Considered without risk of pain and complications, the installation of an IUD is nothing trivial. For some women, the intervention had everything of a nightmare.Image: Imago, montage watson
The installation of a IUD is officially considered to be not very restrictive. However, some women evoke strong pain, discomfort, even losses of knowledge. Where are the gaps?
26.08.2025, 05:3526.08.2025, 05:35
Diana Sonja TOBLER / CH Media
Priska’s mother hands him a crescent and cold tea to comfort her daughter. “I’m a little nervous,” she says, just before starting the procedures and going through the reception, the toilets, then the waiting room.
A choice of contraception that scares a little
Priska is 17 years old, she has been in a relationship for a few months and was looking for a reliable means of contraception. His choice fell on a hormonal IUD. This small plastic rod in the shape of a T diffuse proggestatives preventing ovulation for three to five years.
With a 0.2 PEARL index, this method is one of the safest (the Pearl index is a statistical tool that measures the effectiveness of a contraceptive method). Over 1000 women using this contraception for a year, only two fall pregnant on average. By way of comparison, the vasectomy displays an index of 0.1, and the condom varies from 3 to 15 depending on the use.
Condoms, pill, patch or IUD? There are a multitude of contraception.Image: Keystone
A very reassuring notice
On paper, the decision seems simple. Any young woman who does not wish to get pregnant in the coming years could logically opt for an IUD. However, there are brakes, especially linked to insertion itself.
The intervention consists in fixing the cervix using a pliers, measuring the uterine cavity with a probe, then in introducing the device. The instructions for a widespread model simply indicates:
“You could feel a feeling, but it is generally not painful”
A IUD is placed here in a model uterus using the inserter.Image: Alamy
Testimonies that worry
However, on the Internet as in personal testimonies, circulating differently more alarming stories. Many women talk about acute pain, nausea, even fainting. Jasmin, was offered a saline infusion without anesthetic effect, supposed only to reassure it. In vain. Aline, meanwhile, says:
“It’s done, but I would never do it again. The pain was unbearable “
Julia has lost consciousness during the installation and endured intense pain. Today mother of two children, she compares pain to that of childbirth, shorter, but without the comfort of a baby in her arms. A sentence often comes back, like an echo to the instructions:
“I was told it wouldn’t hurt”
This is also what Priska says. His gynecologist, Dan Rauch, plans to use a local anesthetic spray. Priska is tense, but confident. The doctor calls him in the examination room to explain the procedure to him one last time.
A big gap between theory and practice
In the information protocol of the Swiss Society of Gynecology and Obstetrics, it is indicated that the intervention does not generally require anesthesia. The joint recommendations for German, Austrian and Swiss gynecology companies, published in December 2023, go in the same direction. It is written:
“Neither local anesthesia nor non-steroidal anti-inflammatory drugs (such as ibuprofen) are necessary to alleviate pain.”
A notable discrepancy with the testimonies of patients. Several gynecologists interviewed report a completely different approach. In Lucerne, the doctress Ingrid Schneider administers ibuprofen and misoprostol upstream. The latter is also used in medical interruptions of pregnancy, as it softens the cervix. Schneider admits:
“It is more to reassure the patient than by real conviction of efficiency”
In women with endometriosis, where pelvic pain is frequent, it practices a cervical block with two anesthetic injections.
In Lucerne also, Doctor Jörg Klatt insists on the principle of humanity. According to him, even a placebo effect deserves consideration if it can alleviate suffering.
As for Doctor Thomas Eggimann, secretary general of the Swiss Society of Gynecology and Obstetrics (SGGG) and deputy chief at the Gynecological Clinic of Emmental Hospital, he explains that his 30 -year experience led him to favor detailed explanations and the verbalization of each gesture to “take” the patient with him. It only exceptionally uses anesthesia or the cervical block.
Switzerland late on the United States?
In Switzerland, official directives therefore do not reflect real practice. In the United States, this inconsistency has been corrected in the summer of 2024. Since last August, it is recommended to develop an analgesic plan for each patient, and which may include local anesthesia or a cervical block. The American guidelines also insist that the perception of pain is highly individual. Is Switzerland late?
For doctor Stephanie Verta, former service of service at the gynecological clinic of the cantonal hospital in Lucerne, and specialized in the management of women suffering from endometriosis, the answer is clear:
“The United States is often a little ahead of medical knowledge. Switzerland follows a few years later. We are a bit old school. ”
But why do we persist in considering that a gesture that can cause discomfort does not require analgic treatment? For Stephanie Verta, the answer is neurological:
“Nausea, dizziness, losses of knowledge can be explained by the stimulated area. Some nerves react very strongly to contact ”
According to her, another problem lies in the way in which women’s pain is often minimized. She says:
“We can speak here of” Medical Gaslighting “. We make women believe that their feelings are exaggerated or wrong. This is also due to the fact that we give less credit to female complaints concerning pain. ”
Better inform to better protect
For Verta, the challenge is also to ensure better access to the IUD, which remains an excellent way of contraception:
“Here we have an effective method. It must be offered so that women want to use it ”
The first step is to inform clearly about the possible pain, without minimizing them or dramatizing them. As with Priska, who had been warned, who received an anesthetic spray and felt sufficiently confident.
Priska finally comes out of the medical office:
“The pliers really pinched, it was very unpleasant for three seconds,” she says, “but I thought it would be worse.”
Translated from German by Joel Espi
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