If you’ve had an intrauterine device (IUD) in the past, you’re probably not looking forward to having it replaced. After all, the procedure has been described on social media as “brutal” and “the worst physical pain I’ve ever felt,” among other things. “My female OB literally told me ‘just a pinch.’ I’m still angry,” one woman wrote on X, formerly known as Twitter.
But women are speaking up about the pain associated with IUD insertion, and many are calling for pain relief options to at least be offered before you undergo an IUD insertion. Some companies are listening.
Women’s health company ASPIVIX recently teamed up with Bayer Switzerland to launch a product called Carevix. This is a cervical stabilizer that’s designed to minimize pain and bleeding during transcervical procedures, which includes having your IUD placed or replaced.
Carevix uses suction to secure the cervix during procedures like IUD insertion verses the traditional tenaculum, which is a surgical instrument that resembles a pair of scissors with sharp-pointed hooks at the end, ASPIVIX explains. Preliminary research from the ADVANCE Women Study found that there was a “significant reduction” in pain and bleeding during IUD insertions with Carevix compared to using the tenaculum, according to a company press release.
Unfortunately, the healthcare system is notorious for ignoring or minimizing women’s pain, with several studies finding a gender bias when it comes to pain relief offered to men verses women. Research has also found that many women with chronic pain say that they’re less likely to be believed and have their pain be untreated than men.
Some organizations are wising up to pain management around IUD insertion and replacement. For example, select Planned Parenthood locations in the U.S. now offer sedation to patients during IUD insertions and removals. But IUD insertion, removal, and replacement is usually done in a doctor’s office, where anesthesia typically isn’t an option. Still, doctors have a few recommendations on what you can do to ease the pain.
One is to ask your doctor to inject xylocaine, a local anesthetic, into the cervix. This isn’t a perfect solution, though. “Unfortunately, placing xylocaine in the cervix to help in and of itself can be uncomfortable,” says Mary Jane Minkin, M.D., a clinical professor of obstetrics and gynecology and reproductive sciences at Yale School of Medicine. “Just grasping the cervix to hold it in place can cause cramps.”
Many experts will recommend getting the IUD inserted during ovulation, when the cervix is potentially more open than at other times during the month, making it easier to insert the IUD, says women’s health expert Jennifer Wider, M.D., co-host of the Open Wider podcast. “Taking an NSAID [like ibuprofen] 40 minutes to an hour before the procedure can help reduce pain and cramping,” Wider says.
Of course, ovulation can be hard to predict for women in perimenopause who may be experiencing irregular cycles.
Some providers will also use a transcutaneous electrical nerve stimulation (TENS) unit, which is a small device that delivers an electrical current at or near your nerves to block or change your perception of pain, Minkin says.
But Minkin points out that replacing an IUD can be painful, too. “Some practitioners suggest doing the change of the IUD with a period, as the cervix is a bit more open then,” she says.
If you’re worried about pain during your IUD placement or replacement, talk to your doctor or their care team in advance. They should be able to offer up some personalized advice to help.