit the roof when I had mine done. I was 3 months post partum after a delivery that involved lots of tears. I felt sick and faint from the pain and had to sit down for a while before I was safe to drive. Apparently it was my own fault as I hadn’t mentioned all the damage (I hadn’t looked and didn’t realise how extensive it was). If they had known about the damage I could have had some local anaesthetic. Knowing I was post partum maybe they should have asked me? It was so bad I ended up breaking down in tears waiting for my next smear but luckily the nurse was amazing, gentle and kind.

I had my second syntocin induced baby on gas and air (my choice) so I don’t think I am a wimp.

[quote WeWantAMackerelNotASprat]@toastantea it wasn't a problem for me either but I'm not sure why that's a problem! Should I complain and say it hurt when it didn't? I took a paracetamol before and one 4 hours later and that was it. I've had 2, maybe if I have another it'll be horrendous but I can only give my opinion on what it was like for me! I shouldn't be made to feel bad just because it was ok. I'd never deny a woman pain relief for the coil but I'm a bit pissed off you feel woman who don't feel pain are part of the problem 🤷🏼‍♀️[/quote]
I agree. Mine was uncomfortable but was only very, very briefly painful. Same for my daughter. Sorry that our experience offends you but that was how it was for us. I’ve had children; my daughter hasn’t. I used hypnotherapy and cocodomal. My colonoscopies are more unpleasant—and I’ve had five.

Pain relief should be offered, of course.

And no sedation routinely offered in my area foe colonoscopies.

Had one fitted twice, excruciating - including removal. Both times they found it was actually in the wrong place. This idea that because some people don't find it painful, it isn't, is so unhelpful and actually can be traumatic.

I think some women need more than paracetamol and pain relief options should be discussed in advance and include numbing gel, lock anesthetic and in the case of women with trauma even a light sedation.

Of course it should be offered. What on earth are the possible objections?

I’ve had two, both before kids and chosen because I wanted to avoid hormones. First one was uncomfortable but not painful, the second I went into shock and fainted in the surgery. That came straight out and I am never repeating the experience. Painkiller or not.

I've had 3, all very painful to insert and remove. I dread getting it replaced but the advantages outweighs the downsides
Although I did have an acute pelvic infection which left me in hospital on IV antibiotics for a week a few years ago, which they attributed to a displaced coil... so maybe I'm a fool continuing with them

For the last one they really struggled to insert it so ended up going back and having an anesthetic injection to help with the pain and rummaging

First time I thought it was horrible and extremely painful but apart from feeling a bit faint it was over quickly. But my second one - I went into shock and the surgery had to call my DH to come and get me because I couldn't stop shaking enough to stand up never mind drive.

Best contraception I've ever had EXCEPT the fitting.