I Have Something to Say

Getting an IUD Doesn’t Have to Hurt

If you struggle with pain and anxiety, as I do, here’s a method you might ask your doctor about.

An IUD with half-closed, drowsy eyes.
Photo illustration by Slate. Photos by Getty Images Plus.

I’ve always hated going to the gynecologist. No offense to gynecologists, of course, but every time I would go, I’d have an incredible amount of anxiety. Because, point No. 2, I have an incredible amount of anxiety all the time. I refuse all medical exams or procedures unless they’re absolutely necessary, out of fear of pain or bad news or even slight discomfort. On top of my clinical diagnosis of “Woman With No Chill,” gynecology exams have a special sort of pain and discomfort attached: Having unmentionable parts of your body pried open to accommodate a device is, for me, horrifying.

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So obviously, for a very long time, I never thought I’d get an IUD.

On top of the regular OB-GYN visit anxiety, the process of getting one has always sounded discomforting and painful—to put it very, very lightly. Over the years, friends have regaled me with stories of passing out in the exam room after the insertion, which involves expanding your cervix to stick a little metal-and-plastic thing up in your uterus. One friend said she tried to drive home afterward but was instead debilitated in her car, doubled over. I heard of extreme amounts of bleeding, of contraction-like cramps, of the need for prescription-strength painkillers. Writer Casey Johnston once described the pain as “three huge blinding waves” and the “deep biological sense that something in [my] body that should not be messed with is being aggravated.” Why would I ever put myself through any of that?

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Well, it turns out, I now have. Sort of—I have an IUD inside my body, but no idea what the insertion feels like. Because instead of withstanding this notoriously awful process, I went a much smoother route. I was completely, 100 percent unconscious for my procedure.

The thing is: IUDs are quite useful (I like mine, so far!). As I’ve gotten older, my once anemic period has become a one-woman blood drive. Without getting into gruesome details, I’ve spent the last few years writhing in back pain and nausea a few days a month, every month. It’s annoying, expensive, and uncomfortable. I started looking into hormonal birth control to regulate it a bit after I decided I couldn’t take it anymore. But I already take at least five different pills a day, so I wasn’t really eager to add another into my rotation. The doctor said the arm implant, Nexplanon, would mess with my depression. I gave the soft, squishy NuvaRing a go, but found it to be ineffectual for my purposes: It made my period less painful but last twice as long. What I really dreamed of was a way to eliminate my period altogether. My doctor told me that meant I wanted a hormonal IUD, which she said could lead to amenorrhea, meaning a total loss of period. Research shows that roughly 20 percent of those with hormonal IUDs experience amenorrhea within the first 12 months after insertion. Those aren’t perfect odds—but they were incredibly appealing.

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I remained fearful of the pain that was sure to come with having a medical professional lodge something in my body semi-permanently (especially if there was some chance I might still be bleeding monthly). But I recalled that, as I’d polled friends about their IUD experiences, there was one who had wholly positive things to say about the procedure itself: She was sedated for hers. The gynecologist knocked her out just before she got down to business. When my friend woke up, she was out of the surgery room and chilling in a recovery area. It was a totally painless process, she told me.

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I immediately asked the gynecologist if this magical sedation would be an option available to me, too.

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“Sure,” the gyno said, already getting out her calendar to schedule me in. “We can absolutely sedate you.”

That’s all it took—asking if she could do it. So much for so many years of thinking I’d never have this very useful medical device for fear of the pain of getting it installed.

Thankfully, the anesthesia was covered by my insurance, so I didn’t have to pay any extra exorbitant fees for it. I also don’t have a history of bad reactions to anesthesia or any medical issues that might have made it a no-go for me. All the reading I did about IUD procedures with sedation ahead of time gave me further hope; magical as this gynecological cheat code may seem, going under was totally valid. This line, from writer Jamie Peck in a piece for Medium’s Elemental blog about her own experience really resonated with me: “Why is IV sedation so common for commensurately invasive procedures—wisdom tooth extraction, for example—but basically unheard of for IUD insertions?” It’s a meaty, frustrating question. Peck describes having a hard time finding an OB-GYN who would do it. She notes that some may be hesitant because of the risk inherent in being sedated for any procedure—but also, that women should be able to assess this risk for themselves and decide if it’s worth it. For this piece, I checked with a source who was not my own doctor or secondhand information from another story. “Sedation is safe as long as your airway is being adequately monitored by the anesthesiologist,” said Courtney Alexis Penn, an OB-GYN in Los Angeles, noting that patients with “difficult anatomy or issues with pain” were candidates for the sedation method of insertion.

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This risk vs. reward calculation made plenty of sense to me—though I have to admit the whole thing still made me nervous going in. As I sat in a chair in the gynecology office’s surgery room, getting poked by needles to shove an IV into me, I felt myself fighting off panic. Was I really doing this? Was I really not going to feel anything? This all seemed fake! I’m already in pain from this dang IV! And then, abruptly and who knows how long later, I woke up in a chair in another room down the hall. I felt comfortable, drowsy, but more well-rested than I have in a long time. I was escorted home by my boyfriend, given a muffin and some painkillers, and spent the rest of the day napping and watching TV. I had some cramps in the hours afterward, but they weren’t any worse than my worst period cramps. And now, just a little bit out, I am mostly fine—my period is still there so far, but lighter, and the pain is manageable.

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I don’t ever think about how my uterus has a new neighbor. I didn’t have to help her move all her crap in. She’s just there, minding her own business, attending to her own yard and collecting her own mail.

Why isn’t everyone shouting about the get-knocked-out method of IUD insertion, all the time? It was simple and quick and even pleasant. Women’s pain is considered to be a necessary evil, but the truth is that it absolutely doesn’t have to be. Sedation is an option. It’s not a well-advertised one, unfortunately, but hey—now you know.

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