During a conversation with a friend, Mallory Tatman found out that they were both scheduled for intrauterine device (IUD) insertions in the upcoming weeks.

Neither of them felt anxious about the procedure, as many young women are now opting for IUDs as a method of contraception. After her friend called from the doctor’s office to describe the pain she experienced, Tatman thought her friend was overstating it. As someone who believed she had a high pain threshold, she decided to film herself during the IUD insertion to show how manageable it was.

However, the reality of her experience was shocking.

“I thought it would feel like a Pap smear — something routine,” she recounts. “But when (the doctor) inserted the IUD, it was excruciating. It felt like someone had stabbed me.”

Later, Tatman shared the video on TikTok to highlight how painful these procedures can be.

She’s not the only one sharing her story. Nicole Marpaung, 23, also made waves online by posting her IUD insertion experience on TikTok, garnering 6.5 million views. In her comment section, others voiced their shared agony, revealing that their IUD insertions were among their most painful experiences. “It’s never disclosed just how painful this process can be,” one user lamented.

In August, the CDC released updated guidelines urging healthcare providers to offer lidocaine and other pain relief options during IUD insertions. Nevertheless, Tatman believes there’s still much more to accomplish to prevent others from experiencing what she went through, viewing these videos as a crucial step in sparking vital conversations.

What exactly is an IUD and what causes discomfort during its insertion?

An intrauterine device, or IUD, is a small device placed within the uterus to prevent pregnancy. There are two primary types of IUDs: hormonal and copper.

IUDs are a long-term reversible contraceptive option and represent one of the most reliable, error-proof methods of birth control. They also exceed 99% effectiveness as emergency contraception if inserted within five days post unprotected intercourse.

The insertion process involves the doctor placing a speculum into the vagina and then utilizing an inserter (a slender tube) to guide the IUD through the cervical opening and into the uterus.

Some individuals experience little to no pain during the insertion process, while others find it quite painful, according to Dr. Franziska Haydanek, an OBGYN and health educator online.

Experiences vary significantly; women who have recently given birth are generally less likely to feel discomfort during placement. Conversely, if a person’s cervix is tightly closed, passing the IUD inserter can be more painful. Additionally, when the IUD is expanded (unfolded in the uterus), it may press against the top of the uterus, leading to cramping in some patients.

Why are people sharing their IUD experiences on social media?

Initially, Marpaung recorded her video for her own reference but later decided to share it online to draw attention to the painful nature of the process. Tatman, left in a state of disbelief after her procedure, sought to learn if others had undergone similar experiences.

“I was shocked that I endured that level of pain,” Tatman states. “Most of the feedback I got simply echoed how painful it is. It’s an older video, yet I still receive comments like, ‘I’m about to get mine. How painful will it be?'”

Prior to the CDC’s updated recommendations in August, the latest information originated from a 2016 CDC report. At that time, doctors were not advised to offer pain relief options for IUD recipients, leaving many uninformed about how to manage their discomfort during the procedure.

Marpaung recalls inquiring about the pain beforehand, and her doctor reassured her that the procedure would simply be uncomfortable rather than painful.

“I had no clue what to expect from the procedure,” she explains. “They brought out this clamp to help dilate my cervix. Then they introduced this scissor-like tool to hold at my uterus, which honestly resembled something out of medieval torture.”

This tool is known as the tenaculum; it has two hooked ends that secure the cervix during the measurement of the uterus and placement of the IUD.

Marpaung began feeling cramps “instantly,” but the doctor minimized her discomfort while attempting to keep her calm. “Once the procedure was done, I barely had five minutes to recover before they said, ‘You’re good to go, bye,'” she shares.

She ended up needing to leave work early and struggled to drive home due to feeling unwell.

Videos from individuals like Tatman and Marpaung act as a “heads up” before the procedure, allowing people to ask questions and support one another; both videos have received thousands of comments.

However, these personal narratives may also heighten anxiety for viewers before their own procedures. Haydanek cautions that while sharing experiences on social media is beneficial, it’s essential to discuss any information found online with your healthcare provider.

“If not, you risk taking anecdotes from everyday people as evidence, which may be misleading or not applicable to your medical situation,” she notes.

Will the updated CDC guidelines bring enough relief?

According to Haydanek, healthcare providers can stay updated on new CDC recommendations through yearly continuing medical education sessions, conferences, and medical publications. However, providing pain management is currently not mandatory.

Haydanek emphasizes that discussions on pain management should occur beforehand with patients, ensuring they are aware of all available options. In contrast, Tatman and Marpaung argue that the use of lidocaine should be a requirement, rather than an option, for all IUD procedures.

“It should be standard for everyone so that no one has to endure it,” Marpaung states. “It’s an unnecessary source of pain.”

In the reality show “The Secret Lives of Mormon Wives,” some cast members were given laughing gas (nitrous oxide) before their Botox treatments. A local dentist’s office near Tatman also utilizes these same anesthesia options for regular checkups: “It’s perplexing—people are getting laughing gas just to have their teeth cleaned, it’s quite backward. I don’t get it.”

“In the realm of women’s health, it’s incredibly difficult to secure anything that isn’t traditionally provided,” expresses Tatman. “There ought to be a comprehensive approach that includes pre-care, care during the procedure, and post-care, just as with any other medical procedure when receiving an IUD.”