If you ask a random group of women on the street, chances are that they will all know a story of a sister or girlfriend who would describe the placing of the hormone or copper spiral as painful or even terribly terrible. Anecdotes are over, but how intense that pain is really, and for what percentage of spiral users actually applies, surprisingly, there was no real answer to that. Until this week.
Ava,a client organization for contraception and abortion,therefore left it to research By research agency Ipsos I&O. Half of all spiral users, according to that research, experienced “serious to unbearable pain” when placing. Four in ten women also suffered from nausea or dizziness during placement. Almost one in ten fainted.There was no difference between the copper and hormone spiral. It also didn’t matter whether the spiral was placed by the doctor or the gynecologist.
Fear of removing
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around 2,800 women participated in the study,just under 600 of them had a hormone or copper spiral installed in the last five years. The respondents with a spiral were asked to give their experienced pain a score of 0 (no pain) to (10 the worst pain that someone can imagine). Only 4 percent of women were not bothered at all when placing. Even in the first hours after placement, a third of the women had serious pain. One in five women also had such severe pain when removing the spiral, some five to eight years later. Moreover, almost one in ten women postponing the removal of the spiral, for fear. If you wait too long, the spiral will no longer protect against pregnancy.
“There have been worries about the falling number of women who use birth control for years,” says Alina chakh, chairman of AVA. “Then it is also crucial to look at the thresholds to use contraception.The spiral is potentially a suitable contraceptive for many women, but the fear of pain keeps three out of ten women from taking a spiral, shows our research. It limits them in the freedom of choice for contraception. ”
According to Chakh, the results of the research stand for something bigger than just that spiral: the conversation about pain relief in all kinds of gynecological interventions is not sufficiently conducted. “It symbolizes how we look at women’s pain. At the dentist you can just get anesthesia if you want, with gynecological procedures that is suddenly intricate. We seem to think that the benefits of contraception always outweigh the disadvantages.The protection against pregnancy is always worth the pain, it is part of it. The fact that there was hardly any research on the pain experience of the spiral confirms that image. “
In April of last year published de Volkskrant An opinion piece Van Ava, in which the writers argued for more and better pain relief while placing the spiral. A local anesthesia with a puncture, such as, or a narcotic gel or spray. According to the current guidelines, doctors can advise to take paracetamol or ibuprofen in advance. This also happens in many cases, according to this study, but AVA wants women to be able to claim other forms of pain relief than now that is currently the case. The Dutch GPs Genootschap (NHG) said it would again study the guidelines last year, but has not yet made a decision.
Doubts about anesthetize
Gynecologist and professor Annemiek NAP of the Radboudumc does not recognize the high pain scores from her own practise. “That does not alter the fact that you should always take experienced pain as a doctor seriously.” If women want that, Nap says, they can get a intoxication with her. “Then the sedation specialist must be used, and a new appointment must be made, but it is possible.”
She has her doubts about the local anesthesia. “You can give someone four punctures, but I estimate that more painful than putting a spiral.” Nap suspects that narcotic gels and sprays will not remedy the real painFor many women, the process of placing an intrauterine device (IUD) can be a daunting and painful experience. A recent study highlights that nearly half of women report severe pain during the procedure,raising questions about the adequacy of current pain management practices.
“The most painful moment of placing is pulling the peritoneum,” explains one expert.“But with a spray, you don’t reach that peritoneum—it only numbs the cervix. So I wonder if that helps.” This observation underscores the limitations of localized anesthesia in addressing the full scope of discomfort experienced during IUD insertion.
Astrid Masters, a pain psychologist and assistant professor at the Open University, emphasizes the subjective nature of pain. “pain is pre-eminently a subjective experience, on which many factors influence,” she says. “What stories do you know from your area? Have you had earlier nasty gynecological experiences? But also: how much control do you experience about the situation?”
The act of installing a spiral—lying in a gynecological chair with legs wide apart, unable to see or predict what’s happening—can amplify feelings of vulnerability. “By being offered at least the option of anesthesia, you have a choice,” masters notes. “That can benefit the fear of pain, or the actual pain experience.”
Masters also stresses the long-term implications of a negative experience.“A nasty experience in placing or removing the spiral can make gynecological treatments extra exciting in the future,” she warns. “Fear of pain can enhance the actual pain.”
Key Factors Influencing Pain During IUD insertion
| Factor | Impact |
|—————————|—————————————————————————|
| Anesthesia Options | Offering pain relief can reduce fear and perceived pain. |
| Previous Experiences | Negative gynecological history can heighten anxiety and pain. |
| Perceived Control | lack of control during the procedure can intensify discomfort. |
| Fear of Pain | Anticipatory anxiety can amplify the actual pain experienced. |
The findings of this study call for a more empathetic and patient-centered approach to gynecological care. By addressing both the physical and psychological aspects of pain, healthcare providers can improve the overall experience for women undergoing IUD placement.
For more insights on this topic, visit the original study here.
Expert Insight: Addressing Pain During IUD Insertion
Editor: Dr. Nap, can you share your outlook on the pain women experience during IUD insertion?
Dr. Annemiek Nap: Certainly. While I haven’t seen extremely high pain scores in my own practice, it’s important to take every woman’s pain seriously. If a patient requests anesthesia, we can arrange for sedation, though it requires scheduling with a sedation specialist. However, I have reservations about local anesthesia. Administering multiple punctures might actually cause more discomfort than the IUD insertion itself. Additionally, numbing sprays or gels may not effectively reach the peritoneum, which is often the most painful part of the procedure.
editor: Astrid,how do psychological factors influence the pain experience during IUD placement?
Astrid Masters: Pain is inherently subjective and shaped by various factors. A woman’s past experiences, notably negative gynecological encounters, can heighten anxiety. The lack of control during the procedure—lying in a gynecological chair with legs apart, unable to see what’s happening—can also intensify discomfort. Offering anesthesia as an option can empower women by giving them a sense of control, which may alleviate both fear and actual pain.
Editor: What long-term effects can a negative IUD experience have on women?
Astrid Masters: A traumatic IUD insertion or removal can make future gynecological treatments more daunting. Fear of pain can create a feedback loop, where anxiety amplifies the perception of pain. This underscores the importance of ensuring a positive experience from the start, both for the patient’s well-being and for thier willingness to seek care in the future.
Editor: What steps can healthcare providers take to improve the IUD insertion experience?
Dr. Annemiek Nap: Open dialog is key. Providers should discuss pain management options upfront and listen to the patient’s concerns. While sedation is an option, it’s not always practical due to scheduling constraints. More research is needed to develop effective and accessible pain relief methods for IUD placement.
Astrid Masters: I agree.Providers should adopt a patient-centered approach, considering both physical and emotional needs.Offering choices, such as the option of anesthesia, can make a significant difference in how women perceive and experience the procedure.
Conclusion
Addressing pain during IUD insertion requires a multifaceted approach that combines effective pain management techniques with empathetic, patient-centered care. By acknowledging the physical and psychological factors that influence pain, healthcare providers can improve the overall experience and outcomes for women seeking IUD contraception.
