Why don't they offer anaesthetic for coil fitting on the NHS?

[OneBluntZebra]

I had a coil fitted a few years ago (since taken out) and it was incredibly painful. My sister had one fitted privately and they gave her anaesthetic. Why don't they do that on the NHS? I have to have another one fitted soon and I am dreading it.

This. Dressed up as a cost issue, probably, but this is the real reason. If it were men suffering, it would be deemed value for money and a complete no-brainer. It would be standard.

I've had two fitted on the NHS and was given a numbing spray both times. It only numbs the cervix though. If in doubt ask if it's available before they start the procedure.

I've had 3 done the last 1 was painful as it was a 10 year coil so a bit bigger but due to the size I had to have a cervical stretcher used that opened my cervix a bit more than the usual clamp . It was done by a male doctor but he was great and told me that if I felt pain that was too much he had a numbing spray he could use to help me and to just tell him so it's definitely available. To be fair to him he asked frequently if I was ok and tell gim the second that i wasnt . First 2 fitted be a female doctor and she offered nothing to help nor did she ask if I was ok at any point.

Totally agree.

I had mine fitted at the hospital by a very experienced gynecology consultant and it was painless.

Felt like a smear test.

I had a copper coil fitted privately and was offered either the spray, numbing injection or gas and air. The gynaecologist fitting it said pain relief is supposed to be offered with NHS fittings but due to cost/ time/ training its often not and no mention of it is ever given. It's one of the main reasons she went private was because of women's pain and consent been ignored. You have the right to ask for pain relief for fitting of coils, smears or any internal exam. However you usually have to be referred to either the hospital or gum clinic (depending on area) where the staff are trained with anesthetic.

At our local GP the family planning nurse does them as well as the smears. She is brilliant but she is very very experienced and very good at using different positions to maximise comfort. So when she does them they are a little uncomfortable but not painful. During COVID I had to go to the GUM clinic and it was the most painful smear and coil I've ever had. The nurse wouldn't listen to the fact I have a tilt and so usually I have to put my fists under my back for a better angle. She was just ramming the speculum in there as hard as possible and got very impatient. I'm not the only woman in my area that had issues with the nurses at the Gum clinic. I refused to go back after COVID and paid for a private fitting until the service pre-covid offerded at my GP resumed last August.

I've always had an NHS GA for mine as I find them excruciating painful when the GP attempted it I fainted with pain and I've had kids without epidural.

There are a lot of uncomfortable procedures it's on a par with, like a colonoscopy and dental work.

There are also sedation options between nothing and a general, and pain killer/anxiety/muscle relaxant options - that'd probably make a better campaign.

If it can be done without the risks and costs of a general anaesthetic then it should be, if women have a reason for further sedation, then it should be offered but not routinely.

Exactly the same with me - have had x 2 fitted & 1 removed and just felt a bit of pinching but a few seconds

I'm on my 4th Mirena. Each fitting was hideous, but I survived and I feel the effects of the Mirena are worth the distress of the insertion. The only thing I have found that helps (apart from skilled and sympathetic practitioners casting out the procedure) is Diazepam. Mirena no 2 was the worst and I went into shock. For no3 I was given 10 or 15mg Diazepam. I don't remember much of the procedure and had to phone dh to come and take me home because I was stoned. For no4 I was given only 5mg, but it was still enough for me to relax a bit and for the procedure to be blurry in my recollection. Also, I was able to get myself home afterwards with no problem, just went to bed at home and had a lovely afternoon nap. I remember the procedures being painful and distressing, but the Diazepam reduces the severity and the detail of those memories.

I wish Entonox was available for this procedure.

It must depend on the NHS Trust as we offer it in the clinic where I work.

We offer anaesthetic gel, anaesthetic spray, cervical block and gas and air or all of them if that's what you want!

Mine was worse than labour, and I had no pain relief with DS2.
The actual coil going in wasn’t the most painful part, it was when they were poking around measuring my uterus from inside 🤮

Also dare I say it the more experienced the fitter the better the experience is. Fitters only have to fit a certain amount per year to remain competent and GP's are generally at the low end for eg 20 per year whereas in a gynae or sexual clinic it's 10/20/30 per week.

Bloody hell.
This is pretty horrific reading.
I shall report back if I'm not passed out or hospitalised later.
For clarity - no information given just abstinence from sex for 21 days. Pain relief paracetamol suggested when I asked reception.

I've had two mirena coils put in on the NHS with local anaesthetic. I've had 2 vaginal births but that didn't seem to be a consideration.

A friend who has never had a baby had a mirena inserted with no anaesthetic, and said it was only a little bit sore, so I think everyone is different.

I've had 4
My last one was the least painful but I went faint after fitting. I do always book with the "awkward complex patient clinic" which probably has another name but they know what I mean!

They offer anaesthetic into the cervix, local anaesthetic gel and the fitters are really good

I have had 4, never worse than a sharp pinch. I think the skill of the doctor is absolutely vital. And of course anesthesisa should be offered. I certainly didn't need it but it doesn't mean other women don't. I held my daughters hand whilst she had hers fitted. The doctor was brilliant, said she would stop if she felt pain, could come back and have anesthesia if needed. She was fine and got through it without any further intervention needed. Pain relief should be offered as standard. I declined as for me it would have just prolonged the experience

I fit coils- analgesia is hard with coil fittings and the evidence is mixed. I offer and use the xylocaine numbing spray on the cervix and make it clear during the pre consultation that this is what we have available and if patients want a cervical block or occasionally a GA there are over services that offer this and signpost them (usually a long wait though...)
The numbing spray and injection (cervical block) only numb the cervix not the whole uterus. It does help with the pinching pain of the clamp but the more painful part for most women is the sound (where the womb is measured) and when the coil is actually inserted. Honestly aside from a GA there is v little you can do to mitigate this pain- some clinicians insert lidocaine gel into the womb but there is no evidence for this and some people say it is more painful than nothing.
A calm, skilled (quick!) fitter is key- and a fully informed and counselled patient also v important. I am honest with patients- it does hurt for some people. But generally it's a short procedure and 99% of my patients are absolutely fine.

I have hyper mobility and have walked on broken bones for several days. I went for gynaecology referral whilst still wearing moon boot - they tried to fit coil I passed out - the consultant has said I will need general if I try it again. It is a different type of pain

I had one fitted last week, it was painful but quick

I didnt know you have to abstain from sex for 21 days though ! No one told me this and it wasn't in the leaflet 😳 I

I've had three fitted under general anaesthetic. You have to push for a hospital referral to gynae. First two consultants accepted I needed the GA without any question. The third tried to persuade me that I didn't need it. I pushed and he agreed.

My reason was that my first ever coil was fitted by a private consultant ( under my health insurance plan ) who told me he would never attempt to fit a coil on a woman who has never given birth without a GA.

Each time I've had one fitted the doctor has told me after that there were issues getting it in.

Sorry that should say I've had three fitted by the NHS - the first was in a private hospital.

The lady on BBC breakfast (Naga Munchatty) spoke about her rather painful experience and how she had been told to "take a couple of paracetamol" before hand!

Yes several text messages about this!

My reason was that my first ever coil was fitted by a private consultant ( under my health insurance plan ) who told me he would never attempt to fit a coil on a woman who has never given birth without a GA.

Concerning. No vaginal deliveries here.

Positive story for my copper coil fitting but I put that down to the GP who fitted it. Similar to a smear test and I don't have a problem with those. I have had vaginal births though so maybe it makes a difference as my sister has no children and she found it extremely uncomfortable and was in pain for days after.
I was not told about abstinence for 21 days though. 🤔 didn't even read that on Dr Google at the time.