A few weeks ago, I got my third IUD.
You’d think I would have been prepared. I am one of the many women who girded her loins against the possibility of a “Handmaid’s Tale”-style dystopian future by getting my first IUD shortly after the events of Nov. 8, 2016. The idea that my uterus would calmly surf the waves of political unrest for at least another 12 years was appealing.
At that time, I elected for the copper IUD, which is hormone-free and works by releasing copper ions, which apparently interfere with “sperm movement” and “egg fertilization.” Um, who discovered this and how??
The insertion, which I’d been told would be a “little pinch,” was by far the worst pain I had experienced during my lifetime. Afterwards, I felt vaguely unwell and crampy for the next few days. It seemed worth it, however, because I wouldn’t have to worry about birth control for over a decade, like some kind of witch.
The side effects, which I was indeed warned about, include the possibility of experiencing longer and heavier periods, but I was not specifically warned that my vagina might gush blood like the hotel hallway in “The Shining.”
For six-ish months, everything was perfect between me and IUD numero uno. Then, abruptly, I began suffering from menorrhagia, which is a catch-all term for abnormally heavy or prolonged menstrual bleeding. After an ultrasound revealed that nothing was wrong with the IUD placement, my gynecologist decided that the best course of action was to remove the copper IUD that was turning me into a mid-30s version of Carrie at the prom and replace it with a hormonal IUD, which offered the added benefit of treating my Polycystic Ovarian Syndrome.
I went through the extreme pain of having the copper IUD removed, and then more extreme pain when it was replaced with the Liletta, which like most hormonal IUDs (Mirena, Liletta, Kyleena and Skyla) sounds like the name of a discontinued Bratz doll.
For the next eight years, the Liletta served me well. The excessive bleeding stopped immediately. Even better, my new hormonal IUD eventually stopped my periods entirely, an amazing and underrated side effect I feel we don’t talk about enough.
Recently, however, Liletta was approaching the end of her reign, and I found myself once again staring down the barrel of a Trump presidency, this time in a post-Roe climate that was even more hostile to women’s reproductive rights. With conservatives going after IVF and other previously noncontroversial forms of reproductive freedom, and women losing their lives over arguments about fetal heartbeats in emergency rooms, I wanted to make sure my uterus was locked down before the president-elect took office, and thus we come to IUD number three.
My previous IUD experiences had been extremely painful, but enough time had gone by to make it hard to remember just how excruciating the insertion can be. And it was excruciating. This time, my new gynecologist had to use a cervical dilator to open my cervix enough to access my uterus. I whimpered and heavy-breathed my way through the removal of the old IUD and the sharp knife-like cramping during the insertion of the new one, only relaxing when she told me I was all done.
“Men would NEVER do this,” I blurted, and my doctor instantly agreed.
She told me to make a six-week follow-up appointment to check the placement of my new IUD and left the room to allow me to get dressed. Cramping too heavily to sit up right away, I was kicking myself for the fact that I had to go back to the office instead of having planned to go straight home when I felt a rising heat in my body that rapidly turned into a swell of nausea.
Breathing deeply until the urge to vomit passed, I managed to sit up and take a single step off the papered bed, but I stumbled backward, barely catching myself before I careened into a tray of medical tools. Holding onto the bed as a support, I took a few dizzy steps before realizing I was too light-headed to walk. Somehow I managed to get myself back on the bed without passing out, but it was several more minutes before I felt steady enough to get dressed and find a nurse to bring me some water. I then had to sit and sip water for 15 minutes in the waiting area before I felt safe to take an Uber back to the office. In the car, every bump in the road exacerbated the pain I was feeling.
I later found out that the nausea and dizziness I’d experienced is called a “vasovagal reaction” and it can happen when your nervous system reacts to the pain of IUD insertion (among other situations). No one had ever warned me about this potential side effect, and it was terrifying to experience without knowing what was happening.
The thing is this is not some rare, one-off IUD horror story. This is, in fact, an everyday, run-of-the-mill IUD story, which is the worst part. While the pain of IUD insertion can vary widely from person to person, I have spoken to many other women who have had the same experience. In one 2015 study, 78% of women rated insertion pain as moderate to severe, and 46% experienced vasovagal symptoms (nausea, sweating, lightheadedness) like mine. According to Planned Parenthood, “Some people feel dizzy during or right after the IUD is put in, and there’s a small chance of fainting.”
This time around, I wasn’t expecting a “little pinch,” but I still wasn’t prepared for what I experienced. In the eight years since my previous IUD, awareness has grown significantly that IUD insertions are extremely painful for many women. On TikTok or other social media sites, you can even watch in real-time as users writhe and scream during their filmed insertions. In Washington, House Representative Amy Walen recently filed a bill that would require physicians to discuss pain management before IUD insertions, after witnessing a horrifying experience while accompanying a young woman to hers.
In 2024, the CDC similarly updated their guidelines to say, “Before IUD placement, all patients should be counseled on potential pain during placement as well as the risks, benefits, and alternatives of different options for pain management. A person-centered plan for IUD placement and pain management should be made based on patient preference.” Also in 2024, some Planned Parenthood locations began offering IV sedation upon request for IUD insertion and removal.
And yet, less than 5% of doctors offer so much as an injection of a local anesthetic during the procedure. Most women I know were lucky if they were told to take an Ibuprofen beforehand.
A few weeks later, I met up with my friend Erik who had gotten a vasectomy a few months previously. He’s 38. My painful IUD insertion fresh on my mind, I asked him about his experience with pain management before, during and after the experience. He told me he was given the options of local anesthesia/numbing meds: being put under with anesthesia and chose to be numbed with local anesthesia.
With the local anesthesia, he did not have to experience any pain during his procedure. “There was a moment where the anesthesia wore off and it was painful, but I told my doctor and he gave me more shots to finish the procedure which really helped,” Erik told me. He said he felt “safe and secure” during his vasectomy, and that his medical team was “aware of and taking care of any concerns he had.” He was even prescribed a prescription painkiller to use post-vasectomy, which he said he did not need after the first day.
Erik says a vasectomy would “absolutely not have been an option for him“ if the procedure was painful. “I have been with two partners who have gotten IUDs, and it was painful and traumatic for them,” he added. “I do not understand why they were not offered anesthesia or pain meds after the fact because NO MAN would get a vasectomy without anesthesia.”
So why are so many women still having to endure extreme pain in order to have an IUD inserted? There’s absolutely no reason besides sexism, and the medical industry’s attendant refusal to take female pain seriously. In fact, a 2015 study found that medical professionals tended to underestimate the degree of pain experienced by patients during this procedure. This isn’t limited to IUD insertions ― one study showed that female patients are less likely to be given pain medication in hospital ERs than male patients, despite reporting the same level of pain. Another showed that women are less likely to be prescribed painkillers after surgery than men who underwent the same surgery.
It’s a shame because, a few months later, the pain of insertion in the past, I can say I truly love my IUD. It’s one of the most effective forms of birth control (over 99%), I haven’t experienced the negative side effects I did with the (many) other forms of hormonal birth control I’ve tried, and it lasts for a whopping eight years. Having an IUD is wonderful; so why is getting one still so painful and traumatic for so many women?
We Need Your Support
Already contributed? Log in to hide these messages.
At 41, I am hoping I’ll have started menopause by the end of my current IUD’s efficacy, because I honestly don’t know if I can go through the pain of insertion again. If not, I hope that eight years from now, we’ll finally be looking at a medical landscape that is willing to listen to women when we say we’re in pain, and treat that pain accordingly. Anything less is unconscionable.
Do you have a compelling personal story you’d like to see published on HuffPost? Find out what we’re looking for here and send us a pitch at pitch@huffpost.com.