Getting an IUD can hurt. B.C. doctors say it doesn't have to
Dr. Ana Armas Enriquez remembers the agony of getting an intrauterine device (IUD) as a teen.
“It was a horrible pain,” she said. “It’s excruciating.”
Decades later, the Nanaimo-based women’s health physician strives to alleviate that pain for her patients.
There are several pain-management tools to choose from, including oral painkillers, numbing gel, a cervical anaesthetic, and in extreme cases, sedation. Those options aren’t always offered to patients, Armas Enriquez said.
“It’s like going to a dentist and getting a root canal or a tooth extraction and not being offered freezing,” said Armas Enriquez, owner of Women’s Vita Medical Clinic.
Kaitlynn Hoffman has had several IUDs, which are inserted into the uterus through the cervix.
“It was quite painful and I was not offered any… pain management aside from being told Tylenol would work,” she said.
“It just feels like somebody is stabbing you with… some sort of sharp object in your uterus.”
She underwent the procedure for the third time in October. That time, Hoffman said she was offered cervical numbing and an Ativan.
“That was the best experience that I’ve had,” Hoffman said.
'WOMEN'S PAIN DOESN'T MATTER'
Last year, the Society of Obstetricians and Gynaecologists of Canada released a statement outlining pain management options. Still, a family planning physician said there aren’t any firm rules that explain how to make a patient more comfortable.
“Pain management is individual and it involves combining multiple methods. That’s very hard to study and so that’s why we don’t have clear guidelines and a lot of people assume that means to use nothing,” said Dr. Renée Hall, co-medical director at Willow Clinic.
Hall trains other physicians on IUD insertion. She said medical schools need to provide more robust training for the procedure.
“We have a lot of people who would never even consider one of the most effective options for birth control that has one of the lowest doses of hormones… because of all that they’ve heard from their friends about how painful and traumatic it was,” she said.
Asking women to grit their teeth through the procedure sends the message, "That women’s pain doesn’t matter or that we can tolerate more,” Hall said.
MEDICATION COMES AT A COST
Hall and Armas Enriquez said doctors need to be paid more for IUD insertions.
Their practices focus largely on women’s health, which means they aren’t compensated under B.C.’s family physician payment schedule. The province introduced the payment model in 2022 to address the doctor shortage through increased pay.
“I cannot participate in such a program because then I have to redefine my practice,” Armas Enriquez said.
As a result, she and Hall are compensated under the old fee-for-service model. That means they make $46.79 per IUD insertion.
That fee does not cover the cost of a cervical anaesthetic, an injection that numbs the cervix.
“How many people… with a debt of three quarters of a million dollars from going to med school in family practice can afford to do all of this?” Armas Enriquez said.
The health ministry said work is underway to improve compensation for IUD insertions.
Going forward, Hoffman is optimistic more patients will have a positive experience like she had in October.
“Hopefully we can learn from the doctors that are doing the work and taking the time just to make the experience a little bit better,” she said.
CTVNews.ca Top Stories
Potential tornado 'surreal' for residents who witnessed damaging storm in southern Ontario
Witnessing a potential tornado was 'surreal' for residents who caught a glimpse of the damaging storm in southern Ontario on Wednesday night.
Was this the bug that stung you? Wasp sightings revive murder-hornet concerns; no detections confirmed
As temperatures rise out of a mild El Nino winter, Canada's buggy season is already upon us again, and this year, the bugs are looking especially big.
Minister tables bill to extend citizenship rights to children born abroad
Immigration Minister Marc Miller tabled legislation today that is intended to extend citizenship to some children born outside of the country.
WestJet planning new fare category for travellers willing to forgo carry-on bag
WestJet Airlines plans to launch a new cheaper fare category that would be available to travellers willing to fly without a carry-on bag.
Hundreds have applied for this 'adventurer' job in Banff National Park
Coined as Banff's 'ultimate summer job,' the Moraine Lake Bus Company says hundreds of people from across the world have applied for its adventurer position.
'We'll need all hands on deck': Details emerge after deadly boat crash near Kingston, Ont.
Police say they have wrapped up their on-scene investigation into a deadly boat crash in eastern Ontario as details of the incident begin to emerge.
Jennifer Lopez's response to question about Ben Affleck is a reminder of their decades of love in the spotlight
Plenty of people are wondering if Jennifer Lopez and Ben Affleck are having problems in their marriage, but one person had the nerve to ask in a public forum.
U.S. Justice Department says illegal monopoly by Ticketmaster and Live Nation drives up prices for fans
The U.S. Justice Department filed a sweeping antitrust lawsuit against Ticketmaster and parent company Live Nation Entertainment on Thursday, accusing them of running an illegal monopoly over live events in America -- squelching competition and driving up prices for fans.
Adding just 10% ultraprocessed foods to healthy diets may raise risk of cognitive decline, stroke
Eating more ultraprocessed foods is linked to a higher risk of cognitive decline and stroke, even if a person is trying to adhere to a Mediterranean diet, the DASH diet or the MIND diet, a new study found.