Pain Relief during IUD procedures

[1stWorldProblems]

Apologies if this has already been covered - the search facility doesn't seem to be working today on MN. I know that Caitlin Moran is a bit of Marmite person for Mumsnet (& even for me some days) but today's Times magazine is a) laugh out loud funny in parts and b) made think about something I'd just taken for granted as a given - why is it that coil insertions & removals are done with out any offer of pain relielf? It never just "hurts a bit" and leaves me feeling physically odd for several days after.
www.thetimes.co.uk/article/why-we-all-need-pain-relief-when-having-an-iud-fitted-7qks82srw

She has recently had a particularly bad procedure and has been tweeting about a petition by Lucy Cohen calling for more information & pain relief for the procedure. This bit made me laugh out loud

"Interestingly, several who worked in the medical industry pointed out that during colonoscopies – a unisex procedure – people are offered either gas and air or sedation. In many ways a colonoscopy is similar to an IUD insertion – doctors are putting something up one of your special, private holes. The big difference between the two is in scale and accessibility. The sphincter is essentially like the Blackwall Tunnel; it’s built for daily traffic. It’s a well-travelled route, open 24/7.

The cervix, on the other hand, is a bit like my nanna’s sitting room. The door was always closed, it was only used on “special” occasions, and she’d be quite agitated that someone might break something precious while they were in there. She was relieved when everyone left."

[NiceGerbil]

If existing pain relief doesn't help then finding one that does might be useful you'd think.

[PawsQueen]

@Faffertea I think it's when they said "mild discomfort"
For me it's like a giant severe cramp with the sound and then the fitting. I booked deliberately with the "awkward patient" clinic (it probably has a proper name!) who can do injections, more pain relief and have double appointments
Weirdly the pain wasn't as bad (third coil, no DC) but I had a cervical shock reaction and had to be upended with a fan and lucozade after my BP dropped. Suspect it was removal and insertion in one go that did it!
Honestly I wouldn't find it anywhere near as bad if it wasn't for the sounding thing, that's what hurts me the most. And I guess some of it is nerves, I never know how badly it's going to hurt because each has varied

[NancyDrawed]

I had a mirena fitted and it was fine, although my niece had a horrendous experience where they had to abandon the attempt.

The clinic I went to said that it was to be inserted during your period (can't remember between which days) which wasn't ideal for me as my cycle was a bit irregular and appointments had to be made in advance and the clinic wasn't open every day.

Anyway, all that aside, it was explained that insertion was easier if the cervix was open (as it is during menstruation) which made sense to me and I had no issues, but I haven't heard of anyone else being advised the same.

I agree that pain relief should be available to those who need it.

[siblingworried123]

I had a spinal anaesthetic for mine (mirena) and fentanyl in recovery - can’t understand how anyone could have one awake/without anaesthetic, I was in agony and flooded the bed after . Kept in for 24 hours as kept fainting after .

[Lockheart]

I've never had a coil but have been investigating the copper IUD as it's my last non-hormonal resort. I believe there are private clinics here in London which will insert one under sedation for £400ish. Honestly I'd be happy to pay it after reading many women's experience. Even if it turns out to give me horrendous periods and I have to have it removed, I'd rather pay to avoid the horror of having it done with nothing but a paracetamol.

I can't believe in this day and age it's seen as acceptable. Women's healthcare can be so barbaric and practically medieval.

[Helen8220]

@Lockheart I had mine done under sedation on the NHS. After they couldn’t get it in normally they referred me to the specialist clinic and they referred me to the hospital as it was clear they’d never get it in otherwise. Although I don’t know if that’s possible in all Trusts, and/or if it had anything to do with the fact my vaginismus is so bad I can’t even use tampons.

[PawsQueen]

@Lockheart I'm on my third copper coil and it's been the best contraceptive for me. If you take out the fitting (removal didn't hurt at all, just felt odd) then it's years with no fuss. They managed to get a 10 year one in this time for me too (had 5 year ones previously)
I did say "oh this will be my last" and she was "no love, sorry, you'll need one more before you're free"

[teawamutu]

@Pawsqueen Same here, only for Mirena. Apart from the insertion (which was bad on the two situations where my cervix had never been properly open, or hadn't been for seven years), it has been a life-changer.

No periods at all. No spotting, bloating or hormonal swings. No need to even think about contraception. Amazing.

Just sort the pain relief about and stop imagining paracetamol will do the square root of fuck all, and you're golden 😁

[olivethegreat]

I've just turned down having the mirena inserted (under Ga , during a hysterocopy), in case I didn't get on with it and it needed to be removed without GA.

I won't be having anymore smears now either, the pain was just too great for the last one . I tested negative for HPV so I feel that's a fair decision.

[teawamutu]

@olivethegreat

I've just turned down having the mirena inserted (under Ga , during a hysterocopy), in case I didn't get on with it and it needed to be removed without GA.

I won't be having anymore smears now either, the pain was just too great for the last one . I tested negative for HPV so I feel that's a fair decision.

Olive, just in case it helps - none of the removals have been uncomfortable (in the usual sense of the term) for more than a few seconds. Even the one that went walkabout and had to be removed by a consultant.

[olivethegreat]

Thanks but I'm very much of the minimal intervention school! I don't have a partner, so it's just for heavy period, and I'm going to increase my pain relief intake (have codeine !) and also changing diet and increasing exercise to see if it helps . It was actually fine when I was running then I got injured for several months - due period insanity . Going to try and get back to running carefully .

[yetanotherusernameAgain]

Naga Munchetty is reported to have spoken of her experiences, this morning on Radio 5 Live:

www.bbc.co.uk/news/health-57551641

Apparently she fainted twice when it was inserted, and once when it was removed.

[CousinKrispy]

I was lucky and had only bearable discomfort when my Mirena was inserted and removed, though I asked for removal after only a year or so. My periods were very light but I still had regular and painful cramping, and like any other remotely hormonal birth control, the effect on my mood was unacceptable.

I guess offering GA would complicate things significantly, e.g.risk from GA, more time off work for recovery, having to fast in advance etc. but I'm sure there are ways of working out appropriate care standards and procedures.

[TurquoiseLemur]

@Faffertea

I fit a lot of IUD/IUSs. The evidence for using local anaesthetic is that it doesn’t really help and you have at least partly put the inserter into the cervical canal to do it otherwise you are just applying it to the end of the cervix which is not much help. A cervical block (injection of local anaesthetic into the cervix) is generally considered a more specialist procedure so is not usually carried out in GP surgeries.
A coil fit is not really a similar process to a colonoscopy so I don’t think that comparison is helpful.
For me, the important things are that women should be as comfortable as possible during the fit and the expected level of pain should be similar to that of period type pain (although obviously that is variable) and manageable with over the counter pain relief. Most important of all though is that if at any point a woman wants to stop or have a break that should be done immediately.
As an aside, for some women procedures involving the cervix can trigger stimulation of the nerve pathways that lower blood pressure and heart rate making some women feel faint.

When I arranged to have a coil fitted 12 years ago, I didn't know that it could hurt. And the nurses at the clinic didn't tell me. No anaesthetic. It was way more painful than period pain! I asked them to stop; they didn't.

Immediately afterwards, I felt faint and sick. I asked them if they could open the window next to the couch; they said they couldn't, that it was locked for security reasons. I asked for a glass of cold water. They said that the taps had only just been fitted and that they only dispensed warm water. (???)

There was no apology. Not even an acknowledgement that it had been painful.

I'm aware that I shouldn't really keep a coil in indefinitely. But I have no confidence now that the removal would be handled any better.

[PanamaPattie]

@Faffertea

I fit a lot of IUD/IUSs. The evidence for using local anaesthetic is that it doesn’t really help and you have at least partly put the inserter into the cervical canal to do it otherwise you are just applying it to the end of the cervix which is not much help. A cervical block (injection of local anaesthetic into the cervix) is generally considered a more specialist procedure so is not usually carried out in GP surgeries.
A coil fit is not really a similar process to a colonoscopy so I don’t think that comparison is helpful.
For me, the important things are that women should be as comfortable as possible during the fit and the expected level of pain should be similar to that of period type pain (although obviously that is variable) and manageable with over the counter pain relief. Most important of all though is that if at any point a woman wants to stop or have a break that should be done immediately.
As an aside, for some women procedures involving the cervix can trigger stimulation of the nerve pathways that lower blood pressure and heart rate making some women feel faint.

I don’t want an acceptable level of pain. I want NO pain. Why are women expected to put up with this?

[PawsQueen]

@TurquoiseLemur that's awful
I had an unexpected reaction like I said above to coil 3, they put a BP monitor on me, switched the fan on, upended me and pottered around the room until I felt better. I did take lucozade (I must have known!) and they passed me that too, no rush or panic just waited until I felt better. They did mention if I didn't recover they would have to remove it and I was "no bloody way"

[TurquoiseLemur]

[quote PawsQueen]@TurquoiseLemur that's awful
I had an unexpected reaction like I said above to coil 3, they put a BP monitor on me, switched the fan on, upended me and pottered around the room until I felt better. I did take lucozade (I must have known!) and they passed me that too, no rush or panic just waited until I felt better. They did mention if I didn't recover they would have to remove it and I was "no bloody way" [/quote]
Thank you. Yes, it was shabby. Unacceptable.

It really depresses me that far too many health professionals think these things aren't important. The lack of care. The ignoring of a clear request. The shrugging-off afterwards.

As well as the thing itself, they don't seem to grasp that a bad experience can make someone not want to engage at a further point. Given what happened then, they will have to make a very solid case to me before I will agree to having it removed. They have made something fraught with anxiety that needn't have been.

If this kind of thing habitually happened to men, it would be 1) widely publicized and 2) stopped.

[TurquoiseLemur]

Panamapattle, Can't link directly but I agree with you.

"Acceptable" level of pain? "Manageable" level of pain? Manageable and acceptable to whom?

This attitude runs right through women's healthcare.

[PawsQueen]

@TurquoiseLemur if it helps, the removal was a LOT easier for me. They get the strings, ask you to cough and it's out
Try a different place too and ask if they have anyone who can do cervix injections (you won't need one but it's usually the complicated insertion type clinic and they are used to coils!)

[TurquoiseLemur]

[quote PawsQueen]@TurquoiseLemur if it helps, the removal was a LOT easier for me. They get the strings, ask you to cough and it's out
Try a different place too and ask if they have anyone who can do cervix injections (you won't need one but it's usually the complicated insertion type clinic and they are used to coils!)[/quote]
Thank you, PawQueen, but sad to say my confidence in the health system is shot to pieces.

I don't trust their reassurances because I have had several in the past that added up to diddly squat.

Feeling upset talking about this, tbh. Not your fault. I'll bow out for a while.

[OverByYer]

I found the removal of my Mirena more painful than insertion . I was crying in pain and trying not to scream abs remember commenting to the nurse at the time that hey should offer gas and air as it was comparable to contractions. I would never have one again.
I also find smears painful and can feel the point of the brush scraping. I’d give anything not to have another test again

[olivethegreat]

I tried to hit the nurse on my last smear!

[olivethegreat]

As in to get her off me as she wouldn't stop either! So best for all concerned that i don't have anymore !

[Pandoraslastchance]

I've had multiple coils inserted and removed at my gp surgery by different doctors. Its been varied from a quick all done to agony.


I had my last fitted at the local sexual health clinic and it was much better. The last doctor had a proper gyne chair with stirrups rather than being wedged against the wall on some old rickety table. I think that definitely helped the ease of the fit.

Women should not have to accept pain. That is barbaric. If a man and a woman both needed a catheter fitting then they would both get numbing jelly. So why is it when it comes to female reproductive health we get shafted?

[Sillyduckseverywhere]

I wonder if it depends on the attitude of the hcp fitting it?
My first was agony, I was in a right state afterwards and they couldn't have cared less. I was ushered out with no aftercare instructions, I commented that it was more painful than I expected and they rolled their eyes at each other
The second I had done by a lovely GP that even played spa music in the room. Barely felt it.
Just one of the reasons I have massive trust issues with health care.