Earlier this summer on Naga Munchetty’s BBC Radio 5 Live show, the presenter shared her experience of having a coil (IUD) fitted. While the procedure is safe and effective, for Naga, like plenty of other women, the experience was traumatic and agonisingly painful.
Together with campaigners such as Lucy Cohen, Naga asked the following question on her 5 Live programme: Why aren’t all women offered pain relief when having an IUD fitted?
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Since then, the Faculty of Sexual and Reproductive Healthcare (FSRH) has changed its guidelines and now says that all women should be offered pain relief when having a coil fitted. Naga has reflected on this, and recounted her personal experience, for Refinery29.
Have you ever felt that some women feel, or are made to feel, that their pain is something to endure – not a problem to solve?
I have, and as many recent listeners of my 5 Live programme will know, I have been angry about it.
In June, I read Caitlin Moran's piece in The Times newspaper about the lack of pain relief offered for the removal and insertion of an IUD – known as the coil. She was inspired to write it after campaigner Lucy Cohen started a petition to offer better pain relief for IUD insertions and removals, which was picked up by feminist activist Caroline Criado-Perez’s newsletter Invisible Women. Why, in 2021, was this conversation having to happen?
Caitlin’s description of her IUD insertion really chimed with me – because I've been there. We all know coils are safe and effective and lots and lots of women have no problem at all with them. But like all medical procedures, patients can have a vast range of experiences.
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For those of you who don't know the ins and outs (excuse the phrase), this may come as something of an uncomfortable description, however accurate.
Caitlin Moran asks: "Why is it presumed that women will be fine with having their cervix artificially dilated with a pair of metal barbecue tongs, before having what is basically the wire coat hanger from a doll's house inserted into their uterus?" Before the IUD removal or insertion, women are merely told: "This might be a bit uncomfortable."
Not that I need to justify this but I almost feel obliged to say that I have a very high pain threshold. I know this from my experience of pain and have been told this by medical experts. I am not (well, I wasn't) afraid of being in pain if I know that pain will be temporary. Nor am I squeamish.
I just thought I'd put that out there before I tell you my story. Though it really shouldn’t matter either way. Pain is pain.
I had a coil fitted a few years ago and it was one of the most traumatic physical experiences I have had. I had gone through what the procedure involved with my GP, who was clear, patient and informative. I thought I was prepared for a 'routine procedure'.
A nurse accompanied the doctor in the room where the fitting was to take place. I had been told to take a couple of paracetamol and ibuprofen in the hours before my appointment. I have never been pregnant – therefore my cervix, up until then, had never been opened. My husband was in the GP waiting area as I had been told that it might be helpful if someone could drive me home.
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What followed was this:
I was told that the smallest size speculum, which was used for cervical smear tests, wasn't big enough for this procedure so I had to have the next size up.
That was when the pain started. I won't go into all the details but my screams were so loud that my husband tried to find out what room I was in to make it stop. He said afterwards that those in the waiting room, hearing my screams, looked horrified.
The nurse accompanying the doctor had tears in her eyes. I was asked by the doctor, halfway through, if I wanted to stop. I was determined that the pain I had suffered would not be repeated so I said: "We've got this far, let's finish it."
I fainted twice.
At the follow-up appointment a week later, my GP, who is really great, said she couldn't believe that I had stuck with it. She said: "Most women just give up when it hurts that much." She also said that she felt terrible after my fitting. Though they did ask if we should stop, no one suggested any anaesthetic or sedation.
When the coil was removed a year later (it didn't suit me), the pain was again excruciating. I fainted again, bursting into tears of relief when I left the GP's office. I felt violated, weak and angry.
I have friends who have had very similar experiences, and of course friends who have had no problem at all. This isn't about the coil itself, which we know is safe and effective. It's about how we look at all women's health and pain.
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One of the most heartening results of talking about my vagina on BBC Radio 5 Live was the response from the women around me and listeners of my show. So many of them felt inspired to share their own experiences.
Since various women spoke up, the Faculty of Sexual and Reproductive Healthcare has updated its guidance to members:
"We recommend healthcare professionals to create a supportive environment and offer appropriate analgesia … Not all clinics or GP practices are able to offer local anaesthesia – and where this is the case, referral to another service should be in place."
Soon after, I received this note from a colleague of mine:
"OMG – I just had a gynae procedure at a local hospital and they offered me a local anaesthetic AND gas and air!!!! Obviously I said YES! It was marvellous! I’ve actually had such a wonderful time having needles in my lady parts! I’ve had this same procedure before (an injection in the urethra) and it was absolutely awful. She said it was introduced just last week after feedback from patients and the new guidance!!!!!!! Isn’t this amazing? Obviously I’m still a bit off my head."
This is a great step forward. Women’s voices are finally being heard. At the same time, I can’t help but ask the question: why, until now, were women not routinely offered good pain relief for this type of procedure?
Naga Munchetty presents on BBC Radio 5 Live every Monday to Wednesday from 10am.
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