The intrauterine system (IUD), more commonly known as “IUD”, is a contraception in the form of “t” placed by a doctor in the cavity of the uterus. If it does not protect sexually transmitted infections, it can be effective over a long time to prevent ovulation. However, the American online magazine Vox reports that, for a few years, many women have complained of feeling strong pain during installation, while the latter has long been considered an painless operation.
Research prior to 2016 reveal that patients described at the time the installation of the device as causing a “Minimal discomfort” or “uncomfortable” And ranked it fourth on a pain scale from one to ten. However, the testimonies of women who suffered during this operation are numerous on social networks, some even thinking that their doctors lied to them.
These viral videos have helped to highlight the real sufferings that patients can feel during the installation of a IUD. During 2024, the centers for the control and prevention of diseases (CDC) and the American College of Obstetricians and Gynecologists (ACOG) therefore published updated recommendations for the management of pain during this operation. These two organizations now recommend clinicians to offer local anesthetics such as the Lidocaine spray, the Lidocaine-Prilocaine cream and the paracevical block. Other professionals recommend anxiolytics or general anesthesia.
In the United States, more than 6 million people already use intrauterine devices as a means of contraception. The recent evolution of standards therefore shows that doctors only begin to consider patients as experts in their own body and take their concerns seriously.
A slow evolution
IUDs have been a method of contraception with prolonged action that has gained popularity since the late 1990s, especially among women aged 25 to 34. There are two types: copper IUDs and hormonal IUDs, both prevent the sperm from fertilizing the eggs. The attraction for IUDs lies in part in their effectiveness over time: from three to ten years, depending on the type. No maintenance or renewal of order is necessary. Some users also note a decrease in cramps and bleeding during the rules, as well as a decrease in endometrial pain, while others note a complete disappearance of the rules.
Eve Espey, professor and director of the Department of Obstetrics and Gynecology at the University of New Mexico, posed countless IUDs during his thirty-seven years of career. She says that for a long time, she explained the risks and advantages to her patients and answered all their questions, but did not necessarily insist on the risk of pain, so as not to frighten them. “We were the principle that if a patient came for a IUD, it was because she wantedretrace-t-elle. It is not that we did not mention the pain, but it was a bit difficult, because some writings say that if we announce to patients that something will hurt them, the pain will be more intense, which is true. “
For a long time, the intrauterine system was only recommended to people who have already given birth: a 2012 study revealed that 60% of care providers rarely offered IUDs to patients who have never given birth. “At the time, we reserved the DIUs for women who have already had childrencontinues Eve Espey. We feared that the installation is too difficult and painful for others because in average, women who have given birth by low way feel much less pain during the laying of the IUD than those who did not have or who had only cesareans. “
However, even though more and more women who have never given birth then started to use the IUD, the perception of moderate discomfort persisted. This is explained by the fact that health professionals often believed that the pain felt by their patients was significantly lower than that which they really felt. The developments of ACOG and CDCs remain, however, only recommendations, whose respect by doctors is entirely voluntary …
