When Jess Holmes spoke to her GP about getting a routine contraceptive procedure, she never expected the process to end with excruciating pain.
"It was definitely the worst pain I've ever felt in my life, and it was quite traumatic," she said.
"I think the only thing that could ever rival it would be childbirth."
Ms Holmes is one of about 130,000 Australian women per year who select the Intrauterine Device (IUD) as their contraceptive of choice.
She is also one of many who feel they were unprepared for the insertion of the device.
The 26-year-old said the medical professional who administered the IUD told her the pain would be minor and feel "just like a small pinch".
Instead, Ms Holmes said she endured hours of severe cramping after only being offered paracetamol before the insertion.
"It was full, head-to-toe body pain. Every few minutes, an entire wave of pain came and all I could do was curl up in the foetal position and just wait for it to pass."
Experts say this is part of a broader issue with the treatment of women's pain in Australia's healthcare system.
University of Sydney psychologist and pain specialist Louise Sharpe says there is a long history of women's discomfort being viewed as an emotional issue rather than a genuine physical response.
"Psychoanalysts talked about women having psychological symptoms labelled as 'hysteria', which actually comes from the Greek word for the uterus."
Dr Sharpe says this bias is exemplified by the lack of applied scientific research into pain relief for IUD insertions.
A recent study in international medical journal, Fertility and Sterility, found ibuprofen and paracetamol — the most popular and often the only form of pain relief offered for IUD insertions — work no better than a placebo.
"There are studies about some of the medications that do help with IUD insertion yet, more often than not, women aren't offered this pain relief," Dr Sharpe said.
Mild sedation and numbing cream are generally regarded as the most effective pain-prevention methods, but these are often unavailable or very expensive in Australian clinics.
Family Planning NSW medical director Deborah Bateson says that, although some women may experience pain during insertion, IUDs are still one of the most desirable and safe options for reliable contraception.
Once placed, IUDs offer around 99 per cent protection from pregnancy for up to 10 years.
"Most women tolerate the insertion of the IUD well," Professor Bateson said.
"Evidence tells us that around 15 per cent of women who haven't had a vaginal delivery will experience severe pain."
Even a past childbirth didn't protect Liz Neist, 31, from significant pain during the insertion and removal of her IUD.
"My GP removed the IUD and, oh my God, it was so painful — way more painful than I had been expecting," Ms Neist said.
"I got the vibe from my doctor that it was uncomfortable for her, like I had overstepped by voicing my discomfort.
"This made things very awkward … it felt like I had done something wrong by voicing that I was in pain."
Brydee Pickup — a University of Sydney PhD candidate who is researching the experiences of women with endometriosis — says this kind of reaction from healthcare professionals is, disappointingly, common.
"I've been hearing a lot of stories of invalidation," Ms Pickup said.
"Women's pain is commonly dismissed as just, 'Oh, that's normal women's pain. It's not that bad. Just take some Nurofen and you'll be OK'."
However, patients who have endured the procedure say they want to see things improve for women who opt for IUDs in the future.
"Just because [the uterus] is more of an external organ that you've got access to put something in, doesn't mean that it's any less painful than any of your other organs," Ms Holmes said.
"If you got a stent or a pacemaker put in, would you send someone home with a Panadol? I don't think you would.
"There needs to be a proper pain management plan for IUDs and women should be warned about what to expect."
Professor Bateson says that, while there is still progress to be made, autonomy and choice over contraception is improving.
The newer, low-hormone IUDs are smaller than their predecessors, making insertion more comfortable.
"The key thing is to have a discussion with your healthcare provider about what's going to happen and what pain relief is available," Professor Bateson said.
"It's all about having a full understanding so you can make an informed decision."
