This Winnipeg doctor wants others to take women's pain more seriously when inserting birth control devices

A Winnipeg health-care leader says doctors need to to be more proactive in addressing patients' pain when inserting an intrauterine device, a highly effective form of birth control that can sometimes cause significant discomfort.

Dr. Joss Reimer, the Winnipeg Regional Health Authority's chief medical officer, says it's "way too common" for patients not to get any pain management while undergoing a procedure to insert an IUD.

"It's a long-standing practice where we just don't value the pain of women the same way we do men and expect them to go through painful procedures that we wouldn't expect in other circumstances," she said in an interview on CBC Manitoba's Information Radio on Friday.

"It's really a practice that we're trying to move the needle on and change."

An IUD is a small T-shaped object that's inserted into the uterus by a doctor.

It's more than 99 per cent effective against pregnancy and, once it's in, you don't need to think about it for years. 

Not only does it serve as birth control, but it works to decrease periods and is effective at preventing some types of cancer, Reimer said.

For some, the IUD insertion can be very painful, and it continues to be standard practice not to address that pain, Reimer said.

Because it's unpredictable who will experience pain, sometimes doctors just don't address it at all, she said.

LISTEN | Dr. Joss Reimer on why too many women deal with pain during IUD insertion:

"We don't want to give people medication they don't need, but I think the bigger issue is that this is just how it's been done," Reimer said.

"This is how I was trained, this is how many people were trained, and it becomes normalized that somebody might be in pain, and that's what we're trying to shift."

There are many options for reducing pain or eliminating it altogether, including a numbing spray that can be applied to the cervix, freezing, sedatives during the procedure and medication before and after.

Winnipegger Sam Slade has had two different IUD insertions — one without any pain management and one where she was anesthetized.

"The initial procedure was not terrible, but almost immediately after, I just was cramping and sweating and super light-headed and nauseous," Slade said in an interview earlier this week.

"I felt like I had to go to the bathroom, so I got up to go to the bathroom and just fell over and essentially passed out. It was that bad."

Several years after her first insertion, Slade received anesthesia during her second procedure, which was a game changer.

"I didn't feel a thing. There was no recovery time. I felt honestly great after," she said.

Slade thinks doctors and patients alike should have a better understanding of the procedure and possible painful outcomes.

"I honestly think there should be more information around the kind of immediate side-effects that can happen after the procedure and different ways you can combat it, because I honestly wasn't aware that [anesthesia] was an option," she said.

"Considering how invasive a procedure it is, I honestly think that it should just be standard."

Reimer says pain management during these procedures should be included in medical curriculum, and she is having conversations with other doctors she interacts with about how to make IUD insertions easier for patients.

"My first IUD was quite excruciating, so to think someone who is well-educated still went through this means we have a lot of work to do in the system," she said.

"What's it like for someone who is not white, who is not highly educated trying to advocate for themselves?"