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Have you had a contraceptive device fitted (also known as an IUD or coil)?

What was your experience like?

Perhaps you are a healthcare professional who can share your clinical insight?

Today (21 June), we've published an interview with Lucy Cohen who experienced high levels of pain and is now calling for better consent processes and pain management for women. 

Please share your thoughts on the interview below. You'll need to sign up to the hub to comment, it's free and easy to do. 

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I have personal experience of a very painful IUD fitting (Mirena Coil). I was told to take a couple of paracetamol beforehand. I had no forewarning of the possibility of high levels of pain and for me it was absolutely excruciating. I screamed and swore out loud (those poor patients who must have heard me as they sat in the GP waiting area).

I was told to expect cramping but was totally uninformed about the impact afterwards in terms of feeling extremely shaky and tearful. I felt violated - due to the level of pain but also the fact no one had warned me of this possibility. I wasn't advised to bring someone with me. I actually had to go away for the weekend straight afterwards with friends but spent the whole time in bed, crying and genuinely traumatised by the event. This is very difficult for people to understand if they had a good experience. It's not about how well you 'cope' though, it's about different bodies having different physiological reactions. 

I have since requested my GP notes and there was no record or mention of my pain experience. I was never asked to rate it out of 10 or provide feedback. How can things improve of this feedback isn't being collected?

Not all women experience this level of pain and IUDs can be an excellent choice of contraception for many, but there needs to be more data collected to understand the extent of the issue and how many women are feel their pain was not adequately managed or responded to. There needs to be more investment into research to inform practice and to make sure women are being told of all of the benefits, risks and alternatives. So they can make the right choices for them. 

Patients need to feel empowered to say no at any point - this should be made very clear from the start. 

I spent years terrified of having to go back and have it removed. There is so much opportunity for improvement in this area, and some wonderful clinicians trying to change things and advocate for patients. I can't imagine it's pleasant being a health worker witnessing the sort of reaction I had. Everyone needs to work together to change this. 

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Guest Niki
Guest Niki

I had a cool fitted a few months after experiencing an early stage miscarriage. I went in expecting very little pain. I was told it could hurt, but have a high threshold so expected to be able to ride it out just fine. I had a local anaesthetic gel administered and then the nurse held me down, which was a shock. Then the doctor got to work. Almost instantly I was in an excretory amount of pain. I tried to breathe through it but I had to vocalise my pain as tears rolled down my cheeks. I was in pain for two days after. I was so scared to have it removed again to try for a baby. I've since had two babies. I didn't make a peep either time, despite one being with only paracetamol as a painkiller. 

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Guest Sacha Patterson
Guest Sacha Patterson

Recently had my 1st coil fitted after having 2 children. Was in no way expecting the level of pain I experienced. I nearly passed out. We had to move to the smaller coil. No forewarning that I may need someone to drive me home so I drove home in agony and spent 24hrs in bed recovering. Was not advised to take pain relief beforehand either. Have had a colcoscopy previously which wasn’t brought into consideration. 

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Guest DMuz
Guest DMuz

I had two copper coils fitted pre-children and they were nothing short of agony on insertion but they were my only contraceptive option at the time. I wasn’t warned either time how bad it would be.

6 week after I had my son, I went for my third coil. It was worse than the 3 day labour I had with him (and he was a forceps delivery!). Turns out they perforated my uterus and bowl on insertion and there it stayed for 2 years. I was in pain but a new mum with no time to think about myself. I figured it was recovery from a traumatic birth. I was always ill. Enough was enough; I went to get help for the pain which was when they discovered the perforation- just not how bad it was. I went for keyhole surgery which ended up being full bowel surgery and a temp stoma (ileostomy) for 3 months. I was in agony, totally broken from having a stoma bag without any mental preparation and the recovery took years. Nobody ever told me this was a possibility and I am desperate for people to know the risks.

I tried to make a medical negligence claim (only because I wanted them to be forced to tell women the risks) and there wasn’t a murmur on my health records about how much pain and trauma I was obviously experiencing when I had it inserted so the claim failed.  I was crying and trying to breathe through the pain - I remember at the time the GP saying it was the most tricky one she’d ever done. She worked in a sexual health clinic!

Never ever put up and shut up. If it feels wrong, it is wrong. You are entitled to better care than this. 

 

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Guest Holly G
Guest Holly G

I had the Mirena Coil fitted in November 2020, I was 24 at the time. I wasn't nervous at all as 3 of my closest friends had recently had the coil and said it was fine, and I'd recently had my first smear test which was fine too. My friend advised me to take painkillers beforehand and bring a lucozade, which I did.

When the nurse used the instrument to measure my cervix, I felt an agonising wave of pain wash which drove me to shout "Ow, ow, ow" totally unexpectedly. A nurse came over and held my hand, and said that I didn't look very well. I proceeded to faint, and came to lying down on the examination bed with my legs elevated, surrounded by 5 nurses, one of which told me that my blood pressure had dropped massively. I felt like I was experiencing the worst pain I've ever felt shooting through my uterus. I also felt incredibly nauseous and was dripping in sweat.

The nurses gave me a lucozade tablet, some paracetamol, and put an oxygen mask on me, which stayed on for an hour, throughout which I kept feeling like I was going to faint repeatedly. Eventually I felt able to sit up, so they moved me to a wheelchair and wheeled me into another room. I lay down for another 30mins, and then a friend came to collect me and we walked the 10mins back to my house.

I was off work for 2 days as I had awful cramping pains and could not stop crying. I am usually very good at handling my emotions and putting things behind me when needed, but for a whole week afterwards I cried most days, and felt unable to articulate why to anyone.

I rang the sexual health clinic I booked the procedure through, as although the nurses at the clinic had been lovely and extremely comforting, they hadn't explained why this happened to me, and didn't tell me if there was anything I needed to look out for. The clinic said that it happens "several times a week" when coils are fitted, and that I should keep taking painkillers until I felt better.

When I booked the procedure, I was never warned that this might be the case, and other than being told by the nurse I booked with and by a friend to take painkillers 30mins before, pain relief was not mentioned at all.

It's now 7 months on, and after 5 months of bad period pains around my periods, and getting acne for the first time in my life, things seem to be improving and I'm now happy with the coil as my method of contraception. However, unless pain relief is offered to me when it is time for me to get a new coil fitted, I will not be having another one.

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I have had two Mirena's - the first one at a Sexual Health Clinic I was told to take 2 paracetamol before hand. It was horrific - the feeling of the sound being inserted to measure the uterus was bad enough, before the ripping feeling of the actual Mirena being inserted and the clamping of the cervix.

The 2nd one was worse, this was at a GP surgery (GP used to practise as a Gynaecologist). I explained the extreme pain of the first fitting, and that I was very anxious. I was told I could have a local anaesthetic but this would delay the appointment by around 15 minutes. On the fitting day, I was asked if I really wanted the anaesthetic as I looked like a strong girl - I wasnt strong enough to demand it. When the new one was inserted, I screamed and shouted and cried, I remember them telling me to gold on and it was nearly over. I went into shock, I remember everything going black and the voices in the room seeming to go very distant. I was very cold yet sweating profusely, and felt very sick. They had to put a fan on me, and inject me with an anti-sickness jab before I could move. I wasnt well enough to leave when I did, but I was concious of holding the GP up any more (I had been in there 45 minutes plus).

When it came to be removed (early as it was agony, I feel placed incorrectly due to my distress) - I cried and cried and had to have my partner to hold his hand. To this day (6 years later), I still cry if I think about it, and I cry during smear tests as the memories flood back. Never again, unless I am under GA or sedated.

I feel that it probably shouldn't be offered to people who haven't had a vaginal birth, unless under proper pain relief - and even people who have had such a birth should have proper pain relief. My cervix didnt want to be ripped apart, the agony is undescribable.

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Guest Alicia
Guest Alicia

I had my coil fitted when my first child was about 4 (1997) , it's was one of the most painful procedures I've ever had. The fitting was so painful it felt like the Dr had inserted his whole hand.. The pai after was horrendous, I honestly felt like a knife had been inserted inside me. I spent 3 days on the sofa in agony, I sat in the bath and tried to remove it myself, when I called the Dr he said he'd have to wait to remove it until I was on my period.. Which was 3 weeks late... The discomfort continued during the removal process... But the relief was immense once it was removed... The coil was barbaric 

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Guest Jaundice
Guest Jaundice

With my first Mirena I had severe cervical shock. I was not informed prior to the procedure that this was a risk. I remember feeling my pulse drop into the 30s and informing the doctor who just kept saying she’d almost finished. The pain was excruciating. I was symptomatic (slow heart rate & faint) for a further hour although they left me in the waiting room to recover on my own. 

For the replacement, I took my partner with me so that he could deal with any emergency as I’d lost trust in the GP by then. It was excruciating again.

How come we use local analgesia for inserting a urinary catheter into a man’s penis, but we get nothing other than a bit of paracetamol as a woman for having your cervix dilated.

As a very experienced nurse I realised just how wrong and unsafe this was. I took my partner with me because he’s a doctor I trust more than the GP, but he couldn’t believe the lack of analgesia and was even more traumatised than me by the experience. I know I’ve got a high pain threshold from previous broken bones, appendicitis etc. This pain level was far far worse - and so preventable. I’m demanding more analgesia, sedation or general anaesthetic for the removal.

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Guest Alison
Guest Alison

I had a Mirena coil fitted 4 years ago to combat extremely heavy periods. I’d been told to take a couple of paracetamols as it might be a “bit uncomfortable”. Obviously that was a man’s assumption as it was excruciating.
 

Having had a c-section for the birth of my daughter and numerous smear tests over the years, nothing prepared me for the pain.
 

Digging my nails into the bed while tears streamed down my face, I wasn’t offered any pain relief and precious little sympathy either from the woman torturing me down below. I felt nauseous and was bathed in sweat for most of the procedure but was told to “lie still” as she couldn’t get the right angle and that it would be over “when I’m ready”. I seriously wanted to punch that woman. It was only when I went pure white that she called a second nurse into the room who held my hand and chatted away to keep me focused elsewhere. 
 

I bled constantly for over 2 weeks but was told this was “normal” and it would settle. It did eventually but am now terrified of getting it removed. I’m 50 so they’ll probably not insert another one thankfully but will be scheduling a few days leave to recover. It isn’t a “simple procedure” and does hurt  - a lot. Pain relief should be offered and staff a bit more sympathetic. While it did help with the heavy periods in the long run, I honestly don’t think I’d ever recommend it to my daughter as it’s barbaric.

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Guest Imogen
Guest Imogen

I have endometriosis, I have tried everything to reduce my symptoms, so I decided to try the mirena coil implant, the procedure of having it fitted was the worst experience of my life, the pain was excruciating I was screaming in pain. I am in pain 24/7 anyways from my condition so having this done was dreadful. The nurse asked if I wanted to stop but I said can we please get this over and done with. It has now been a month since the procedure and my pain and symptoms from my endometriosis hasn’t got any better at all. If this treatment doesn’t help it will be surgery to remove the endometriosis. 

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Guest Hannah
Guest Hannah

I have had 2 successful pain free coil fittings (mirena). Uncomfortable but not painful. The fitting of the 3rd was extremely painful, 8 out of 10, I have no idea why it was different. Whether the procedure had changed, whether I was in a different stage of my cycle and perhaps that made a difference. I seriously wondered whether the fitter was some kind of psycho who enjoyed inflicting pain. At the time I thought I’d never have another fitted, but it is an extremely convenient method of birth control and period management once it’s in.

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Guest AWSJ
Guest AWSJ

My first Mirena insertion was extremely painful. I had to be dilated to fit it, which was painful enough. Then about 10 minutes after leaving the appointment, I had a vasovagal reaction and felt absolutely horrible (nausea, dizzy,etc).  No one warned me this could happen. However, after the initial shock and light spotting for a month or so, it was great. Never felt a thing and had no periods. 
 

My second mirena was after I gave birth for the first time. Insertion was great and I felt absolutely nothing. But after it felt so uncomfortable, like I could feel it in my uterus. Then the strings went missing and couldn’t be seen by the NP so I had to have an ultrasound (which took months of chasing, partially due to COVID-19) to make sure it hadn’t implanted as I was still having a lot of pain. The ultrasound found it was fine and the strings reappeared, but then my partner could feel them during intercourse. Because of this, and because I was still having pain, I asked for it to be removed- but due to covid they wouldn’t. So I managed to remove it myself and now I feel much better. 
 

Would still be willing to try another IUD in future. 

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Had Mirena inserted, was excruciating but very quick and soon forgotten. Having it replaced was a whole other matter. The GP put those torture hook clamps on my cervix and left them there while she faffed about with packets. I told her it really hurt, the nurse tried to placate me but I had a vasovagal. I didn’t let her put the other one in. I’d rather risk another pregnancy than that. I have never felt so disempowered, ignored, and dismissed

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Guest ptr83
Guest ptr83

I did not have an IUD fitted after the dismissive attitudes of two different doctors.

I saw my GP to complain about heavy periods. She offered an IUD. I said I wouldn't as I was concerned about the pain of insertion.  She said that it 'isn't painful' and that she had had two painless fittings. I said I could give numerous stories of women I know who had fittings that ranged from very painful to excruciating; she is literally the only women I've ever heard describe it as pain-free. I mentioned that one friend had gone into shock and spent 3 hours at the surgery after passing out and then vomiting into a bin with labour-like contractions. My GP said that 'THAT doesn't happen'.

She then said I could 'ask for a local anaesthetic'. I told her I'd not be having an IUD at all. Why would something that 'doesn't hurt' require a local anaesthetic? It doesn't add up. Why was it up to me to ask? If I'd been daft enough to have an IUD with no anaesthesia and experienced extreme pain, would she have admitted to misleading me? I doubt it. Either way, given the landmark ruling of Montgomery vs Lanarkshire I thought she'd be more eager to seek informed consent from her patients...

I left the surgery with no treatment for my heavy periods.

Some time later, I visited a gynaecologist privately for an unrelated matter. The topic of heavy periods came up. She asked if I'd consider an IUD. Again, I said I wasn't keen and explained why. I pointed out that I have never been pregnant so I would likely feel more pain. "YOU DO NOT NEED TO HAVE BEEN PREGNANT TO HAVE AN IUD!" This is the only time in my life that a doctor has ever shouted at me. I am medically literate and I am very keen to read medical reviews in the journals, along with reading up on clinical guidelines relevant to my health. My research had shown that nulligravid women are more likely to experience pain with IUD insertion. After I told her this she then admitted that I might feel 'slightly' more pain. She offered to fit an IUD privately with sedation if I wanted to. I could not afford this, but more importantly I'll not be treated by a doctor who responds to evidence-based concerns by screaming at her patients.

I find it staggering how two female doctors don't think pain with IUD insertion is a valid concern for a patient. I have never been pregnant, I find examinations painful and have a history of trauma, yet these doctors did not acknowledge that IUD is even painful, let alone that I was at higher risk. My GP did not offer to refer me to a specialist NHS service that offers IUD fitting under sedation, given my complex medical history. Instead, my concerns were met with lies and aggression. I note that I have only had problems with doctors' attitudes with regards to female-specific complaints.

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Guest Vixx
Guest Vixx

I had my first coil fitted in 2007. It was so painful that I felt like I'd been macheted in half! I passed out from the pain and one of the nurses told me that  happens to 'some' women. I'd been told it wouldn't hurt. I went home expecting to be able to care for my family but could hardly move from the pain for about 24 hours. I put off having it replaced because I was so scared but eventually was persuaded to. The 2nd time I took some very strong pain killers but fainted again. It's barbaric to put women through this with option of proper pain relief.

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Medium article about iud

hello, I operate a medium publication called I am cheese where we share healthcare experiences with vision of empathetic healthcare and stories can be submitted in any language. I thought I would share a recent article submitted to my pub. Please reach out to me if interested in sharing your stories. I am a patient advocate and a pharmacist in US. Thank you! 

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Guest Sas
Guest Sas

I had mirena coil fitted. The fitting was very painful, I had taken paracetamol and ibuprofen in readiness. I had to lean forward to hold the speculum in place whilst the doctor found some scissors to cut the cords because the first ones she grabbed were blunt. I spent the next 2 days with bad cramps and very emotional. On the 3rd day I discovered a lump in my vagina, it turned out to be a urethral diverticulum caused during the fitting, this required months of antibiotics and surgery. The coil caused constant bleeding for 6 months, I had bad anxiety and back pain to the point I could not sleep. Removal was easier, whilst it caused cramps they passed quickly and within 2 days I felt normal again. 

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Guest Teresa
Guest Teresa

I had a mirena coil fitted in 2007.  Initially they tried to insert it in my local surgery but the pain was so intense that it was impossible and it was fitted under anaesthetic in hospital.  Removal was another experience altogether.  It was removed in 2019 (after some worried telephone calls made by me about the length of time it was in).  The removal in the surgery was very much like others have described, take paracetamol, screaming in agony, tears, fainting, a hand to hold.  They did ask if I wanted to stop but like many others I said carry on because I just wanted it over.  Afterwards I suffered very bad blood clots of bleeding and was sent for a hysteroscopy.  At this point I got told by the technician that I had adenomyosis (something I’d never even heard of before) and a very large fibroid. I’ve been told neither should give me any problems as I’m menopausal, but I still think maybe my bad back is not my back at all.

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Guest Lyndsey
Guest Lyndsey

I realise that my experience is not IUD related. However, I think the issue of pain management and support for women is broader. 
 

I have just had a horrifically upsetting experience during a colonoscopy. I was in so much pain that I had to beg them to stop the procedure. I have never experienced anything like it. 

This was not my first colonoscopy. I have had 12-15 since my diagnosis with ulcerative colitis over 20 years ago. There have been no issues previously and all have been fully completed.  This was the first one that I have had only using sedation. 

After the procedure the nurse said to me that they had been unable to complete the colonoscopy and something like “oh it’s probably because you have had a hysterectomy. It’s more painful”

No one had explained that to me and there was no discussion beforehand that it was very possible my pain would be more severe. Why not? Are my likely pain levels as a woman who has had a hysterectomy irrelevant?

 

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Guest Casey
Guest Casey

I had a copper IUD inserted in 2017. I had tried almost every other contraceptive and wanted to try a non-hormonal option. 
I was told to take paracetamol and ibuprofen beforehand as the procedure could be ‘uncomfortable’, I took them both. I was in my early 20s and had not had children. 
The pain of the procedure was excruciating, 9/10 pain, I was told if I could just relax it would be less painful. I was made to feel like it was my fault I was experiencing pain at all. It took four attempts to insert the device, the doctor initially doing the procedure had to call in another doctor who was more experienced, as they failed to insert it. 
My device will need to be replaced mid next year and I am absolutely dreading the experience, the pain was horrific. 

I’m now a Registered Nurse and it is unbelievable to me that women are expected to endure that level of pain without effective analgesia and are told that the procedure will only cause some discomfort. 
I know multiple women who have experienced severe pain during the procedure. I have research the ‘IUD insertion and pain’. Most pieces of evidence state the same thing I was told, if women relaxed, it wouldn’t be painful and rather than pain relief, health professionals should focus on making it a less stressful experience to reduce pain. This is completely dismissive of the experiences many women have shared. For health professionals to completely ignore what their patients are stating as their lived experience is shameful. 

This is just another example of women’s pain not being taken seriously and seen as unimportant. 
 

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Anonymous
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