When Jess Holmes talked to her GP about getting a routine birth control procedure, she never expected the process to end in excruciating pain.
“It was absolutely the worst pain I’ve ever felt in my life, and it was pretty traumatic,” she said.
“I think the only thing that could ever compete would be childbirth.”
Ms Holmes is one of approximately 130,000 Australian women each year who choose the IUD as their preferred method of contraception.
She is also one of many who feel they were unprepared for the insertion of the device.
The 26-year-old said the medical professional administering the IUD had told her the pain would be minor and would feel like “just a little pinch.”
Instead, Ms. Holmes said she endured hours of severe cramping after being given only acetaminophen for insertion.
“It was a full body ache from head to toe. Every few minutes a whole wave of pain came and all I could do was curl up in the fetal position and wait for it to pass.”
Experts say this is part of a wider problem with treating women’s pain in the Australian health care system.
University of Sydney psychologist and pain specialist Louise Sharpe says there’s a long history of seeing women’s discomfort as an emotional issue rather than an actual physical response.
“Psychoanalysts spoke of women with psychological symptoms labeled as ‘hysteria,’ which actually comes from the Greek word for womb.”
dr. Sharpe says this bias is illustrated by the lack of applied scientific research on pain relief for IUD insertions.
A recent study in the international medical journal Fertility and Sterility found that ibuprofen and acetaminophen — the most popular and often the only form of pain relief offered for IUD insertions — work no better than a placebo.
“There are studies on some of the drugs that help insert an IUD, but more often than not, women don’t get this pain relief,” said Dr. sharpe.
Mild sedation and numbing cream are generally considered the most effective pain prevention methods, but these are often unavailable or very expensive in Australian clinics.
Family and planning NSW medical director Deborah Bateson says that while some women may experience pain during insertion, IUDs are still one of the most desirable and safe options for reliable birth control.
Once placed, IUDs provide about 99 percent protection against pregnancy for up to 10 years.
“Most women tolerate IUD insertion well,” said Professor Bateson.
“There is some evidence that about 15 percent of women who have not had a vaginal delivery will experience severe pain.”
Even a previous delivery did not protect Liz Neist, 31, from significant pain during the insertion and removal of her IUD.
“My GP removed the IUD and, oh my gosh, it was so painful – much more painful than I expected,” Ms Neist said.
“I got the vibe from my doctor that it was uncomfortable for her, like I’d crossed the line by expressing my discomfort.
“This made things very uncomfortable… it felt like I had done something wrong by saying I was in pain.”
Brydee Pickup – a University of Sydney PhD candidate who studies women’s experiences with endometriosis – says these kinds of responses from health care professionals are disappointingly common.
“I’ve heard a lot of stories about disability,” said Ms. Pickup.
“Women’s pain is often dismissed as just, ‘Oh, that’s normal women’s pain. It’s not that bad. Just take some Nurofen and you’ll be fine’.”
However, patients who have gone through the procedure say they want to improve things for women who opt for IUDs in the future.
“Therefore [the uterus] being more of an external organ that you have access to to put something in doesn’t mean it’s less painful than any of your other organs,” Ms Holmes said.
“If you get a stent or a pacemaker, would you send someone home with a Panadol? I don’t think you would.
“There should be a good pain management plan for IUDs and women should be warned about what to expect.”
Professor Bateson says that while there is still progress to be made, autonomy and choices about contraception are improving.
The newer, low-hormone IUDs are smaller than their predecessors, making insertion more comfortable.
“The most important thing is to discuss with your healthcare provider what will happen and what pain relief is available,” said Professor Bateson.
“It’s all about a complete understanding so you can make an informed decision.”
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