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

Once I advised my physician, she mentioned swapping the tablet for an additional type of contraception referred to as an intrauterine machine (IUD) would possibly doubtlessly assist scale back my newfound ache. However the concept of somebody (even a medical skilled) placing the plastic, T-shaped machine into my uterus scared me—regardless that it is solely in regards to the measurement of 1 / 4. I’ve additionally had a number of damaging experiences with gynecological exams previously, so between these reminiscences and pals’ tales of painful IUD insertions, it is secure to say I used to be hesitant.

However the advantages of IUDs are onerous to disregard. Whereas it’s important to bear in mind to take contraception capsules each day, an IUD will be positioned and left alone to do its job. IUDs are additionally 99 % efficient at stopping being pregnant, per Deliberate Parenthood, they usually could scale back the quantity you bleed each month or cease your durations altogether, which will be useful for individuals coping with circumstances like endometriosis, per the American Faculty of Obstetricians and Gynecologists.

Once I discovered a pal of mine with endometriosis was in a position to get an IUD beneath sedation, blissfully unaware whereas hooked as much as an IV with sedative medicine, I jumped on the alternative myself. I shortly booked my appointment at her OB/GYN’s workplace in New York Metropolis and efficiently bought my IUD this spring.

Most OB/GYNs that provide IUD insertion beneath sedation do not usually promote that they do. There are various doable explanation why, from price and insurance coverage protection points to lack of assets and employees out there 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 colour². These misconceptions imply sufferers are sometimes denied sufficient ache administration, per a March 2024 paper in eClinical Drugs from The Lancet.

However sedation is slowly turning into extra out there—even at native well being clinics. And you understand your physique (and your ache tolerance ranges) finest. In the event 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 fashion. Here is how I did it, and ideas for how one can, too.

First, what occurs throughout a typical IUD insertion?

Getting an IUD normally 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 via the opening of your cervix and into your uterus (the place it would keep), in response to Deliberate Parenthood.

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

“I might say in my expertise, there’s a very, very broad variation by way of individuals’s ache,” says Julia Cron, MD, FACOG, a board-certified OB/GYN at Weill Cornell Drugs/NewYork-Presbyterian. “Some individuals do wonderful; some individuals have lots 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 obtained hormonal IUDs was 5 on a scale of 10. The examine additionally discovered ladies who’ve by no means given beginning vaginally or have already got painful durations 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 usually larger than ache in the course of the precise process. These expectations, and the quite a few IUD tales I would seen on social media, are what saved me ready on getting one. Although Dr. Cron warns these tales usually exist in a vacuum: “Typically, it is similar to a restaurant: In the event you had a traditional expertise and all the things was tremendous, you are much less more likely to put that on social media.”

Having a pleasant physician who will discuss you thru the process is one other necessary piece. Throughout insertions for her sufferers, Dr. Cron will usually 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 could keep within the room with you to ensure you’re feeling okay.

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

Apart from the really useful 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 capsules⁶ and lidocaine gel⁷ being the primary choices, the analysis is blended⁸ on how effectively these strategies truly work to mitigate ache in the course of the process. A more practical methodology could be lidocaine paracervical block—a neighborhood anesthetic generally used throughout labor to numb the world across the cervix, per Johns Hopkins Drugs. However that is normally solely used if requested upfront, or in the event 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 methodology which relaxes you and generally makes you go to sleep. Any such sedation, referred to as “twilight” or “aware sedation,” is used for minor, much less advanced procedures that do not essentially require complete anesthesia, like knowledge enamel elimination for instance, per the American Society for Anesthesiologists (ASA).

As demand grows, increasingly 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 in addition 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 capsules and lidocaine gel being the primary choices, the analysis is blended on how effectively these strategies truly work to mitigate ache in the course of the process.

My expertise getting an IUD beneath sedation

As quickly as I discovered that IV sedation for IUD insertion was an possibility, I talked to my pal’s OB/GYN and made an appointment. Some individuals could must 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 heart as an alternative).

A number of days earlier than my appointment, I bought directions on find out how to put together. I used to be advised to quick (no meals or water for at the very least eight hours beforehand) and to carry somebody to drive me house after my appointment. I used to be fairly anxious the evening 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 become a robe and talked with my OB/GYN. She eased my anxiousness with an encouraging however detailed overview of what was to come back. Then she launched me to the anesthesiologist, who defined he’d be giving me a really low dose of propofol (a standard anesthetic) via 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 shortly felt the consequences of the IV, and earlier than I might hear the refrain of the track that was taking part in, I used to be quick asleep.

I awoke a bit disoriented, however had solely been beneath for round 20 minutes, which simply felt like an extended nap. I used to be escorted to a different room to get better, the place my cousin (who’d accompanied me to the appointment) was ready. My physician was in a position to give me some ibuprofen via 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 in a position to safely stroll out with my cousin. The one proof I would had of the IUD was the acquainted heavy feeling in my stomach that normally 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 again and again if I needed to. It was such a aid to bypass any ache or anxiousness in the course of the precise process, and I did not have any unintended effects from the anesthesia. I did have some cramping and light-weight recognizing for the remainder of the week, which is regular post-IUD insertion, and was in a position to take OTC ache relievers such as you would after a typical insertion.

Suggestions for getting an IUD beneath sedation

Getting an IUD this fashion shouldn’t be at all times marketed or available. Listed below are some ideas I’ve discovered from the consultants and my very own expertise.

Name round

Top-of-the-line issues to do is name round and ask in regards to the choices totally different OB/GYN workplaces present. Be ready to reply questions on why you are on the lookout for IV sedation. The entrance desk could must name you again after checking with suppliers on whether or not sedation is an out there possibility. If they do not provide it, you may 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 price and protection can actually be a problem. “Going to the working room is awfully extra pricey than having it performed within the workplace,” notes Dr. Cron.

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

Test in along with your particular person insurance coverage firm about your protection. It’s possible you’ll even have the ability to discover a appropriate OB/GYN this fashion, too.

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

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

That is usually the case. “Typically, I do not provide it proper off the bat,” says Dr. Cron, except 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 elements related to sedation.

How your physician reacts to you talking up, sharing about your ache tolerance and fears, and making requests is usually all you should find out about whether or not or not they’re the proper supplier for you. You will finally need somebody who listens to and validates your wants. Do not be afraid to face agency in your requests and selections, particularly in the event you’re getting pushback.

Weigh out the advantages and dangers

I did not really feel unintended effects from the anesthesia, however that is one thing you need to think about in the event you’ve had a nasty response to sedation previously. Based on the ASA, the most typical unintended 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 you could really feel after insertion with out sedation. Getting sedated additionally takes longer and requires extra prep earlier than your appointment.

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

The underside line

As somebody who’s had uncomfortable experiences on the OB/GYN previously, and has danger elements for elevated ache throughout IUD insertion (i.e., painful durations and no historical past of vaginal beginning), I am so glad sedation was an possibility for me. However I acknowledge it is a privileged take—not everybody is ready to get an IUD this fashion.

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

In a super world, we would 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 possibility, and advocating in your consolation, is an effective place to begin.