Back in 2010, he paid $ 450 for a hormonal intrauterine device or IUD. The tiny T-shaped device – first developed in the 1960s – is inserted into the uterus to prevent pregnancy by changing the way sperm move or preventing eggs from leaving the ovaries. The O’Byrne spiral offered long-term birth control with less fuss. “You adjust it and you forget it … That sounds amazing,” said the 39-year-old emergency nurse from Peace River, Alta, about 500 miles (500 km) northwest of Edmonton. But she was not prepared for the painful pain of the admission process that would have prevented her for years. Taryn Wahl, a teacher at Planned Parenthood, a nonprofit sexual health clinic, holds an IUD. The microscopic T-shaped device is inserted into the uterus to prevent pregnancy. (Matthew Howard / CBC) O’Byrne, who says she has a high tolerance for pain, was told it would look like a Pap smear, a common gynecological procedure where cells are scraped from the cervix and tested for cervical cancer. “He started out as a grandfather, but then gradually got worse,” he said. “I was very surprised that the pain was so intense.” LISTEN Canadians share painful experiences with IUDs: White coat Black Art26: 30The problem with the IUDs IUDs are an effective and popular form of birth control in Canada. But many women experience severe pain from the introduction for which they were not warned. In this episode, women across the country share stories of unexpected pain, complications and emotional distress. In Part 2, what some gynecologists do to make the IUD experience more comfortable. O’Byrne said the process left her sweating and having difficulty driving home. He said he had to pull on her several times. Years later, after giving birth, she realized that the pain of IUD placement was similar to the pain of childbirth. O’Byrne’s experience was echoed by a group of 15 women who spoke to CBC Radio’s White Coat, Black Art about their experiences with the IUD placement. They are part of a growing chorus of voices – from women of childbearing age to gynecologists at Tik Tok and social media – demanding better education and pain management for IUD users. Wahl shows how to insert the IUD into a matrix model. Although the device has revolutionized birth control and improved reproductive health outcomes, for some people, insertion can be painful. (Matthew Howard / CBC)

They “get pain” for some

By 2019, approximately 159 million people worldwide were using IUDs, according to data collected by the United Nations. IUDs are sold as a reversible, simple, long-term option in less reliable forms of birth control. The IUD can also reduce the risk of certain types of gynecological cancers and cervical cancer, including endometrial and ovarian cancer. The copper or hormone injection device revolutionized birth control and improved reproductive health outcomes, but for some, the introduction can cause severe pain. According to several Canadians who spoke to the CBC that the pain was a surprise. Alison Steele, 26, of Prescott, Ont., Advises women to wait a day off to recover after the procedure. “I just remember feeling pain,” he said. “I was screaming and crying.… In my mind, it lasted about an hour. I’m sure it lasted five minutes, but it was quite brutal.” Alison Steele, 26, of Prescott, OD, says she suffered “severe” pain during an IUD procedure. (Cameron Style) Alison Lennie, 40, from Edmonton, chose an IUD because of a heavy period. He said the acquisition of the device is being treated as a “mythical thing that people are just experiencing”. He says it would help to demystify the process so that people do not have to “go through this ordeal as if they were in search”. He said it was not helpful to tell patients that “you will feel a slight sting” when the pain could feel much worse. “Your legs are in agitation, your whole lower body is exposed to the air,” he said. “You are in a very vulnerable position with a speculum holding you open and there is nothing you can do and it starts to hurt.” Alison Lennie, 40, of Edmonton, says it’s not helpful to tell women that inserting an IUD would be like a slight sting when it could be much worse. (Submitted by Alison Lennie)

Ask for better pain management

In an interview with Dr. Brain Goldman of CBC Radio’s White Coat, Black Art, Dr Fiona Matatal said listening to such trials “breaks my heart as a doctor”. The Calgary obstetrician-gynecologist has been inserting an IUD for 20 years. The procedure only takes a few minutes, he said, and some patients experience only mild discomfort while others experience anxiety. The pain can be caused by the clamp used to keep the cervix open, the piercing of a tool used to measure the depth of the uterus or the insertion of the IUD itself. According to Mattatall, the problem is that there are no standard pain control methods that have been shown to work for all women. It’s difficult to develop a protocol because there is no one-size-fits-all approach to everything. – Amanda Black, head of the Society of Obstetricians and Gynecologists of Canada. Patients are often advised to take an anti-inflammatory, such as ibuprofen, in the hours before the procedure. Some doctors use a local anesthetic cream or injection, or even a drug called misoprostol, to dilate the cervix to make the insertion less painful. “It simply came to our notice then [the pain relief methods] “It does not seem to make a difference,” said Mattatall. He said he tries to help patients by ensuring they are comfortable and in control, stopping at all times. She discusses at length what is going to happen to her patients. It then tries to determine if an office setting is appropriate, given each individual history. For example, survivors of sexual assault may do better in an out-of-office environment using anesthesia. For most women, research has shown that IUD placement is bearable, according to Amanda Black, head of the Society of Obstetricians and Gynecologists of Canada (SOGC). “The variability in patient experience is quite exciting; the majority of women tolerate the procedure and their pain is tolerable,” Black said. “It’s difficult to develop a protocol because there is no ‘one size fits all’ approach. We have to remember that.”

Female pain is minimized

Mattatall says Canadian health care providers and the system need to improve pain care for women. “I’m concerned that there are places where women’s pain can be rejected or minimized,” she said. “We can always do a little better.” Mattatall learned from her own experience after undergoing a painful IUD placement. “Never [you] become the patient, you see things from the other side “. LISTEN Pain management of contraceptives: Radio Active5: 38 Pain management for IUD surgeries One of the most reliable forms of birth control can also be a source of fear and pain for some women. We talk to a gynecologist about IUDs and pain management She is concerned that patients who have had painful experiences with IUDs may refuse optimal gynecological care for fear. “IUDs are an amazing form of birth control. They are much more effective than the traditional methods we have had. And with progesterone-containing IUDs, they have changed the game in gynecology,” said Mattatall. Progesterone IUDs are often used to suppress heavy menstrual bleeding and menstrual pain. He said that led to a steady reduction in the need for complete hysterectomies. “The person was able to live his best life until menopause without undergoing major surgery.” By 2019, approximately 159 million people worldwide were using IUDs, according to data collected by the United Nations. (Shutterstock / Image Point Fr)

No need for horror stories

In 2011, about a year after receiving her first hormonal IUD, O’Byrne chose to remove it. She thought she was done with the devices despite the fact that her body had adapted. But after giving birth, she tried a bronze spiral before her husband had a vasectomy. “It was a much better experience.” O’Byrne says women should be offered the same pain management for IUD placement as they would for a patient for something like a colonoscopy. Usually, this means a combination of drugs used for conscious suppression. “It just doesn’t have to be this horrible experience that happens sometimes.” Written by Yvette Brend. Produced by Stephanie Dubois.