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."

[Helen8220]

@Y0YO ah, yes, I can see that would throw a spanner in the works. I was lucky I got it in in 2019. I’m glad the progesterone is helping you a bit at least. I tried that for about a year, as I was terrified of the coil, but didn’t get on that well with it.

[Y0YO]

@Helen8220
Glad it helped you, my neighbour said it was fantastic for her!

[Didiusfalco]

Gosh I’m so glad to see this thread. It’s just not good enough is it?

I’ve had two children, a hysteroscopy without pain relief, an abortion. I found this both painful and traumatic. I was shaking afterwards and couldn’t leave the surgery because my blood pressure was so high. Even though it was consensual I felt violated because the discomfort was so unexpected and so beyond anything I would expect from a standard procedure carried out in a gps surgery.

[JellySlice]

@334bu

*A lot of this could be avoided if these people just bloody listened!*

100% this.

By the way is their a financial incentive in not offering suitable pain relief? For example does it take less time, fewer staff needed? How much is money driving this?

Probably. Less time, fewer staff, less specialist training.

But I had my latest Mirena removal/insertion under the influence of diazepam. I requested it from the GP who had done all my other Mirenas, and she readily agreed. I remember very little of the procedure, so, even though it was as difficult and painful as previous times, I was not traumatised by it. Afterwards, I got as far as a local cafe before calling dh to fetch me home. He says I was totally, goofily stoned when he got there.

What did making the procedure actually tolerable cost the NHS? A brief telephone appointment with my GP and 3 tablets of diazepam.

[FudgeSundae]

@InkieNecro I agree, my smears have always been incredibly painful- like, gasping, screaming painful. I’ve had two labours with zero pain relief and the worst bits of both have been the sweeps and other cervical examinations. The contractions and even crowning weren’t nearly as bad. I’ve also had a colonoscopy and I’d do that in a heartbeat rather than have my cervix touched.

I did look it up and apparently in the early 20th century a (male, naturally) doctor concluded based on a small sample of women that the cervix had no nerve endings and so couldn’t feel pain directly. This seems to be true for many women but a significant minority find this not to be the case!

I now want a copper coil and I explained all this to my GP and asked for help. She said that it might be possible to get it fitted under general anaesthetic but that I’d have to try to have a regular fitting first: she said we could tie this in with an upcoming smear that is due so I’m happy with that - I’m betting that after they’ve seen me in a smear they won’t even try.

[PawsQueen]

Looks like changes might be coming. And yes for me the sounding was the worst bit

https://www.fsrh.org/news/fsrh-rcog-statement-iud-pain/?fbclid=IwAR2wQ1D0HgNcpSUEOEWMgf72lRR-SXUsMOVzqzWBklLgsPwSy7JLGP2VX0w

[PurgatoryOfPotholes]

Mine was finally inserted after the woman doing the insertion put some anaesthetic gel on my cervix. How much can that anaesthetic gel cost the NHS, I wonder?

[mineofuselessinformation]

Just to add to what has already been said:
I have no idea what insertion was like, as I was under GA.
Removal, on the other hand..... I nearly had to be peeled off the ceiling. I've never been able to scream, but if I'd been able to, it would have happened - not voluntarily.

[mineofuselessinformation]

And another addition (sorry):
It really pisses me off that pain for women undergoing procedures like this is minimised.
For 'it might be uncomfortable' they actually mean 'it's going to bloody well hurt', and if they say ' it might be painful', that just plain means for most women it will be agony.

[Ghislainedefeligonde]

For most women it’s not agony though is it? I had one and it was no worse than a smear. I’ve spoken to friends with similar experiences. This is bad journalism and will no doubt put some women off having coils despite them being great for lots of problems including heavy periods and can be used as part of HRT as well.
I think the nhs is generally not great at pain relief for stuff like this and it would be great if something like entonox was available for things like this as well as colonoscopies, hysteroscopies and endometrial biopsies. (Plus prostate biopsies for men while can be pretty excruciating I’m told)

[OverByYer]

@Ghislainedefeligonde yet so many of us are posting here to say it is painful?
Most of my friends have had similar experiences to me. I don’t know anyone who has had more than one Mirena

[ilovemydogandmrobama2]

Had my coil out last week although should have been taken out last year, delayed due to Covid etc.

My GP who is usually quite supportive said before she took it out, 'well, you've had 3 children so you will be fine...'

[PawsQueen]

Saying "most women" makes it feel like people are the odd ones out for experiencing pain though
In the survey done (copied and pasted) Almost 1500 people have so far shared their experiences with me. On a pain rating scale of 0-10, 43% of respondents rated their pain as a 7 or higher with the associated descriptions of:
Extremely painful 
Almost unbearable 
Excruciating 

If nearly half of women are describing it as excruciating then something isn't right

[OverByYer]

Another misleading headline
www.bbc.co.uk/news/health-57557296

One Dr saying it shouldn’t be that painful and one saying it is and pain relief should be offered.

Yet the headline is implying that it’s not painful for ‘ most women’

[MummBraTheEverLeaking]

Mine was agony going in and agony coming out, in fact they struggled to get it out for a while which only ramped up my anxiety about it. Shit show all round really. This was pre childbirth.

I'm one and done with DD, but haven't got round to having it back in. Post birth I'm still very bad with smears, have to have the small speculum, so I imagine another coil fitting would be the same the as the first time round and I'm not brave enough to risk it.

Although it shouldn't be a matter of brave, it should be a matter of decent bloody pain relief beforehand, not a couple of poxy paracetamol

[InkieNecro]

[quote FudgeSundae]@InkieNecro I agree, my smears have always been incredibly painful- like, gasping, screaming painful. I’ve had two labours with zero pain relief and the worst bits of both have been the sweeps and other cervical examinations. The contractions and even crowning weren’t nearly as bad. I’ve also had a colonoscopy and I’d do that in a heartbeat rather than have my cervix touched.

I did look it up and apparently in the early 20th century a (male, naturally) doctor concluded based on a small sample of women that the cervix had no nerve endings and so couldn’t feel pain directly. This seems to be true for many women but a significant minority find this not to be the case!

I now want a copper coil and I explained all this to my GP and asked for help. She said that it might be possible to get it fitted under general anaesthetic but that I’d have to try to have a regular fitting first: she said we could tie this in with an upcoming smear that is due so I’m happy with that - I’m betting that after they’ve seen me in a smear they won’t even try.[/quote]
Why can't they just sedate you and do a smear and insertion at the same time? I don't think it's right to force you to have something like that done before you can be offered any way to make it tolerable. Plus think of the time wasted by you having to go through two appointments when one would be fine!

[PawsQueen]

I think the key is options. If you've had a coil fitted and know you're fine, great
But a) flag up the reality of pain to manage expectations and b) offer effective pain relief

[smearsagony]

[quote FudgeSundae]@InkieNecro I agree, my smears have always been incredibly painful- like, gasping, screaming painful. I’ve had two labours with zero pain relief and the worst bits of both have been the sweeps and other cervical examinations. The contractions and even crowning weren’t nearly as bad. I’ve also had a colonoscopy and I’d do that in a heartbeat rather than have my cervix touched.

I did look it up and apparently in the early 20th century a (male, naturally) doctor concluded based on a small sample of women that the cervix had no nerve endings and so couldn’t feel pain directly. This seems to be true for many women but a significant minority find this not to be the case!

I now want a copper coil and I explained all this to my GP and asked for help. She said that it might be possible to get it fitted under general anaesthetic but that I’d have to try to have a regular fitting first: she said we could tie this in with an upcoming smear that is due so I’m happy with that - I’m betting that after they’ve seen me in a smear they won’t even try.[/quote]
Smears are hell ... my last one GP refused to believe me when I said I had vaginismus/PTSD and tried to force along with two nurses, literally said ‘I’ll believe that when I see it’ when I explained I was terrified . I ended up in floods of tears; another patient in the waiting room took me home in her car - was four miles down the road before I realised I had no clue who this woman was and had just gotten in to her car without question, I was that upset .

Won’t have a smear again if I can help it, I’m not even sure of the point as I can’t have penetrative sex !

[TurquoiseLemur]

SmearsAgony,

That is appalling. "I'll believe that when I see it". The arrogance. If s/he doesn't understand about PTSD and vaginismus s/he should not be practising as a GP.

No wonder you were upset. I'm glad the other patient helped you but what a pity the nurse, the receptionist, etc apparently didn't see the need.

[Ghislainedefeligonde]

smears that’s absolutely awful and should not have happened. Have you ever been referred to a specialist to try to help with your vaginismus?
I think they are currently looking at introducing self taken smears so maybe in the future that would be an option for you??
I hope you can find a GP you can trust to help you with this in the future

[Sweetpeasaremadeforbees]

I think the entire NHS downplays the pain experienced by women having medical procedures.

Two friends have recently had mammograms and were told that they would experience 'mild discomfort'. Both said they were in absolute agony and have no intention of repeating the experience because it felt like it was actually damaging them in some way. I think it's horrendous that women are misled like this, like if you feel pain the issue is with you. But then I guess if women were told the truth they wouldn't consent. It all makes me so angry.

[smearsagony]

@Ghislainedefeligonde

smears that’s absolutely awful and should not have happened. Have you ever been referred to a specialist to try to help with your vaginismus?
I think they are currently looking at introducing self taken smears so maybe in the future that would be an option for you??
I hope you can find a GP you can trust to help you with this in the future

Thank you, I’ve been sent for physio but that involved internal vaginal/perineum massage so I couldn’t cope with it . NHS said I’ll learn to live with it/try to push past pain and ‘you’ll enjoy it eventually’ - but I’m 30, can’t have intercourse, can’t use tampons, and am utterly fed up with the whole thing . I’m having counselling at the moment but finding all the stuff about coils on social media, twitter etc has brought back horrendous memories . For years I thought I was the only one being treated this way - I can’t believe I’m not .

[TurquoiseLemur]

@Sweetpeasaremadeforbees

I think the entire NHS downplays the pain experienced by women having medical procedures.

Two friends have recently had mammograms and were told that they would experience 'mild discomfort'. Both said they were in absolute agony and have no intention of repeating the experience because it felt like it was actually damaging them in some way. I think it's horrendous that women are misled like this, like if you feel pain the issue is with you. But then I guess if women were told the truth they wouldn't consent. It all makes me so angry.

I think this is the thing. Medics indeed do fear that if we are told the truth we won't consent.

And we have an absolute right not to consent! Consent that is not properly informed is not genuine consent. This concept applies to all other areas of Western medicine nowadays so why not, apparently, to anything specific to women?

It comes down to an attitude towards women which is as old as the hills. We can't be trusted with our own health choices, apparently. We are silly, emotional, illogical, etc etc. If we find something painful, that's because we are silly, emotional and illogical. If we have the temerity to complain, that's because we are silly, emotional and illogical.

And it's not just (some) male medics etc who have this mindset, it is lots of women too. Many women doctors, many women nurses, many midwives (the great majority of whom are women.) The attitude must be ingrained in the training they receive. And because they have been trained like that, and their predecessors have, there are way too many people in the health professions generally who don't see a problem.

I got summonsed for a mammogram the other day. Yes, the phrase in the letter is "mild discomfort." I know they have a value. I also know that a percentage of women tested end up going through a lot of invasive and painful procedures and treatments as a result and find out later that the abnormality detected wasn't malignant and would have caused no harm. (The leaflet does mention this, to be fair.)

I won't be accepting the invitation. If they can't be genuinely and consistently honest, then I just don't trust them enough. Life's hard enough right now without some patronizing so-and-so poking me about and talking to me as if I am 3 years old.

[JellySlice]

Trouble is, if you are told something will be painful you are more likely to experience greater pain. So there is some benefit to warning women that a procedure may be 'uncomfortable', rather than warning them it may be 'painful'.

What I would rather hear is whenever an HCP says "This may be a bit uncomfortable" they should immediately follow up with "If you find it too uncomfortable, tell us. We will stop and give you pain relief."

If I'm at the dentist and I tell them I'm in pain, the dentist doesn't tell me to relax or force me to just get on with it. They don't belittle or ignore my pain. No, they stop the procedure and give me more pain relief. And they wait until it has taken effect before continuing. Why don't gynaecological procedures merit the same attitude?

[olivethegreat]

I'd rather be told some people find it painful tbh. I've had more mammograms than smears and don't mind them at all or have anything like pain but anything involving my cervix will in future be done under GA! We obviously all have very different sensitivities in different areas so it is not ok to be told that most women find something ok, because those women do not have my body so that info is irrelevant to me.