Social media scares women away from IUDs, but pain may depend on communication, not procedure skill.

By Michelle Arauz

Social media has become a powerful platform for sharing personal experiences with medical procedures, including intrauterine device insertion (IUDs)—a contraceptive device inserted into the uterus through the vagina. The pain associated with the insertion procedure has gained widespread attention, with many posts and videos influencing the public’s perception. On TikTok alone, searching the phrase “IUD insertion” brings up over 6,000 posts, many of which describe traumatic experiences. These firsthand stories have drawn attention to complications associated with the procedure and sparked discussion and clinical conversations.

Intrauterine devices are among the most effective forms of contraception available, offering protection that can last anywhere from three to twelve years, depending on the type. They are a highly reliable option compared to birth control pills or condoms. However, many new patients fear the procedure will be unbearable because previous users rank their experience of insertion pain as high as 10 on a scale of 1 to 10. Thus patients believe they are not suited for an IUD and instead choose condoms or pills.

A study published in August 2025 in the journal Contraception reframes the way we perceive pain during IUD insertion. It shows that patient satisfaction during the implant placement does not hinge on pain itself, but rather on the level of support and communication provided by healthcare professionals. The study highlights how communication and empathy are the real drivers of client satisfaction.

“Clinicians have to focus on other supportive behaviors, not just addressing pain, although that is a large part of it,” said Anna Kulangara, a fourth-year medical student at the Medical University of South Carolina and the second author of the study. Kulangara emphasizes that clear expectations can make the experience more enjoyable and patient-centered.

There is no consensus on how painful IUD placement actually is. Women who go through childbirth experience less procedural pain in comparison to those who have not. A 2015 article in the Open Access Journal of Contraception found that supportive and communicative provider behavior, not the actual level of pain, determines patient satisfaction during an intrauterine device placement.

Providers do not always use or prioritize pain management during such visits, consequently leaving patients feeling unprepared for the procedure. Practitioners often focus only on medication and overlook important aspects of the client’s experience, determining whether they feel cared for or dismissed.

Patients reported an average pain score of 5.7 on a 10-point pain scale, and 62 percent of participants still reported being very satisfied. Kulangara says, “Clinicians have to focus on other supportive behaviors, because the ambiguity leaves the participants feeling lied to,” proving that setting expectations is more important to the patients than the actual level of pain experienced. Higher provider support scores were linked to greater satisfaction, even after controlling for pain levels.

The authors surveyed 79 patients to rank their pain levels and conducted in-depth interviews with 24 of them. They asked questions about the aspects of the procedure that mattered the most and noted factors that influenced patient satisfaction. Their goal was to explore the topic of patient-centered care in the context of an intrauterine device insertion, which goes beyond solely reducing discomfort before and after the procedure.

For instance, a patient in the study may have reported a high pain score, but the interview might have revealed that the reassurance from the provider made the experience more bearable. This way, the researchers can capture not only how much pain patients felt but also how communication and the provider’s behavior shaped their interpretation of that pain.

To humanize the process, the research team relied loosely on an interview guide. Kulangara explains that they wanted to keep the interview organic so the participants would feel comfortable opening up about personal and sensitive topics. For example, if the authors wanted to understand the level of patient anxiety, they asked, “How did you feel in the morning before the IUD placement?” The openendedness of these questions allows patients to move beyond pain ratings on a scale of 1-10. “Our interviews with patients were quite eye-opening in that we were able to get more about the story,” Kulangara says,

A study publised in August 2025 in the Journal of Pediatric and Adolescent Gynecology analyzed TikTok videos to understand the influence of social media on the patient perspective. Most videos were made by non-healthcare professionals sharing their personal IUD experiences. They described the procedure as more painful than they had initially expected. analyzed TikTok videos to understand the influence of social media on the patient perspective. Most videos were made by non-healthcare professionals sharing their personal IUD experiences. They described the procedure as more painful than they had initially expected. Rachel Allen, the study’s first author and a medical resident at Boston University’s Chobanian & Avedisian School of Medicine, says, “(Patients) weren’t told exactly what would happen during the procedure and how much it would hurt.”

Lack of transparency and empathy can harm patient and practitioner trust. In that recent study, patients reported dissatisfaction when they experienced significant discomfort during the procedure having been told it would be an uncomfortable procedure with only mild discomfort. The disconnect and lack of clarity and trust left recipients feeling that their pain was neglected, especially because providers sometimes viewed the intrauterine device insertion as routine. Researchers recommend providers pay attention to broader supportive factors like clear counseling, provider empathy, and expectation setting, as they have a significant impact on the overall procedure.

In 2022, the Supreme Court overturned Roe v. Wade, ending the constitutional right to abortion and returning the authority to regulate abortion to individual states. This consequently allows each state to set its own policies regarding abortion, varying access to abortion across the United States. This ruling is commonly referred to as the Dobbs decision, from Dobbs v. Jackson Women’s Health Organization.

Future studies should examine whether perceptions of IUDs have shifted since the Dobbs decision and how messaging on platforms like TikTok has changed. Researchers suggest investigating how training practitioners in more patient-centered practices affects the experience of IUD insertion. Specifically, how clear communication and validating patient concerns affect ratings of their clinic and a patient’s overall satisfaction. By studying the impact of these approaches, researchers will have more data to analyze anxiety levels, satisfaction rates, and overall patient experience.

Patients’ emotional context revealed that anxiety and communication shaped their understanding of the procedure, showing that recognizing each patient’s experience as authentic and unique is key to patient-centered care.