Understanding Pain Management & Sedation Options in IUD Insertion

Among the many women’s health services we are proud to offer at Gynaecology Centres Australia (GCA) a long-acting reversible contraception to help prevent unwanted pregnancy, called an intrauterine device, otherwise known as IUD (both hormonal and non-hormonal). The hormonal IUD can also be used to treat heavy, painful periods and be used as the progesterone part of hormone replacement therapy (HRT). 

Insertion of an IUD can be an uncomfortable or a painful experience for many women, especially if the insertion is carried out without appropriate pain relief, which is important for the patient’s comfort. 

Here at GCA, our commitment to women’s health and wellbeing is unwavering, and this includes maintaining utmost comfort and patient-centred care at all times. Our unique value is offering women undergoing IUD insertion in our clinics providing intravenous medication sedation for all of our IUD insertion procedures – at the same cost as for regular IUD insertion

IUDs – An Introduction

An IUD or intrauterine device is a reliable (>99% effective) long-acting, yet 100% reversible contraceptive and family planning solution that has become very popular among women in Australia. IUDs, like the progesterone-releasing  intrauterine device are placed high in the uterus, where they release the hormone levonorgestrel (otherwise known as progestin / progesterone). They help prevent pregnancy and can remain in place for five years, sometimes longer. They are easy to remove at any time in the clinic or at the GP clinic, and fertility is quickly resumed upon their removal. There are also copper (non-hormonal) IUDs that may be requested by women who choose not to have any hormones. 

Unlike the Combined Oral Contraceptive Pill and the Vaginal Ring, the progesterone-releasing IUD does not contain oestrogen and is suitable for use by women who are breastfeeding. It also provides other benefits for women nearing menopause, those who have heavy periods, and those who cannot use oestrogen. 

Once inserted, the IUD can essentially be “forgotten about” until you either choose to become pregnant or have it replaced in five years.

Is it Painful to Insert an IUD?

IUD insertion can indeed be uncomfortable. Some women experience mild to moderate pain, and some find it intolerable and may describe the pain as severe, while others report short-lived but tolerable discomfort during the procedure. 

Your medical provider will do everything in their power to make the procedure as pain-free and comfortable as possible – and GCA is at the forefront of maintaining patient comfort during IUD insertion with our unique approach of utilising intravenous medication sedation for IUD insertion, administered by an experienced doctor sedationist, in addition to the experienced proceduralist who inserts the IUD. 

The IUD insertion itself is a relatively quick procedure that requires the vagina be opened with a speculum, antiseptic administered, the cervix stabilised and gently dilated (slightly opened to allow insertion of the device), and the IUD inserted via the cervix and positioned into the top part of the uterus. As well as feeling a sharp (cervical) or cramping (uterine) pain, some women may also feel lightheaded, dizzy, nauseous, or faint, whilst they are completely awake. If medication intravenous sedation is given, then these feelings are not experienced. 

Following insertion, (after sedation has worn off) it’s normal to experience mild cramping for a few days (sometimes a few weeks), spotting, or light vaginal bleeding, and possibly some mild hormone-related side effects (headache, breast tenderness, etc) which usually resolve within a few weeks. (Learn more here).

Can I Be Sedated for IUD Insertion?

Yes. At GCA, we provide intravenous medication sedation for all of our IUD insertions. This is a light form of “twilight” sedation that is administered via a needle into a vein in your arm. You will be asleep during the procedure, will feel no pain upon insertion, nor likely to have any memory of the procedure itself (in most cases). 

If you choose to be awake and completely lucid for your IUD insertion, then many GPs offer this option at their surgeries. 

Pain Relief During IUD Insertion – What Are My Options?

Many women will prefer to be sedated for their IUD insertion. 

Here are GCA, we are committed to the wellbeing and comfort of our patients, and we provide medication sedation during the IUD insertion process for all of our patients.

Other providers of IUD insertion (including GPs) use different approaches to pain management rather than sedation for women during the procedure. 

Not all women will elect (or require) to be sedated for their IUD insertion. Or it may be completely by choice. The need or desire for sedation depends on various factors, including a women’s personal pain tolerance, preference, medical and gynaecological history, whether she has ever or recently given birth vaginally, and other factors. 

For women who prefer not to be sedated, there are pain relief options. an IUD can be inserted in their GP’s office (as long as the GP offers this service) or by their gynaecologist in his or her office. Pain relief options include oral analgesia (ibuprofen, naproxen sodium) taken thirty minutes before the procedure or a local anaesthetic applied to the cervix. Many women find that oral analgesia alone is inadequate. 

The “Green Whistle” Approach – a New Trend in IUD Insertion Pain Management

There has recently been a lot of “buzz” in the media regarding what is commonly known as the “Green Whistle” for IUD insertion. 

Methoxyflurane (“green whistle”) is a pain relief drug that has been used for many years in Australia and overseas by paramedics and emergency workers (and commonly in professional sports). It is a fast-acting form of emergency pain relief that is breathed in by the patient from a tube with a mouthpiece. 

Some women may choose methoxyflurane “Green Whistle” inhalational device at their GP clinic or gynaecologist, where each dose lasts approximately 30 minutes. Pain relief begins after 6–8 breaths and continues for several minutes after stopping inhalation. 

Pain experienced can also be strongly influenced by anxiety, stress, fear, and expectation. Many GPs offer these services if you wish too be awake. 

The “green whistle” has been used over several months by some providers (but not GCA) for pain relief during IUD insertion. It may be considered a substandard alternative for many women when compared with intravenous (IV) medication sedation provided by a separate doctor (sedationist) to the proceduralist (who inserts the IUD). This is the method utilised at GCA. 

Here are GCA, we are committed to the wellbeing and comfort of our patients, and we offer medication sedation during the IUD insertion (and/ or removal) process and tend to insert all IUDs that way. Because many GPs can insert them at their surgeries, uncomplicatedly, we tend to see patients who either request sedation or are referred to us where IUD insertions or removals have been problematic whilst the patient is awake.  

Making the Right Choice – How to Decide for Yourself

A positive IUD insertion process requires that you are properly informed and feel complete confidence in your medical provider. At GCA, we ensure you understand the process, know what to expect, and are supported by us to make the right decision for you. 

Our patients choose GCA for IUD insertion under sedation as it represents the most comfortable, less stressful experience possible.

When deciding whether to have your IUD inserted under sedation or not, you need to consider:

• Personal choice 
• Your personal pain threshold
• Expectations
• Medical/gynaecological history
• Convenience
• Understand that when you undergo IV sedation, you will not be able to drive until the next day after your appointment with us and will need to be accompanied home.
• There are risks associated with sedation and not all patients are suitable because of pre-existing medical problems or excessive BMI (>/= 40) or weight more than 110kg. It’s important to contact us if you have any medical conditions that may prevent  you from having sedation at our clinic. 

Summary

1. What is an IUD?

An IUD is a long-acting contraceptive device that is inserted into the uterus where it may remain for several years to prevent pregnancy, manage heavy menstrual bleeding, and assist with perimenopause for some women.

1. Does IUD Insertion Hurt?

Insertion of an IUD can be uncomfortable or painful, but with the right approach to sedation and/or pain relief, it doesn’t need to be. Pain AFTER insertion (after the sedation medication has warn off) is variable amongst individuals. 

1. Can I Be Sedated for IUD Insertion?

Yes. Gynaecology Centres Australia uses intravenous (IV) medication sedation for IUD insertion procedures. 

1. Why Choose Gynaecology Centres Australia for IUD Insertion?

Gynaecology Centres Australia is a leading private women’s health provider committed to providing high-standard, compassionate, confidential care. Our approach prioritises the comfort and wellbeing of our patients at all times.

Contact Gynaecology Centres Australia Today for a Consultation

Embrace a Pain-Free IUD Insertion!

Gynaecology Centres Australia is a leader in Women’s Reproductive Health and Gynaecology. We also provide vasectomies for men.

With clinics conveniently located in five NSW cities (including one adjacent to Canberra ACT at Queanbeyan), we provide an unrivalled level of care and compassion to our patients. 

Please reach out to us for all of your women’s health concerns, including pain-free IUD insertion. Take control of your body and your family planning with us – book a consultation today for confidential and personalised care. 

Contact us now online or call  (02) 9585 9599