Content warning: This article mentions PTSD, anxiety and themes of consent, and some readers might find the article distressing.
An intrauterine device (IUD) is a long-acting reversible contraception inserted in the uterus. While patients are told they’ll feel a “slight pinch” during the procedure, many report feeling intense pain with calls more should be done. Re: News talked to patients about their IUD insertion experiences.
Ainsley Duyvestyn-Smith was 24 when she says she passed out from the pain during her first copper IUD insertion and told herself she’d never do it again.
But when she turned 30 and started experiencing bad endometriosis symptoms, she was advised to get the Mirena IUD to help manage it.
An IUD is a small device put inside the uterus to prevent pregnancy for three to 10 years, according to Sexual Wellbeing Aotearoa’s website.
There are two types: the hormone IUD, Mirena or Jaydess, and the copper IUD.
Ainsley Duyvestyn-Smith was 24 when she says she passed out from the pain during her first copper IUD insertion. Photo by Ainsley DS Photography
Ainsley says she was nervous about feeling that pain again from an IUD and felt dismissed by the gynaecologist.
“[They] said, ‘You might have just got unlucky and it’s probably not going to be that painful again’,” the now 33-year-old adds.
Ainsley went ahead with getting the Mirena and says she was given a minimal dose of morphine before the procedure, and four injections of local anaesthetic into her cervix, but neither helped with the pain.
“We had three attempts, and I was screaming, sweating and crying, and I thought I was going to pass out. I just got told to breathe basically.”
She says she begged the nurse to stop, which she did, but Ainsley says the nurse then tried again without her consent.
She says the Mirena just wouldn’t work so she agreed to get Jaydess instead, which was smaller and easier to insert.
But a week later, Ainsley says she ended up in the emergency department with “severe pain” because her body was “birthing out” the IUD.
She says she’s since been diagnosed with severe PTSD and realised the procedure made her feel coerced and violated.
“I was unable to work for a long time, I had nightmares, severe anxiety, flashbacks, any gynaecology appointment after that was extremely traumatic and terrifying.
“It kind of destroyed my life in a lot of ways. It really changed my brain.”
Sophie Rodwell says her first IUD insertion was awfully painful and was told to take Panadol afterwards. (Photo: Supplied)
Sophie Rodwell was 20 when she got her first IUD and was told by the gynaecologist it shouldn’t hurt much because there “aren’t many nerve endings” in the cervix.
“[The gynaecologist] said to me it would feel like a smear test, but I was much younger and I’d never had a smear test at the time.”
The now 26-year-old says it was awfully painful and was told to take Panadol when she got home.
She says after the procedure, she was told she could bleed, but wasn’t given a pad, and bled through her jeans on the way home.
Despite this, she says she only has great things to say about the Mirena in the five years she had it, so getting it again was no question.
“Easily the most painful medical procedure I had done.”
Before getting her next IUD, Sophie took a couple of Panadol and brought pads saying she felt better prepared.
The doctor told her she would feel a “slight pinch” but Sophie says she was brought to tears after instantly feeling a sharp, shocking and piercing pain.
She says she was told her cervix didn’t open so there were five attempts to get the IUD in.
“Each time I could feel myself hyperventilating and my whole body was tensing.”
She says she would prefer getting anaesthesia for her next insertion.
“I've had a few medical things happen in the past, but it was easily the most painful medical procedure I had done.”
But it’s not just Ainsley and Sophie with traumatic IUD insertion experiences.
When Re: News put up a callout, we were inundated with responses from people who wanted to share their stories. Here’s what some had to say.
Leearna Amos, 24, had her first IUD insertion in January.
“I found it extremely painful and traumatic, but thought to myself ‘at least it'll last 5 years…’ Long story short - it did not. It migrated and I had to get it surgically removed.”
Kirsty Brownlie, 33, had a copper IUD insertion when she was 27.
"[It started] with it getting inserted incorrectly, to having it removed in Wellington through a specialist as it became embedded in my uterus.”
Montana Sullivan, 22, had a Mirena IUD inserted during surgery for endometriosis.
“For 10 months post-surgery I received complications, bleeding, cramping, bloating, etc constantly. I was repeatedly told the IUD [was] not the issue and we should not remove it as that will be painful. I ended up having to go to another gynaecologist to have it removed, it was an easy process, and all my symptoms went away.”
Calls for change
After Ainsley’s experience, she plans to launch a petition to Parliament, asking for safer and more comfortable gynaecological procedures, including IUD insertion.
Some of the requests include practitioners using clear and concise language detailing the risks, offering a range of pain relief options, including general anaesthetic, and offering patients a backup plan in case of failure or extreme pain.
“It’s just really basic human rights stuff,” she adds.
In the United States, the Centers for Disease Control and Prevention released new guidelines on IUD insertion after videos circulated on social media of women feeling immense pain during the procedure.
Women’s Health Action general manager Isis McKay says what’s happening in the US is timely because the organisation has done a national survey in Aotearoa of people’s IUD experiences, and they’re analysing more than 380 responses.
“We had whānau expressing their concerns about experiences of pain during IUD insertion, feelings around the potential for coercive consent, and not being well-informed of potential risks and benefits for individual circumstances.”
Isis says IUDs can also be used for heavy or painful periods, abnormal bleeding, endometriosis, anaemia and gender-affirming care.
She says while many people don’t feel pain during their IUD insertion, some still have traumatic experiences.
She hopes the survey will provide a national overview of what needs to be done to improve people’s experiences.
Guidelines on IUD pain management
Health New Zealand - Te Whatu Ora is responsible for Aotearoa’s Contraceptive Guidelines and a spokesperson says they’re currently updating the Contraceptive Guidelines, including reviewing guidance for IUD insertion.
According to the 2020 guidance on contraception on the Ministry of Health’s website, paracetamol and ibuprofen are recommended for pain management.
The guideline also stated lidocaine, a local anaesthetic, has been shown to be effective with mixed results, but it isn’t recommended for use.
When asked why, the spokesperson says the evidence available related to best practice treatment options will be considered when they update the guidelines.
The spokesperson also says they recognise IUD insertion can be painful, and expect clinicians to fully inform patients about any procedure’s efficacy or side effects.
“It is important that patients report adverse reactions they may experience following any medical procedure to their health professional.”
Bayer is the manufacturer of Mirena and Jaydess and a spokesperson says several factors can contribute to the comfort of an IUD insertion.
This includes a professional’s level of experience in inserting IUDs, the degree of pre-insertion counselling offered to patients; and the pain management methods used or recommended by the inserter.
“Whilst some women report feeling pain, others report only a mild and temporary discomfort. Each insertion is a unique and subjective experience for each woman.”
The spokesperson says Bayer complements clinical training by providing “product familiarisation” education, offering detailed information on Bayer’s products and their use, and continuously working with both patients and inserters to improve the support they receive.
In New Zealand, the distributor of copper IUDs is ADVANZ PHARMA’s company, Boucher & Miur (NZ) Ltd.
An ADVANZ PHARMA spokesperson says they haven’t received any complaints of pain associated with their products.
“We encourage healthcare professionals to report any adverse events or quality complaints relating to our products to Medsafe and our company so that they can be investigated in accordance with our procedures.”
Note: A previous version of this story did not include comments from IUD manufacturers. Comments have now been added.
Where to get help:
- 1737: The nationwide, 24/7 mental health support line. Call or text 1737 to speak to a trained counsellor.
- Healthline: Free call 0800 611 116. Nationwide 24/7 over-the-phone health service where you can call for free health advice, information, and treatment from professional healthcare providers.
- Youthline: Free call 0800 376 633, free text 234. Nationwide service focused on supporting young people.
- OUTLine NZ: Freephone 0800 OUTLINE (0800 688 5463). National service that helps LGBTIQ+ New Zealanders access support, information and a sense of community.
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