The modern IUD has been an option for women for 60 years now.
CDC just updated its 2016 guideline that advises physicians to discuss pain management options. This comes after continued viral TikTok patient stories about IUD insertion pain have garnered increasing attention from the medical community.
For perspective: According to OB/GYN’s Kristyn Brandi and Aliye Runyan, MD, their patients describe the insertion procedure as sometimes feeling like a hot knife stabbing into their pelvis.
As a future male OB/GYN, I will never be able to truly understand the pains my patients endure throughout their reproductive life journey, before and after it.
The patients we see in OB/GYN are incredibly strong, often displaying remarkable pain tolerance. However, I would never ask my patients to simply tough it out, as each patient experiences procedures differently. Pain management, like OB/GYN procedures, requires a great deal of sensitivity and adaptation; it is truly an art form. I am committed to mastering this art, striving to become competent and skilled as quickly as possible, with the goal of minimizing discomfort for my patients. I am determined to make every process as smooth and painless as possible, even for procedures such as pelvic exams or speculum placement, which are often challenging to perform without causing pain or discomfort.
Now, with encouraging new guidelines for IUD placement, this will be more possible for all OBGYNs.
Updated recommendations/acknowledgments from the CDC:
- Lidocaine to numb the cervix
- “A person-centered plan for IUD placement and pain management should be made based on patient preference.”
- When considering patient pain, it is important to recognize that the experience of pain is individualized and might be influenced by previous experiences, including trauma and mental health conditions, such as depression or anxiety.
At a recent AMSA training retreat we discussed the proper methods of anesthesia injection for cervical procedures, something called paracervical blocks. So within just a week of this major practice update, tangible trainings and changes have been made to take better care and management of OB/GYN patients.
As these new guidelines take effect and physicians incorporate patient-centered pain management strategies, we stand on the cusp of significant improvements in OB/GYN care. This shift in focus not only addresses the immediate stigma surrounding pain in reproductive health procedures but also confronts broader systemic prejudices within medicine against women and people of color. It’s crucial that we, as health care providers, recognize pain as a critical component of patient care, not an inconvenience. By treating it with the seriousness it deserves, we move towards a more compassionate and effective medical practice, ensuring all patients receive the dignity and personalized comfort they deserve.
Daniel Chen is a medical student.
