In the days before her appointment to have an IUD inserted, “Lara” spent long hours reading women’s experiences online. She was not looking for its effectiveness rate or how long it lasts, but for an answer to a single question: how much would it hurt?
Lara says she had heard repeatedly that the procedure is “simple” and that she might feel only fleeting discomfort. But when the IUD insertion was over, another question stayed in her mind: why did the experience seem more painful than she had expected? It was not the pain alone that troubled her, but her feeling that her fears had not been taken seriously from the start.
Women have long lived under a culture that views female pain as something ordinary. Menstrual cramps are “natural,” the fatigue of pregnancy is “natural,” the pains of childbirth are “natural,” and even in medical procedures related to reproductive health, the discussion is not always focused on how to relieve the pain, but on a woman’s ability to endure it.
But describing pain as “natural” does not make it any less harsh, nor does it always mean that it is natural from a medical standpoint. According to the American College of Obstetricians and Gynecologists (ACOG), menstrual pain may result from the normal contractions of the uterus, but it may also be an indicator of health conditions such as endometriosis, a condition in which tissue similar to the uterine lining grows outside the uterus and causes pain that may be severe, or fibroids, which are non-cancerous masses that grow inside the uterus or on its wall and may lead to bleeding and pain during the period.
The College affirms that severe pain is not something to be lived with as a natural part of a woman’s life, but rather may call for evaluation and treatment.
Perhaps what is striking is that these complaints are not merely personal impressions. Recent medical reviews published by Harvard Medical School have pointed to what is known as “gender bias toward pain,” where research shows that women’s pain may be taken less seriously compared to men’s pain, which may lead to delayed diagnosis or treatment in some cases.
" The College affirms that severe pain is not something to be lived with as a natural part of a woman's life "
Contraception: why does the woman bear the greater burden?
Birth control pills, despite their wide use, may be associated in some women with side effects such as headaches, mood swings, nausea, and weight changes. As for hormonal injections and subcutaneous implants, they in turn impose a continuous intervention in the body’s hormonal balance, which pushes some women to avoid them or stop using them.
By contrast, the IUD is considered one of the most effective means of contraception, as its success rate in preventing pregnancy exceeds 99%. Nevertheless, the fear of its insertion remains one of the most prominent reasons for women’s hesitation to choose it.
But the common denominator among most contraceptive methods is that the physical burden ultimately falls on the woman. She is the one who bears the side effects of hormonal methods or undergoes the medical procedures associated with some methods, and she also bears the consequences of any unplanned pregnancy if the method fails or if she chooses not to use it. This paradox appears most clearly among women who avoid certain contraceptive methods for fear of their effect on their bodies, only to find themselves facing the possibility of a pregnancy whose physical and psychological changes, health risks, and childbirth pains they will bear alone. And so a woman’s body remains at the heart of reproductive responsibility, whether she used a means of contraception or not.
Women’s experiences with IUD insertion may differ from one woman to another, but what many agree on is the gap between the brief medical description of the procedure and the personal experience they actually go through.
A recent study published in the U.S. National Library of Medicine indicates that a notable proportion of women described the pain accompanying IUD insertion as severe, while others spoke of an experience that was more painful than they had expected. These findings reveal a gap between the common medical description of the procedure as “simple” and the actual experience that some women live through.
A study conducted by Monash University in Australia likewise concluded that the fear of pain during IUD insertion is one of the main reasons pushing some women to avoid this method despite its high effectiveness, which raises questions about the extent to which health systems care about the patient’s own experience, not only the medical outcome of the procedure.
As for “Lina,” she says her suffering with birth control pills began months after she started using them, as she noticed weight gain and mood swings that affected her psychological comfort. She also found that others’ comments on the change in her body’s shape increased her feeling of discomfort, despite her wish to avoid an unplanned pregnancy. Her experience confirms that the effects of contraceptive methods may extend to a woman’s body, mental health, and self-image.
The responsibility of contraception.. on the woman’s body alone
In discussions related to family planning, it appears that the physical burden most often falls on the woman alone.
Birth control pills may carry side effects for some women. The hormonal IUD may not suit everyone. And there are women who refuse to use hormonal methods in the first place out of fear of their potential effects on their bodies or because of previous experiences that were not comfortable.
The paradox is that a woman’s suffering does not begin at pregnancy, but may precede it by years. Between the attempts to prevent pregnancy and the medical options available for that, her body remains at the forefront of the experience. She is the one who takes the hormones, or undergoes the insertion and removal of the IUD, or deals with the side effects and changes that may occur to her body as a result of these methods.
" The paradox is that a woman's suffering does not begin at pregnancy but may precede it by years "
And if a pregnancy occurs despite that, the burdens move to another stage; the woman bears the physical and hormonal changes, the nausea and exhaustion, the possible complications of pregnancy, and then the pains of childbirth and the recovery afterward. She is the one who goes through this entire experience with her body, no matter what support she receives from others.
And in many cases, she finds herself required to bear the cost of preventing pregnancy, just as she bears the cost of the pregnancy itself if it occurs.
According to the World Health Organization, hundreds of thousands of women around the world still lose their lives each year due to complications related to pregnancy and childbirth, in a stark reminder that pregnancy is not merely a passing biological event, but a health experience that may carry real risks that women bear with their bodies alone.
In the end, the pain that women suffer should not be an expected price or something they are asked to live with in silence. Real medical progress is not measured only by the availability of treatments and procedures, but also by the extent to which patients are listened to and their suffering is taken seriously.
The time has come to reconsider the way the health system deals with women’s pain, from diagnosis all the way to treatment and pain management. Reducing gender bias in health care is no longer merely a demand for fairness, but a medical and ethical necessity that ensures women receive the care they need at the right time.
Acknowledging pain is the first step toward treating it, and listening to women is not a courtesy, but the foundation of health care that is more just, more humane, and more efficient for everyone.
