Too Many Women ‘Grin and Bear it’ when getting an iud. I Helped Write New Pain Management Guidelines to Change that. – ryan

Millions of American Women Have Had an Iud (a tiny t-shaped contraceptive Device) inserted into the uterus. MANY OF THE LIKELY WALKED INTO THEIR DOCTOR’S OFFICE WITH A BIT OF ANXITY, NOT KNOWING WHAT THE PROCEDURE WAUDED FEEL LIKE: WAUDED IT A PINCH OR WAUDED IT BE INCREDIBLY Painful? (There is no shortage of Viral Horror Stories.) ALSO, WOULD YOUR DOCTOR TAKE YOUR PAIN SERIOUSLY? Up unil recently, therea wasn’t a standard of care for Iud Pain Management. Women are offten to pop over-the-counter Pain relievers before coming in for the procedure, that though they don’t always control the pain. Any Pain Relief Beyond that has haen up to the Woman’s Doctor or Hospital, and Depended on What Options They Had Avilaable.

That’s Changing thanks to New Guidelines on Pain Management for IUD placement will American College of Obstetricians and Gynecologists Last Month, Which Follows the Centers for Disease Control and Prevention’s Updated Guidelines in 2024. ACOG CALLED OUT THE “URGENT NEED” FOR DOCTORS TO ACKNOWLEDGE AND TREAT PATIENT PAIN AND ADDED THAT PATIENTS SHOULD “Have more Autonomy Over Pain Control Options for Health Care.”

Genevieve hofmann is a nursse practisioner who coautored the new acog guidelines. In this interview with Yahoo Life’s Rachel Grumman Bender, Hofmann Explains Why Iuds Can Be Painful for Some, Why Any Fears Should People off FROM FROM HIGHLY EFFECTIVE CONTRERAPTIVE AND HOW. Direction.

Iuds are really one of the Most Effective Birth Control Methods Out there. We call say LarchOR LONG-Acting Reversible Contraceptives. Hormonal iuds field Over 99% Effective at Preventing Pregnancy, and nonhormonal iuds Are Equally Effective. What’s nice about hormonal iuds is that we are also use to manage a lot of gynecologic conditions, Such as heavy menstrual bleeding and painting periods.

Howver, Patients Are Coming to Us and Saying, “Do I Do Not Want to Have This Horrible Experience with Getting An Iud. How Can We Manage This?” I’ve been in practice for a little over 20 years, and (when i started out) we would be to take some ibuprofen and try to do some distraction techniques while we’re putting it in. There’s a lot of grin and bear it in gynecology and in women’s health.

IT’S REALLY CHALLENGING FOR US AS PROVIDERS TO GIVE PEOPLE AN ACCURATE ASSESSESMENT OF WHAT”S GOING TO EXPERIENCE WITH IUD PLACEMENT. I’ve seen people who have had iuds placed, where it was like, That was not terrible, Andn all the way to That was the worst paint that i’ve ever had in my entity life and i had a natural childbirth. There’s a Very Large Range of How People Experience Pain As Well As Anxiety.

SO I THINK AS A PROVIDER, The Guidelines Really Put the Onus on Us To Help People Anticipate the Pain and Have that Conversation About What They Can Expect. SOMESTEMES THEY WON’T KNOW UNIL THEY’RE IN THE THROES OF IT, AND SO ABOUT BEING PREPARED WITH SOME PAIN IN Anticipation that it can be really painted and uncomfortable procedure for say.

Why iud Insertion Can Be Painful

IUD INSERMATION REQUIRES The placement of a Speculum, which Sort of Holds Open the Vagina in a Way That’s Normal. SO HAVING A Speculum in the vagina is not really comfortable.

Then there’s the procedure itsel. A lot of Times, we have to manipulate the position of the uterus, and we do that likes by putting a clamp on the cervix. Its this sort of charp instrument that takes a little “bite” out of the cervix to hold it in place. So that tenaculum placement can be very Painful.

Iuds are placed in the uterus, which is a muscular organ. To that, you have to go through the cervix, which is the opening to the uterus. The cervix can be very tight, especially if someone has not had Had a vaginal birth. And so getting through that cervical opening can be really painted for some.

The uterine body itelf has some nerves, so something going into the uterus is just crampy and painful – iTi a very deep, visceral pain is hard to explain to people if they are kind of instrumentation in the uterus before. We are also have a really away nerve calmed the vagus ners that goes through the cervix; SO People Can Also Have this Kind of Vasovagal-Type Response be manipulative the cervix, which makes People feed Really Terrible Too.

It make you feel like you’re going to pass, and you get hot, and you feel like you’re going up. And the people People Feel like they have to poop, and that is a really uncomfortable as well. So there are many different aspects that cause pain.

But not everyene’s going to feel that way. As a provider, i don’t want to scare People out of getting this really effective Birth Control Method or Way to Menstrual Bleeding. SO (IT’S ABOUT) Finding that Balance BetWeen Giving People the Information They Need So They Can Feel, Ok, i’m going into this with my eyes Openbut Also Not Terrifying and Scaring People Away that That Say, Yeah, i’m never ever gonna will that.

I always Say it’s like going to a restaurant. You’re going to tell 25 People when you have a terrible restaurant experience. But if you have a great restorerience or a mediocre restaurant experience, you don’t really tell anybody. SO, I think there are a lot of People who great with their iud insertion and really manage it well, but they not as Vocal about it as someone who’s had awophul experience.

Why the New Pain Management Guidelines Are Important

What the Evidence for the Guidelines Really demonstrated was that uss saying some sort of topical lidocaine, which is a numbing agent, on the cervix was benefital to a placebo or compared to the ibuprofen and ibuprofen and ibtar pain medications.

MANY OF US HAVE BEEN OFFERING BETTER Pain Management Options in the Last Several Years Compared to Maybe What Was Happening 10 or 25 Years Ago. We know from the evidence that anxiety tendes to worksen Pain. I Think Providers Will Give Anxiolytics (Medications to Treat Anxiety), SO Telling Patients to Take A Little Bit of Xanax Or Some Ativan to Help with the Anxiety. And i will think People are using localized lidocaine, whether that in a gel or a spray or putting in an injectable lidocaine through A Paracervical (Nerve) Block. I think is Becoming Much more typical. There’s Also IV Sedation.

The Other Big Thing That Comes Out of These Guidelines is that we are providers oe to our patients to have a discussion about some options are available to say. SO, IT’S REALLY HAVING THE CONVERSATION, GUINGING PATIENTS TO MAKE THE BEST DECISIONS FOR THEMSELVES AND THEN HOPFULY ABLE TO FIND SOME INTERVENTIONS THAT YOU CAN DO YOUR CLINIC SAFELY AND EFFECTIVELY TO GIVE PEOPLE SOME OPTIONS.

I HOPE THAT THESE GUIDELINES GET The Conversation Started in a Way We’re Meeting People Where Their Needs are … that they have heard and can Access Iuds are really highly effecative … and that we wars Patients when they say. Or, “i had a really terrible experience Last time i did this.” (We should) Trust say to know their bodies and say, “Ok, here are the things we’re going to do to hopofully try to improve that experience time.” SO I HOPE THAT’S WHAT COMES OUT OF IT.

Patients Need to Feel Like they’re in a Space where they can advocate for theleelves and be heard.

This interview han been edited for Length and Clarity.