Yes, Getting an IUD Under Sedation Is an Option—Here’s How I Did It (and How You Can, Too)

After I informed my physician, she mentioned swapping the tablet for an additional type of contraception known as an intrauterine system (IUD) would possibly probably assist scale back my newfound ache. However the concept of somebody (even a medical skilled) placing the plastic, T-shaped system into my uterus scared me—although it is solely concerning the measurement of 1 / 4. I’ve additionally had a number of adverse experiences with gynecological exams up to now, so between these recollections and mates’ tales of painful IUD insertions, it is secure to say I used to be hesitant.

However the advantages of IUDs are exhausting to disregard. Whereas you must keep in mind to take contraception drugs day by day, an IUD may be positioned and left alone to do its job. IUDs are additionally 99 % efficient at stopping being pregnant, per Deliberate Parenthood, and so they might scale back the quantity you bleed each month or cease your intervals altogether, which may be useful for folks coping with circumstances like endometriosis, per the American School of Obstetricians and Gynecologists.

After I discovered a buddy of mine with endometriosis was capable of get an IUD underneath sedation, blissfully unaware whereas hooked as much as an IV with sedative medicine, I jumped on the alternative myself. I rapidly booked my appointment at her OB/GYN’s workplace in New York Metropolis and efficiently received my IUD this spring.

Most OB/GYNs that supply IUD insertion underneath sedation do not typically promote that they do. There are various attainable explanation why, from value and insurance coverage protection points to lack of sources and employees obtainable in-office (like anesthesiologists). And whereas reproductive care has come a good distance, the medical neighborhood has traditionally underestimated ladies’s ache¹—particularly the ache of ladies of shade². These misconceptions imply sufferers are sometimes denied satisfactory ache administration, per a March 2024 paper in eClinical Medication from The Lancet.

However sedation is slowly turning into extra obtainable—even at native well being clinics. And your physique (and your ache tolerance ranges) finest. Should you’ve been contemplating getting an IUD, however are uncertain due to the ache and anxiousness related to it, you can advocate to get one this manner. This is how I did it, and suggestions for how one can, too.

First, what occurs throughout a typical IUD insertion?

Getting an IUD often solely take a couple of minutes. Your OB/GYN will use a speculum to carry the vagina open, and use a instrument to place the IUD by the opening of your cervix and into your uterus (the place it can keep), in response to Deliberate Parenthood.

Whereas it is fairly regular to really feel cramping a couple of days to weeks after insertion, the severity of ache felt through the precise appointment can range from individual to individual. In actual fact, some medical doctors counsel taking 600 to 800 milligrams of ibuprofen previous to your appointment to assist minimize down on ache, per UNC Chapel Hill.

“I’d say in my expertise, there’s a very, very broad variation by way of folks’s ache,” says Julia Cron, MD, FACOG, a board-certified OB/GYN at Weill Cornell Medication/NewYork-Presbyterian. “Some folks do wonderful; some folks have quite a lot of ache.”

A February 2019 evaluation within the American Journal of Obstetrics and Gynecology displays this, discovering the median ache rating for over 1,000 ladies who acquired hormonal IUDs was 5 on a scale of 10. The examine additionally discovered ladies who’ve by no means given start vaginally or have already got painful intervals usually tend to really feel IUD insertion ache.

And sadly, the worry and anticipation of ache could make issues worse. A February 2015 examine in Open Entry Journal of Contraception discovered that anticipated ache was typically greater than ache through the precise process. These expectations, and the quite a few IUD tales I would seen on social media, are what stored me ready on getting one. Although Dr. Cron warns these tales typically exist in a vacuum: “Generally, it is similar to a restaurant: Should you had a traditional expertise and all the things was effective, you are much less more likely to put that on social media.”

Having a pleasant physician who will speak you thru the process is one other essential piece. Throughout insertions for her sufferers, Dr. Cron will typically ask, “would you like me to speak you thru what I am doing, or simply distract you?” As soon as full, the physician may give you time to relaxation on the examination desk, or a nurse might keep within the room with you to be sure to’re feeling okay.

What pain-management choices are at present obtainable for IUD insertion?

Except for the really helpful 600 to 800 milligrams of ibuprofen (or different over-the-counter ache relievers like Tylenol), medical doctors would possibly put lidocaine numbing gel on the vagina and cervix for additional ache aid, says Alyssa Dweck, MD, FACOG, a board-certified gynecologist in New York.

However regardless of pain-relief drugs⁶ and lidocaine gel⁷ being the principle choices, the analysis is blended⁸ on how properly these strategies truly work to mitigate ache through the process. A simpler technique could be lidocaine paracervical block—a neighborhood anesthetic generally used throughout labor to numb the world across the cervix, per Johns Hopkins Medication. However that is often solely used if requested upfront, or when you require a second try at insertion (as a result of your OB/GYN was unsuccessful at putting the IUD at your first appointment on account of ache).

Then there’s IV sedation—the even lesser-known technique which relaxes you and generally makes you go to sleep. One of these sedation, known as “twilight” or “aware sedation,” is used for minor, much less advanced procedures that do not essentially require whole anesthesia, like knowledge tooth elimination for instance, per the American Society for Anesthesiologists (ASA).

As demand grows, increasingly more suppliers, and even some Deliberate Parenthood clinics, have began to supply IV sedation for IUD insertion and different related gynecological procedures. Not solely is it excellent for people who find themselves delicate to ache, but additionally for “these with a historical past of previous abuse or trauma,” says Dr. Dweck. “Some ladies with cognitive or bodily disabilities may additionally profit.”

Regardless of ache aid drugs and lidocaine gel being the principle choices, the analysis is blended on how properly these strategies truly work to mitigate ache through the process.

My expertise getting an IUD underneath sedation

As quickly as I discovered that IV sedation for IUD insertion was an choice, I talked to my buddy’s OB/GYN and made an appointment. Some folks might have to undergo extra preliminary steps, however I used to be fortunate sufficient to discover a supplier who took my insurance coverage and had availability pretty simply. Whereas the workplace solely supplied sedation as soon as a month, they conveniently had an in-house working room, which isn’t the case for some practices (you’d must go to the hospital or a surgical procedure middle as an alternative).

A number of days earlier than my appointment, I received directions on the best way to put together. I used to be informed to quick (no meals or water for not less than eight hours beforehand) and to deliver somebody to drive me dwelling after my appointment. I used to be fairly anxious the night time earlier than; I hadn’t been sedated since my early teenagers.

At my appointment, I used to be led to an examination room, the place I became a robe and talked with my OB/GYN. She eased my anxiousness with an encouraging however detailed overview of what was to return. Then she launched me to the anesthesiologist, who defined he’d be giving me a really low dose of propofol (a typical anesthetic) by an IV, which might lull me into a light-weight sleep. One other step towards ease: My physician launched me to everybody within the working room and even performed some music. I rapidly felt the results of the IV, and earlier than I may hear the refrain of the music that was enjoying, I used to be quick asleep.

I awakened a bit disoriented, however had solely been underneath for round 20 minutes, which simply felt like an extended nap. I used to be escorted to a different room to recuperate, the place my cousin (who’d accompanied me to the appointment) was ready. My physician was capable of give me some ibuprofen by the IV to assist with any post-procedure ache. After resting for about 45 minutes to let the anesthesia put on off, I used to be capable of safely stroll out with my cousin. The one proof I would had of the IUD was the acquainted heavy feeling in my stomach that often comes with my interval cramps, however nothing too intense.

From begin to end, the entire course of took about an hour and a half—and I would do it over and over if I needed to. It was such a aid to bypass any ache or anxiousness through the precise process, and I did not have any negative effects from the anesthesia. I did have some cramping and lightweight recognizing for the remainder of the week, which is regular post-IUD insertion, and was capable of take OTC ache relievers such as you would after a typical insertion.

Suggestions for getting an IUD underneath sedation

Getting an IUD this manner will not be at all times marketed or available. Listed below are some suggestions I’ve discovered from the consultants and my very own expertise.

Name round

Among the finest issues to do is name round and ask concerning the choices completely different OB/GYN places of work present. Be ready to reply questions on why you are on the lookout for IV sedation. The entrance desk might have to name you again after checking with suppliers on whether or not sedation is an obtainable choice. If they do not provide it, you possibly can ask for suggestions for close by practices that may.

Ask your insurance coverage firm about your protection

My insertion and sedation itself had been each lined by insurance coverage—because the anesthesiologist was in-network with my insurance coverage supplier. However value and protection can actually be a difficulty. “Going to the working room is very extra expensive than having it performed within the workplace,” notes Dr. Cron.

“For sufferers which have good insurance coverage that may cowl it, they won’t see that out-of-pocket value. However for sufferers that possibly do not have insurance coverage or have a big out-of-pocket value, then it is considerably cost-prohibitive,” she provides.

Test in along with your particular person insurance coverage firm about your protection. You might even be capable to discover a suitable OB/GYN this manner, too.

Carry it up in case your physician would not (i.e., advocate for your self)

It is essential to advocate for your self: Even throughout my first appointment with my buddy’s physician, she did not point out the choice of sedation till I introduced it up.

That is typically the case. “Generally, I do not provide it proper off the bat,” says Dr. Cron, until somebody has a incapacity or historical past of sexual assault, for instance. If sufferers request it, she says she has a dialogue about the advantages, particular dangers, and different components related to sedation.

How your physician reacts to you talking up, sharing about your ache tolerance and fears, and making requests is typically all you should learn about whether or not or not they’re the correct supplier for you. You will in the end need somebody who listens to and validates your wants. Do not be afraid to face agency in your requests and choices, particularly when you’re getting pushback.

Weigh out the advantages and dangers

I did not really feel negative effects from the anesthesia, however that is one thing you must contemplate when you’ve had a foul response to sedation up to now. In accordance with the ASA, the most typical negative effects of IV sedation embrace complications, nausea, and drowsiness. And in terms of the IUD itself, you should still really feel ache and cramping within the days after the process—like I did—although that is much like ho chances are you’ll really feel after insertion with out sedation. Getting sedated additionally takes longer and requires extra prep earlier than your appointment.

The advantages might outweigh the dangers for you, or vice versa. Everyone seems to be completely different, however your physique and your wants finest.

The underside line

As somebody who’s had uncomfortable experiences on the OB/GYN up to now, and has threat components for elevated ache throughout IUD insertion (i.e., painful intervals and no historical past of vaginal start), I am so glad sedation was an choice for me. However I acknowledge this can be a privileged take—not everybody is ready to get an IUD this manner.

This should not deter you, nonetheless, from getting an IUD if you’d like one; they’re not at all times intensely painful and are an extremely efficient contraception technique—one thing to remember as sure reproductive rights are rolled again in some states.

In an excellent world, we might have higher methods to handle ladies’s ache. Fortunately, extra medical doctors and clinics are recognizing that ache administration is an integral half in guaranteeing ladies proceed to get the care they want. For now, figuring out sedation for an IUD is an choice, and advocating to your consolation, is an effective place to begin.