How you influence sexual health guidelines through social media
While having your blood drawn, sometimes you are told it will involve “a little discomfort” but pass pretty “quickly”, and anesthesia barely crosses your mind. You wouldn’t expect this to be followed by pain “worse than childbirth” (Ternouth, 2024).
Such horrifying incidents went viral on social media after patients’ IUD insertions were prefaced like a routine flu shot (Bever, 2024). Intrauterine devices (IUDs) are T-shaped contraceptive devices placed in the uterus within minutes at a doctor’s office to prevent pregnancy. Patients have reported varying ranges of pain during this procedure, from only minimal discomfort to excruciating pain that distresses patients days following their procedure (Ternouth, 2024).
The CDC recently released guidelines that doctors should make it protocol to discuss pain management options with patients before inserting IUDs (Curtis et al., 2024). The guidelines cite Wu et al. (2023) that summarized the viral wave of patients’ honest documentation online of their IUD insertions.
February 9th to 15th was Sexual Health Week, and this year marks about 80 years since obstetrics and gynecology was formally recognized as a specialty in Canada. It has shifted from predominantly men to women (Mitchell, 2019), but women’s pain and symptoms are still dismissed across medical disciplines and chalked up to stress, anxiety, menstruation, weight, or exaggeration, which has delayed crucial screening and treatment for larger underlying chronic conditions like endometriosis. Many of these experiences are disclosed under the tag #medicalgaslighting on TikTok (O’Leary, 2023).
On average, clinicians estimate the pain score for IUD insertions to be 35 on a scale of 0 to 100.
Patients report an average pain score of 65 out of 100, and most have previously given birth.
(Hunter et al., 2019)
My intention is not to instill mistrust in you toward your healthcare providers, but to urge a critical outlook on the broader state of obstetrics and gynecology to help you prepare to advocate for yourself and know what conversations to expect or initiate with a provider. Gynecological research still lacks the support to meet urgent needs for improved evidence-based practice to address infertility, low birth weight, pregnancy-induced hypertension, ectopic pregnancies, birth control, sexually-transmitted diseases, and racial disparities in maternal and infant mortality rates (Barss et al., 2025). It is because of deficits in gynecological literature that doctors continue to assure IUD-seeking patients that their cervix has “no sensation”, a grossly incorrect conclusion of a paper from 1953 (Kinsey et al., 1953).
I hope the patients who shared their IUD experiences know how impactful their postings are to improving the healthcare experiences of others who are considering IUDs as part of their sexual health. While social media is not always an ideal way to advocate for healthcare needs due to the permanence and highly public nature of online activity, it is a crucial example of narrative medicine in gynecology. Having lived experience as a patient is often just as—if not more—credible and influential to shaping health policy compared to professional medical credentials. Women have certainly stepped up to inform each other’s sexual and reproductive healthcare where medical research lags behind.
UBC Humanities in Healthcare is hosting our annual Narrative Medicine Case Competition on March 29th and 30th, 2025. This year our case will revolve around commonly underdiagnosed gynecological conditions. Join fellow students in learning the role of narrative medicine in real healthcare experiences, under the mentorship of healthcare professionals in your community!
By: Christina Zeng (she/her) | Blog Committee Member
RESOURCES:
Suggestions on discussing IUD insertion pain with healthcare providers
What Women Should Know About Intrauterine Devices (IUDs)
Further reading on challenges in furthering OB/GYN research
References:
Barss, V.A. Chakrabarti, A. Eckler, K. (2025). What’s new in obstetrics and gynecology. UpToDate. https://www.uptodate.com/contents/whats-new-in-obstetrics-and-gynecology
Bever, L. (2024). After social media outcry, CDC tells doctors to better manage IUD pain. The Washington Post. https://www.washingtonpost.com/wellness/2024/08/08/iud-pain-cdc/
Curtis, K.M. Nguyen, A.T. Tepper, N. K. Zapata, L.B. Snyder, E.M. Hatfield-Timajchy, K. Kortsmit, K. Cohen, M.A. Whiteman, M.K. (2024). U.S. Selected Practice Recommendations for Contraceptive Use, 2024. Morbidity and Mortality Weekly Report, 73(3); p. 1-77. http://dx.doi.org/10.15585/mmwr.rr7303a1
Hunter, T.A. Sonalkar, S. Schreiber, C.A. Perriera, L.K. Sammel, M.D. Akers, A.Y. (2019). Anticipated Pain During Intrauterine Device Insertion. 26;33(1), p. 27-32. https://pmc.ncbi.nlm.nih.gov/articles/PMC6980875/
Kinsey, A. C., Pomeroy, W. B., Martin, C. E., & Gebhard, P. H. (1953). Sexual behavior in the human female. Saunders.
Mitchell, B.M. (2019). The Evolution of Obstetrics and Gynaecology and Related Subspecialties in Canada. Journal of Obstetrics and Gynaecology Canada, 41(2), S224-S226. https://www.jogc.com/article/S1701-2163(19)30765-0/fulltext
O’Leary, D. (2023). Opinion: Here’s why #MedicalGaslighting has taken social media by storm. CNN. https://www.cnn.com/2023/09/06/opinions/medical-gaslighting-social-media-women-health-oleary/index.html
Ternouth, L. (2024). ‘Worse than giving birth’: Calls for stronger pain relief for IUD insertion. Radio New Zealand. https://www.rnz.co.nz/news/national/526329/worse-than-giving-birth-calls-for-stronger-pain-relief-for-iud-insertion
Wu, J., Trahair, E., Happ, M., & Swartz, J. (2023). TikTok, #IUD, and User Experience With Intrauterine Devices Reported on Social Media. Obstetrics and gynecology, 141(1), 215–217. https://doi.org/10.1097/AOG.0000000000005027
