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

Once I informed my physician, she mentioned swapping the tablet for one more type of contraception referred to as an intrauterine machine (IUD) would possibly doubtlessly assist scale back my newfound ache. However the thought of somebody (even a medical skilled) placing the plastic, T-shaped machine into my uterus scared me—though it is solely in regards to the measurement of 1 / 4. I’ve additionally had a number of destructive experiences with gynecological exams previously, so between these recollections and buddies’ 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 you must keep in mind to take contraception tablets on daily basis, an IUD will be positioned and left alone to do its job. IUDs are additionally 99 p.c 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 folks coping with situations like endometriosis, per the American School of Obstetricians and Gynecologists.

Once I realized a buddy 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 rapidly booked my appointment at her OB/GYN’s workplace in New York Metropolis and efficiently acquired my IUD this spring.

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

However sedation is slowly changing into extra accessible—even at native well being clinics. And you already know your physique (and your ache tolerance ranges) finest. In the event you’ve been contemplating getting an IUD, however are not sure due to the ache and nervousness related to it, you can advocate to get one this fashion. This 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 device to place the IUD by way of the opening of your cervix and into your uterus (the place it’ll keep), in keeping with Deliberate Parenthood.

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

“I’d say in my expertise, there’s a very, very large variation when it comes to 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 research 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 concern and anticipation of ache could make issues worse. A February 2015 research in Open Entry Journal of Contraception discovered that anticipated ache was typically increased than ache through the precise process. These expectations, and the quite a few IUD tales I might seen on social media, are what stored me ready on getting one. Although Dr. Cron warns these tales typically exist in a vacuum: “Normally, it is similar to a restaurant: In the event you had a traditional expertise and every little thing was high-quality, 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 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 can provide you time to relaxation on the examination desk, or a nurse could keep within the room with you to be sure you’re feeling okay.

What pain-management choices are presently accessible for IUD insertion?

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

However regardless of pain-relief tablets⁶ and lidocaine gel⁷ being the principle choices, the analysis is combined⁸ on how properly these strategies truly work to mitigate ache through the process. A simpler technique is perhaps lidocaine paracervical block—a neighborhood anesthetic generally used throughout labor to numb the realm across the cervix, per Johns Hopkins Medication. However that is normally solely used if requested prematurely, or for those who require a second try at insertion (as a result of your OB/GYN was unsuccessful at inserting the IUD at your first appointment resulting from ache).

Then there’s IV sedation—the even lesser-known technique 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 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 best 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 also profit.”

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

My expertise getting an IUD beneath sedation

As quickly as I realized that IV sedation for IUD insertion was an choice, I talked to my buddy’s OB/GYN and made an appointment. Some folks 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 offered sedation as soon as a month, they conveniently had an in-house working room, which isn’t the case for some practices (you’d should go to the hospital or a surgical procedure middle as an alternative).

A couple of days earlier than my appointment, I acquired directions on put together. I used to be informed to quick (no meals or water for no less than eight hours beforehand) and to deliver somebody to drive me dwelling 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 turned into a robe and talked with my OB/GYN. She eased my nervousness 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 standard anesthetic) by way of 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 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 a protracted 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 in a position to give me some ibuprofen by way of 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 might 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 might do it again and again if I needed to. It was such a reduction to bypass any ache or nervousness through the precise process, and I did not have any unwanted 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 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 isn’t all the time marketed or available. Listed here are some ideas I’ve realized from the specialists and my very own expertise.

Name round

Among the finest 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 in search of IV sedation. The entrance desk could must name you again after checking with suppliers on whether or not sedation is an accessible choice. 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 have been each coated 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 awfully extra pricey than having it accomplished within the workplace,” notes Dr. Cron.

“For sufferers which have good insurance coverage that can 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. Chances are you’ll even be capable to discover a appropriate OB/GYN this fashion, too.

Convey 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. “Normally, 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 it’s good to find out about whether or not or not they’re the best supplier for you. You may 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 for those who’re getting pushback.

Weigh out the advantages and dangers

I did not really feel unwanted effects from the anesthesia, however that is one thing you must take into account for those who’ve had a nasty response to sedation previously. In accordance with the ASA, the commonest unwanted effects of IV sedation embrace complications, nausea, and drowsiness. And on the subject 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 could outweigh the dangers for you, or vice versa. Everyone seems to be totally different, however you already know 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 choice 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, nonetheless, from getting an IUD if you need one; they’re not all the time intensely painful and are an extremely efficient contraception technique—one thing to bear in mind as sure reproductive rights are rolled again in some states.

In a really perfect world, we might have higher methods to handle ladies’s ache. Fortunately, extra docs 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 in your consolation, is an effective place to start out.