Here at Rescripted, we think a lot about the pain gap. The term refers to our societal dismissal of women’s pain. Think about it: Have you ever expressed that your period pain can be debilitating, only to be told that menstrual cramps are “normal”? Or, have you ever told someone you have a migraine and had them suggest you just “pop a Tylenol and rally”? If so, you’ve experienced this very thing.
The pain gap keeps us suffering in silence, and leaves countless women gaslit and fighting to be heard — which leaves many conditions undiagnosed and the roots of many women’s pain undetected and untreated.
From periods to pregnancy to postpartum to menopause and…well, really throughout our entire lifetimes, we are expected to simply bear pain, as though physical hurt is just baked into the experience of womanhood. And yes, our bodies are complex; some level of discomfort and pain is inevitable. But what we need — what we’ve been needing — is a better reaction from the medical community and society at large to really *hear* women when they express pain, and to find ways to alleviate the preventable suffering we so frequently endure.
Take, for example, IUD insertion. Many women have been told that getting an IUD is the gold standard of birth control — a one-time insertion that allows them to give up their daily birth control pills for years. IUDs also give people the option of either hormonal or non-hormonal birth control, and they can be used as emergency contraception after unprotected sex as well. Birth control access in general is essential, and IUDs represent one effective, generally safe method of contraception that can be life-changing for many people.
But what we’re not often told is that having an IUD inserted is painful, sometimes excruciatingly so.
In one Reddit post, a user shared that she nearly passed out and broke into a full-body sweat during the procedure. By contrast, her husband “didn’t want to know what was happening” during his vasectomy — which is, for the record, a minimally invasive procedure — and he was put under.
Historically, pain has rarely even been mentioned as part of the IUD insertion process, either in cultural conversations or in medical settings. While lidocaine can reduce pain during insertion, the same research indicates that people are often told to take Ibuprofen to manage the pain of insertion.
The result of this, of course, is that women are once again suffering when they don’t need to. And, by not talking about the pain or preparing them for the realities of the experience, we’re making people feel like something is wrong with them, like they’re “weak” for struggling to bear it.
That’s why recent updates to the CDC’s guidelines surrounding IUD insertion are such a huge deal.
They not only acknowledge the pain women and people with uteruses endure during this procedure, they also attempt to do something to alleviate it.
After taking input from experts into account, the CDC issued a revised set of contraceptive guidelines to those released in 2016. The guidelines include revisions to the medical community’s approach to IUD insertion. From counseling users about potential changes in bleeding patterns, to providing information about alternate forms of contraception if someone chooses to remove their IUD to the need to discuss side effects or complications with the provider, these revisions focus on a more individualized, patient-centered approach. But one thing that really caught our eye? The mention of counseling patients on pain management before IUD insertion.
“Before IUD placement, all patients should be counseled on potential pain during placement as well as the risks, benefits, and alternatives of different options for pain management,” the guidelines read. “A person-centered plan for IUD placement and pain management should be made based on patient preference.”
These new guidelines represent a very real step forward in our approach to both addressing and preventing women’s pain — but it’s about more than that. It’s also about how women have used their voices to influence important change.
Much of the discourse around women’s pain, IUD insertion, and contraception in general has taken on new life thanks to the conversations women are initiating within communities and brands like Rescripted, as well as on social media. On TikTok, for example, women have been sharing their stories about how painful getting an IUD put in is. These are the types of conversations that move the needle, not just where awareness and public perception are concerned, but also (if this revision in guidelines is any indication) where policy and approach by the medical community are concerned as well.
Now, social media users are commenting on the revisions, and shedding light on the relationship between social media discourse and changes in the way the medical community approaches issues patients face. As one TikTok user said in a clip shared to the platform, “sharing your stories on here and other platforms resulted in some real change.”
And Dr. Fran, an OB/GYN who frequently shared medical insights on TikTok, weighed in on this change as well. “Only 5% of providers who place IUDs previously were offering pain medication to their patients during insertion,” she said. “I think we’re going to see that number greatly improve now that we updated recommendations for pain management during IUD insertion.”
The board-certified ob/gyn went on to share that she was not taught about pain management during her own residency — and added that she’s learned so much about this topic from both providers and patients on social media.
In short? These public conversations matter. And while it’s not entirely fair that we need to be the ones bringing these issues to light (emotional labor!), this ability to use our voices is our best way to reclaim our power and agency over our bodies, even in a post-Roe world where that very agency is under daily threat.
Zara Hanawalt is a freelance journalist and mom of twins. She's written for outlets like Parents, MarieClaire, Elle, Cosmopolitan, Motherly, and many others. In her (admittedly limited!) free time, she enjoys cooking, reading, trying new restaurants, and traveling with her family.