Madeline Mahoney's Testimony on IUD Pain Management for MA Briefing on Bill H1315

Dr. Shannon West: My question for you is, what does the current research say about people's experiences with IUD pain, and what direction does this field of research need to head into next?

Madeline Mahoney: Thank you so much for having me. To start with the first question about what the research says about people's experiences with IUD pain, we are currently working on a type of study where we use a systematic method of reviewing the current research to understand what it says about people's experiences with IUD insertion pain. We know that IUDs are a highly effective form of contraception and that people are generally quite satisfied with IUDs. And across studies, we see that people really have quite a range of experiences with IUD insertion pain with a substantial proportion of people having moderate or severe pain with their IUD insertion.

One study found that insertion experience was a major reason why people with an IUD either wouldn't get another IUD in the future or would not recommend it to a friend. Beyond those individual interactions, social media is also a place where people can share information about their experience with IUD insertions. And so there is some research that analyzes social media content and it's found that social media users feel their pain was often inadequately addressed by their provider, which can create distrust in the healthcare system, and that people do want more pain management options, particularly anesthesia.

Another study found that seeing negative social media content about IUDs is then associated with increased anticipated pain and anxiety before IUD insertion. So by not adequately addressing people's pain, it creates more anxiety and discomfort for future patients. Healthcare providers play an important role in people's experience with their IUD insertion, and people want to feel adequately prepared for the pain that they may experience and to not have their pain dismissed.

So in summary, people really do have a range of experiences with the IUD insertion process, but want pain to be taken seriously and to be offered pain management options. There's definitely still a lot that we don't know about people's experiences with painful IUD insertions and how that impacts future experiences in the healthcare system as well as future reproductive decision-making.

So my lab, we are currently working on a series of projects related to IUD insertions, including interviewing people who've had painful IUD insertions to try to understand some more of those pieces about how it affects trust and experiences in the healthcare system and future reproductive decision-making.

Dr. Shannon West: Great. Thank you so much for the work that you're doing.