The Centers for Disease Control and Prevention (CDC) updated its guidance to doctors when talking to patients about the potential for pain from the insertion and use of IUDs. The new direction from the federal agency also includes offering pain management options to women.
In the past, “There wasn’t as much preparation for patients in what to expect” in terms of pain when having an intrauterine device, or IUD, inserted, said Dr. Karen Tang, a board-certified gynecologist and author of a book on women’s reproductive health, in an interview with WTOP.
Tang, who is active on a variety of social media platforms, said, “Social media has led a lot of this discussion (with women saying) they deserve more information and more options to prevent this from being uncomfortable.”
The new guidance from the CDC includes recommendations for the use of lidocaine, but Tang said there’s some caveats.
“People can have some pain from the needles used to do the local anesthetic injection, which is why a lot of gynecologists don’t do that automatically,” she said.
Instead, she said, many gynecologists now opt to administer lidocaine in a gel or liquid form into the uterus.
“So a lot of us are doing that now to give some numbing, but to avoid the pain of a needle,” she said.
Nitrous oxide is also being offered by doctors. But Tang said, “In terms of studies and effectiveness, nitrous oxide is not really a pain medication; it’s not something that decreases what pain someone experiences. But it can help with anxiety. It makes the whole experience less uncomfortable in general.”
It may not be covered by insurance, Tang said.
“It’s something that might be an additional cost, but it is an option that many offices are now starting to offer,” she said.
For some women, Tang said, taking an ibuprofen before the procedure can provide all the pain control they need. But, she emphasized, what works for one patient can’t be assumed to work for another.
“It’s most important to have a conversation, talk about what options exist, “and make clear that there are options, she said.
Another issue is, of course, determining whether a patient will require any pain medication at all. Some women have no problem with the insertion of the IUD.
“There’s not a great way to predict, except that if someone, in general, has more pain with just a regular Pap smear, then we probably know that they might be a little more sensitive to discomfort,” Tang said.
She said it’s important to note that IUDs provide a highly effective contraceptive method that works well for many women.
“I will tell you, if you ask female gynecologists what method they have, almost all of us have an IUD,” she said, based on their convenience and minimal side effects.
Tang is the author of the book, “It’s Not Hysteria: Everything You Need to Know About Your Reproductive Health (But Were Never Told).”