“It was not too bad”, “It didn’t really hurt” or “I am happy that he is in it,” patients from Amsterdam doctor Timp often said immediately after the procedure, if she had hurt if placing the spiral hurt . She mainly knew the horror stories about severe pain from the media. “That doesn’t happen at all in my consultation room, I always thought.”
Her gaze changed when she understood from a colleague that patients are not always honest about their pain experience. “Research shows that patients often score their pain higher than the doctor who performs the procedure. Many general practitioners often think that it was not too bad, also because women are inclined to give socially desirable answers after the procedure.”
‘Severe to unbearable pain’
That women are in pain, according to the research of the AVA Foundation, conducted by Ipsos I&O. Of the 2800 women, more than half experienced ‘serious to unbearable pain’ when placing a spiral. Four in ten women also suffered from nausea or dizziness during placement. Almost one in ten fainted. One in five women also had severe pain when removing the spiral and one in ten women postponing the removal of the spiral.
The AVA Foundation has been arguing for some time to include pain relief in the pain protocol for general practitioners. Currently, women who want anesthesia can go to a gynecologist, but in practice this step often turns out to be too great. Chairman Alina Chakh: “It should be a matter of course that women are offered anesthesia to the doctor.”
Timp does not yet use anesthesia when placing a spiral, but wants to start with that soon. For that she wants to learn with a gynecologist. “It’s different from men. Then you can numb the entire ball bag with one puncture. In women, the womb is controlled by a lot of nerves, so you can’t numb everything with one shot.”
She hopes that the guidelines will be adjusted. “It is no unwillingness that we do not use an anesthesia, but it is simply not in the system. We don’t get it during the training so now you as a doctor have to pick it all out for yourself,” Timp explains.
“Is that all necessary?”
In her practice she has already adjusted a number of things to make the placement of a spiral run nicer. Before the procedure, women now always come by for a consultation. Then she asks how they feel, if they take experiences from the past to the consultation room and suggests that the patient will take someone for the distraction next time.
In the beginning, that sometimes resulted in crooked faces with assistants or fellow GPs. “It is a bit of it, is that all necessary? But I think it is very important to take the time. You can’t estimate pain for someone else.”