IUD Insertion—What Is It Really Like?: A Guide for Black Women
“The sensation of IUD insertion is similar to menstrual cramps.”
But is that truly accurate?
Intrauterine devices (IUDs) are small t-shaped devices inserted into the uterus that can provide effective birth control for several years, they require no daily maintenance, and they are reversible, but the five-minute, excruciating experience leaves many women questioning whether it’s worth it.
IUDs are often recommended as the most effective birth control; the Mirena IUD, for example, is over 99% effective at preventing pregnancy for up to eight years. In the case of Uterine Care Collaborative founder Kayla Nixon, M.Ed., it was recommended as the most effective preventative measure against uterine cancer recurrence. “In my personal experience, IUD insertion is the single most painful thing I’ve ever had done to my body—annual biopsies a close second,” she shares. Even with an outstanding and thorough gynecologist, nothing could have prepared her for the pain of getting one inserted and the feeling of having no alternative.
For Black women, navigating the healthcare system, and really any system, comes with its own set of concerns and risks, and our experiences are often marked by lack of information and lack of support, leaving us to piece together the puzzle as best we can. The reality is, many women are not fully prepared for what this procedure entails, and that lack of preparation can make an already difficult experience even harder.
What Does IUD Insertion Feel Like?
Let’s be forreal—getting an IUD inserted is incredibly painful.
That is what physicians should be saying to patients at the time of recommendation.
The procedure involves a medical professional opening the cervix, a part of the reproductive system that is naturally sensitive and can be easily bruised. The cervix is also approximately 4 cm in length and 3 cm in diameter—not very big.
Knowing this about the female anatomy, the process of IUD insertion is literally trying to fit a square peg in a round hole, as the device is T-shaped. Even with a high tolerance for pain, many women find it to be an intense sharpness that radiates through the body.
For Black women, this pain can be exacerbated by systemic issues in healthcare, where our pain is often overlooked or dismissed. The National Institutes of Health found that healthcare providers were less likely to identify pain in the facial expressions of Black faces than on the countenances of non-Black ones.
Studies also showed that Black women report lower levels of satisfaction with their healthcare experiences compared to white women, citing feelings of disrespect and mistreatment.
Even for a routine procedure such as IUD insertion, it would be helpful to feel seen and heard by medical providers, starting with a proper and thorough description of the process that allows women to better prepare physically and mentally for the experience.
How You Can Prepare for IUD Insertion
Having had several biopsies as a part of her ongoing treatment plan for uterine cancer, Kayla made helpful discoveries for getting through gynecologic procedures, not just in the doctor’s office, but for navigating the rest of the day afterward. “From my personal experience, I learned a few steps of preparation I could do to handle the procedure,” she reflects. “The things I share are always what I wish someone would have told me when I first began navigating uterine issues.”
While you can’t avoid all the pain, here are some steps you can take to make the process more manageable:
1. Wear breathable clothing: “Any visit to the gynecologist, especially for a procedure, is the time to dress like Adam Sandler,” Kayla says. Comfortable, breathable clothes can help reduce discomfort after the procedure.
2. Take pain medication beforehand: Taking ibuprofen or other pain relievers an hour before the procedure can help minimize the intensity of the cramps you’ll experience.
3. Use heating pads: After the insertion, applying heat to your abdomen can ease the pain and help relax the muscles. Kayla’s favorite are the Rael for Menstrual Cramps Heating Patch. In her early days, a homemade heating pad was just as effective—try filling a sock with rice, dampening it, and microwaving it for no more than three minutes. Place it on your abdomen for about thirty minutes at a time.
4. Pack a bag: We know—it’s just a five-minute procedure. It can be helpful to take practical items with you and comfort items. Pack a small bag with your pain relievers, heating pads, and pads for bleeding or spotting after the procedure. Consider a water bottle for hydration, snacks for comfort, and a book or magazine to read while you wait.
5. Consider THC or CBD: For those who find comfort in using THC or CBD products, these can be helpful in managing both the pain and anxiety surrounding the procedure. Research indicates that as many as 24-40% of cancer patients in the U.S. use cannabis, and according to the National Academy of Sciences, Engineering and Medicine Report on Health Effects of Cannabis and Cannabinoids, there is conclusive evidence that cannabis is effective for chronic pain in adults. Make sure to check in with your healthcare provider about the safety of using these substances before or after the procedure.
6. Bring support: If you can, bring a trusted friend or family member with you to the appointment. Emotional support can go a long way in helping you feel more comfortable. In the absence of familial support, Kayla’s nurse willingly held her hand during the procedure.
7. Rest and hydrate: Plan to take it easy for the rest of the day after your appointment, as you may experience cramping or discomfort. Drink plenty of water to help your body recover.
What Medical Providers Can Do Better
Engineering the device in a different shape would help immensely right?
We can hope for that over time, but it isn’t the most immediate solution. Here’s what we can ask for from medical providers:
Acknowledge the pain: Be up front about what patients are about to experience. Realistically, validating patients' concerns and fears at all points during a consultation or procedure should be a part of training for healthcare providers. Even if a procedure is necessary, the slightest offering of empathy or compassion can make it tolerable from a mental and emotional perspective.
Provide comprehensive pain management options: Doctors often recommend taking painkillers beforehand, but this may not be enough for some patients. Are additional options like local anesthetics, muscle relaxants, or even anti-anxiety medications an option to help ease the pain and anxiety? Patients don’t have the answer to this question, but it is worth a consideration from the healthcare system.
Explain the procedure thoroughly: Understanding what’s going to happen step-by-step can help reduce some of the anxiety associated with the unknown. Providers should walk patients through the procedure and the sensations they might feel during each part.
Questions to Ask Your Provider Before IUD Insertion
What type of IUD would you recommend for my body?
Can I take a pain reliever or anti-anxiety medication beforehand?
What should I expect during the insertion in terms of pain and discomfort?
Can a local anesthetic be used to reduce the pain?
What should I expect in terms of recovery afterward?
How can I manage cramping or discomfort after the procedure?
What are the risks associated with the procedure for someone with my health history?
The Power of Self-Advocacy
At the end of the day, the most important thing Black women can do in healthcare is advocate for ourselves. Don’t be afraid to ask questions, demand better treatment and pain management, or explore alternative options if you feel like IUD insertion (or any procedure) may not be the right fit for you. We deserve to have our pain taken seriously and to be equipped with information that helps us make the best choices for our health.
