“It Shouldn’t Have to Hurt”: The Growing Demand for Pain Management in IUD Procedures

When it comes to intrauterine device (IUD) insertion, many women know what to expect because they’ve heard about it not from doctors, but from friends, influencers, or strangers online: it can be excruciatingly painful.

A recent publication in BMJ Sexual & Reproductive Health systematically analyzed those personal accounts. The study, titled Pain experiences during intrauterine device procedures: a thematic analysis of tweets, reviewed more than 100 social media posts, mainly from X (formerly Twitter), to understand what people are saying about IUD pain. The findings support what many have been voicing for years: pain during IUD procedures is common, often severe, and frequently minimized or dismissed by clinicians.

While the study is based in the UK, its message resonates globally. Taghinejadi et al. (2024) found that many users described the insertion process as “traumatic,” and a large number were not warned about the possibility of significant pain. One user wrote that she “screamed” during the procedure. Others questioned how a routine medical procedure could be so intensely painful without clinicians intervening with more care.

Some have argued that the pain management practices surrounding IUD procedures are part of a broader legacy of sexism and misogyny in gynecology. As one commentator stated: “There’s a genuine streak of misogyny in gynecology and I'm glad to see it finally being exposed with not only mesh but IUD [insertion], hysteroscopy, endometriosis, etc.”

Though this study is rooted in X, the conversation now spans various social media platforms such as TikTok, Instagram, Reddit, and YouTube. These platforms have become vital outlets for people to share their experiences, especially when they feel unheard in clinical settings. By turning to social media, individuals are not just venting, they are raising awareness, building solidarity, and demanding better treatment. It’s a form of activism. When personal stories gain traction online, they have the power to reach clinicians, policymakers, and institutional leaders, helping to inform and potentially transform standards of care. These narratives push against a long-standing cultural norm that expects people with uteruses to endure pain in silence.

What’s especially troubling is that pain management options do exist. Cervical numbing injections, topical anesthetics, oral painkillers, and even sedation can be used to ease discomfort during the procedure. Some providers already offer them. But access is inconsistent, and many patients aren’t told they have options at all. Worse still, when people request pain relief, they’re sometimes denied or made to feel unreasonable for asking.

Some described the experience as traumatic, while others said they were shocked by how intense the pain was, especially since their providers had downplayed it. I’ve experienced this firsthand. I’ve had a total of five IUD insertions and four removals, all without anything more than Aleve. Each one was incredibly painful. I don’t share this to dramatize, but to echo what many others are saying: these procedures are inherently painful, and patients deserve better options.

If you’re considering an IUD, or planning to have yours changed, know that you have every right to ask for pain management. Not all providers will accommodate you, but some absolutely will. And it’s entirely within your rights to say: “If you won’t administer pain management medications, I will find someone who will.”

Providers agreeing to offer pain relief should not be the exception, but the standard of care.

Pain is not a rite of passage. It’s not a test of strength. It’s a symptom, and one that deserves to be addressed. If clinicians and policymakers take these social media narratives seriously, it could lead to real change in how reproductive healthcare is delivered. Until then, advocacy, especially self-advocacy, remains essential.

Read the full BMJ study here:

Taghinejadi, N., van der Westhuizen, H.-M., Ayomoh, F. I., Ahmed, W., Greenhalgh, T., & Boylan, A.-M. (2024). Pain experiences during intrauterine device procedures: A thematic analysis of tweets. BMJ Sexual & Reproductive Health, 50(4), 271–277. https://doi.org/10.1136/bmjsrh-2023-202011