QUESTION: The Centers for Disease Control and Prevention (CDC), the U.S. national public health agency that sets guidelines for medical care, has for the first time recommended that healthcare providers discuss the “potential pain” associated with IUD insertion and offer strategies for pain management.

QUESTION: What do you think about this?

Dr. O: – First, I want to emphasize that Choices already offers patients different methods of relieving possible pain involved in IUD insertions and other procedures. This is done through medications that relieve anxiety and through Moderate/Light Sedation. Doctors have known for some time that many GYN procedures including IUD insertions, can be very uncomfortable, even painful, and for some people, even PAP smears can be hard to experience. When I first arrived at Choices a year ago, Merle Hoffman and I discussed this, and we developed methods and ways to help patients – different ways to manage discomfort and pain. I’m glad the CDC has made this recommendation.

I want to stress here that pain is a very individual thing and very different from one person to the next. Pinch me, and pinch you, and we respond differently. Likewise, some patients need stronger pain medication than others. Oral pain relievers can be used to help patients relax, and Moderate/Light Sedation can further decrease the level of discomfort. We talk about all this with the patient and let the patient decide what they want. IUDs are a very effective and good form of birth control, and the insertion does not need to be – and should not be – painful.

QUESTION: What about other Gynecological tests and procedures? And why do you need gynecological visits anyway, aside from birth control and pregnancy tests?

Gynecological exams are important to make sure a patient is in good reproductive health. That includes a regular menstrual cycle, no signs of HIV, cancer or other infections, and issues of intimacy and sexual health, as well as other reproductive questions. Regular GYN exams should begin especially when patients become sexually active. And GYN exams at Choices include birth control as well as pregnancy options.

Regular PAP Smears are important for detecting possible precursors to cancer. Some patients experience discomfort or even pain during a Pap Smear, but I’m glad to say the old, intrusive PAP test IS NOW OBSOLETE. Instead of being swabbed by a nurse or doctor, a minimally invasive, FDA-approved self-swab alternative will soon be available. Patients can swab themselves in privacy. Choices is in the process of working with one of the developers of this test, and we will keep you posted on when it is available. There will also be pain management similar to the IUD insertion process.

THANKS DR.O. We encourage readers to go to our Gynecology Web Page for more information.