Women need more pain management during gynecological procedures

Some gynecological procedures can be incredibly painful, and now medical experts are acknowledging the need for change. Women's pain has often been dismissed by doctors, an occurrence that's especially true for women of color. But new pain management recommendations could help bridge the gap in patient care and renew trust in medical professionals.

Gone with the pain

Many gynecological procedures should be done with pain management, according to the American College of Obstetricians and Gynecologists (ACOG). Such procedures include IUD insertion and cervical and endometrial biopsies. There's an "urgent need for clinicians to better understand pain management options and recognize and address patient pain, and for patients to have more autonomy over pain control options for their health care," said ACOG.

This declaration follows a slew of anecdotes from women on the internet who have experienced excruciating pain during gynecological procedures. "Pain is tricky to study because of its subjectivity (not to mention, women's health is underfunded in general), so there's not as much conclusive research on the available options as many would prefer," Rachel Blake, a board-certified OB-GYN in New Jersey, said to Self. However, "doctors should advise patients on what to expect and discuss the options," said The New York Times. In addition, "vulnerable populations, including those with a history of chronic pelvic pain, sexual violence or abuse, or substance use disorder, should be given special consideration as they may have a different pain tolerance than other patients, or a resistance to pain medications."

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Anxiety can also "present barriers to patients accessing needed or beneficial health care," said ACOG. Therefore, clinicians should "ensure that pain management counseling is individualized, culturally competent, trauma-informed and guided by shared decision-making."

A painful history

Women's pain has often been undersold or ignored in health care settings. This is particularly the case for patients with gynecological disorders, according to a study published in JAMA Network Open. Those surveyed "reported clinician behavior that was dismissive, invalidating and led them to question their own experience or consider cessation of care altogether." This ultimately led to "patient dissatisfaction and distrust," Genevieve Hofmann, the coauthor of the new guidelines, said in the ACOG statement. The problem goes deep: "Historically, Black patients have received less analgesics than white patients, and women have received less attention to their pain than men undergoing similar procedures," said ACOG.

While the need to provide pain management options for women is apparent, there is also a need for "more well-designed studies on gynecological pain — including gender-diverse participants and folks of various races and ethnicities — to determine the most effective options for particular groups," said Self. Many times, using a pain management method makes a procedure take more time, which may make physicians less eager to offer it. However, "in the wake of so much governmental legislation that has removed women's voices, bodily autonomy and agency concerning their bodies, these medical recommendations were especially needed," Deirdre Cooper Owens, a historian and University of Connecticut professor, said to NPR.