For years, women have said it loud and clear: IUD insertions hurt more than the pamphlets admit. Now, for the first time, leading medical authorities are backing them up with new guidance that validates their pain and calls for real change in how gynecologists handle the procedure. And yes, this shift is thanks to your TikToks, your tweets, and your stories.

ACOG’s New Guidelines Are a Direct Response to Your Pain

On May 15, the American College of Obstetricians and Gynecologists (ACOG) issued new clinical recommendations. They’re urging doctors not to dismiss the pain patients report during IUD insertions and other in-office procedures like cervical biopsies and uterine imaging. According to The New York Times, this is the first time the organization has formally outlined options for managing IUD insertion pain. These include anesthetic creams, sprays, or injections.

“It’s a response to a groundswell of complaints from patients on social media, in the news, and directly with physicians,” said Dr. Kristin Riley, an ob-gyn and co-author of the guidelines. “We’re all on social media, and we all see it.”

The Guidelines Say It: Don’t Underestimate IUD Insertion Pain

The new ACOG guidance is rooted in one crucial truth: doctors have historically underestimated women’s pain, especially in gynecology. As Psychology Today reported, many women describe feeling “blindsided” by IUD insertion pain. They also report no preparation and zero pain relief offered. The guidelines aim to change that.

They now recommend that providers:

  • Inform patients about what to expect
  • Offer pain relief options like lidocaine before or during procedures
  • Use trauma-informed, patient-centered approaches

“It’s about improving trust,” said Dr. Christopher Zahn, ACOG’s chief of clinical practice and health equity, in a statement reported by Axios. “And ensuring better access to gynecologic health care for every person.”

We’ve Been Here Before—and We Wrote About It

Last year on FIERCE, we published “The Pain is Real,” featuring stories from Latina women in our audience who shared their personal IUD experiences. Some used the IUD to manage heavy periods. Others, like Hannah, got one after Trump’s election to take back control over their reproductive futures.

But a consistent theme was the lack of adequate pain management.

“Imagine the worst menstrual pain you’ve ever experienced and double it,” Lisa Alcántara told us. “Then, I drove home and immediately regretted it.” Some rated the pain a 9 out of 10. Most hear from their doctors it would be “a little pinch.”

Why Doctors Rarely Offer Pain Relief

Here’s what the research says: As of 2024, only about 5% of IUD insertions involved any pain or anxiety medication, according to Axios. That’s because the evidence on how well pain relief works during IUD insertion has been mixed, so many doctors skipped it altogether.

But as Dr. Amanda Black told Chatelaine in 2024, local anesthesia “can be used, but it needs to be discussed in advance.” That lack of conversation? It leaves patients feeling blindsided, unsupported, and sometimes traumatized.

“There’s a common fear among providers that discussing pain might make patients more anxious,” Psychology Today explained. “But not preparing people for pain doesn’t prevent it—it just makes it worse.”

Addressing IUD Insertion Pain Is About More Than Discomfort

The consequences of ignoring IUD insertion pain go beyond the procedure. Patients who feel dismissed are more likely to avoid future care, develop anxiety, or struggle to trust their providers, Psychology Today reported.

“This is especially important in pelvic health care, where vulnerability is already heightened,” the article emphasized. “Better care starts with better communication.”

What This Means for You—and Why It Matters

These new ACOG guidelines are not a mandate, but they represent a major step toward validating patient experiences and demanding accountability in care. “Fewer people will have to endure pain to obtain procedures that are necessary for their health and well-being,” said Genevieve Hofmann, a women’s health nurse practitioner and co-author of the guidance, via ABC News.

As Dr. Ashley Jeanlus put it to the NYT, “ACOG is making it very clear that we should be treating our patients with equity, dignity, and trust—and ensuring they’re not expected to kind of tough it out anymore.”

If you’ve ever had to “tough it out,” know this: your voice helped make this happen.

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