For the first time ever, the CDC is pushing for pain management for IUD insertion procedures

Finally, finally, doctors are starting to take women seriously when we talk about the pain of an IUD insertion. If you’ve had the procedure, you know firsthand. If you haven’t, you’re probably already aware, either from talking to other women who have or from seeing social media videos that have gone viral where women share experiences they describe as “agonizing.” It is downright barbaric that for decades, women have been expected to bear this pain with little to no pain management, while men are given anesthesia and opioids for vasectomies.

But thanks to a groundswell of women speaking out about the issue, federal health officials are finally officially recommending to doctors that they counsel women about pain management for IUD insertions. The updated guidance came from the Centers for Disease Control and Prevention earlier this week.

The CDC guidance offered two major changes in pain management recommendations:

1. That doctors offer lidocaine as a numbing agent (via injection or topical gel) to numb the cervix
2. That Misoprostol is not recommended for routine use for IUD placement, except in certain circumstances (i.e. patients with a recent failed placement).

“Women’s pain and women’s experiences have been downplayed throughout medicine,” Dr. Beverly Gray, an associate professor of obstetrics and gynecology at Duke University, told the New York Times. “This is really validating that for some people, this can be a really painful experience.”

After the fall of Roe v. Wade, the number of women seeking out reliable, long-term contraception like IUDs has risen. But so too have calls for doctors to stop dismissing the pain that many women experience during the insertion procedure. It’s been described by some women as “the worst pain imaginable” and compared to a “hot knife” slowly stabbing them throughout the process.

What’s worse is that effective pain management strategies absolutely exist, but studies show that doctors simply rarely offer them to their patients. A 2019 survey showed that less than 5% of doctors offered an injection of local anesthesia, instead telling their patients to use over-the-counter pain medications. One study of 200 women found that while most women said the pain was about a 65 on a scale of 100, most physicians ranked it as a 35.

“I think it is a significant change,” Dr. Eve Espey, chair of the obstetrics and gynecology department at the University of New Mexico, said about the new CDC guidance for doctors. She added that anxiety about pain may have dissuaded women from seeking IUDs, which are a safe and highly effective form of birth control. “The guidance on this topic has gone from a more provider-centered focus to a more patient-centered focus.”