Whenever anybody asks me how I like my Mirena IUD, I tell them that I love it, as earnestly and vigorously as someone actually earning commission from Big Estrogen. I say that the ease of not taking a pill, the peace of mind that comes with using the most effective form of birth control, and the infrequent periods were all worth the pain. And I mean it! But I wouldn’t exactly call getting an intrauterine device inserted breezy; in fact, I would call it a downright bad time. It’s an experience that’s left me wondering: Why are women expected to pay for reproductive freedom with a procedure that is invasive, vulnerable, and so painful that it’s known to make patients vomit and faint?
While I am glad to have my Mirena IUD, I’m not certain that I would’ve gotten it if it weren’t a necessity. I began taking the combination estrogen and progestin pill in high school after suffering through years of debilitating cramps, aided by nothing more than Advil and some light sympathy. But it took until I graduated from college for a doctor to tell me that because of my chronic migraines with aura, taking the pill greatly increased my stroke risk, and that continuing to prescribe me the pill would violate the American College of Obstetricians and Gynecologists’s guidelines.
I’m slightly embarrassed to admit that I put off getting my IUD for so long because I was terrified by the horror stories. But I’m also not alone in that fear. Every so often, I’ll see young people on TikTok recounting their inaugural gynecological nightmares—many of them Pap smears or IUD insertions. Check the comments on these videos, and you’ll see responses like, “I’m never getting a Pap smear as long as I live,” or, “Getting an IUD was the worst experience of my life and I would sooner die than get another.” A lot of those comments come from a place of naïveté, but that doesn’t diminish their validity: It is completely natural to balk at the idea of making yourself physically and emotionally vulnerable to a stranger, and trusting them to treat you with humanity. And it’s even more reasonable to wonder why we have to physically suffer during a common, should-be-routine procedure.
The “tough it out” mentality seems to particularly plague obstetric and gynecological procedures, a sad fact that is especially true for Black women, who are least likely to have their self-reported pain taken seriously by a medical establishment still rife with implicit bias. Before my own IUD appointment, my doctor advised I take four Motrin, which is basically a dose fit for a hangnail. (I may or may not have also helped myself to one of my dog’s Fourth of July Xanax to help calm my nerves…there are no awards for suffering, as they say.) And, anecdotally, of all my friends and acquaintances with IUDs, I’d never heard of anybody being offered any kind of substantial pain relief at all; nothing beyond 800 mg of ibuprofen, in fact.
