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Speaker 1: You're listening to a Muma Mea podcast. Mumma Mea acknowledges

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Speaker 1: the traditional owners of land and waters that this podcast

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Speaker 1: is recorded on.

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Speaker 2: Hi.

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Speaker 1: I'm Claire Murphy. This is Mumma MEA's twice daily news podcast,

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Speaker 1: The Quickie. What was your IUD insertion experience like? Was

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Speaker 1: it painful? A recent TikTok trend of filming your IUD

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Speaker 1: insertion to show how painful it can be might be

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Speaker 1: putting some off of getting one themselves, but it's also

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Speaker 1: changing women's healthcare overseas. Today we explore IUD insertion and

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Speaker 1: how you can be best prepared for if and when

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Speaker 1: you decide to get one. But before we get into it,

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Speaker 1: let's get the latest from the Quikie newsroom. Monday, August nineteen.

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Speaker 1: We told Larry Mda last week to practice his winning

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Speaker 1: face before heading to the LOGI Awards ceremony last night.

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Speaker 3: I haven't practiced that face. I've shared more time practicing

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Speaker 3: the losing face. I have a really good losing face,

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Speaker 3: so I haven't really thought about the winning face yet.

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Speaker 1: Well, you need to practice winning face. You've got to

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Speaker 1: put the vibes out there that that's going to be

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Speaker 1: what's going to eventuate for you.

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Speaker 3: See, I'm going to take your advice. They're not going

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Speaker 3: to be sitting there like a goose smiling.

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Speaker 4: When I lose.

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Speaker 1: And lucky we did because the forty year veteran of

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Speaker 1: Australian television walked away with the Gold Logi last night.

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Speaker 1: He now has to front Top to the Morning Show

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Speaker 1: today after promising to have the initials of his fellow

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Speaker 1: Gold Logi nominees tattooed on him if he were to win.

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Speaker 1: Some of the other big moments from last night's awards

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Speaker 1: include Sampang's incredible monologue, which did not hold back on

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Speaker 1: the TV networks, even the one he was appearing on

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Speaker 1: with a jab. Also at our now most notorious Olympian.

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Speaker 5: And I'd like to acknowledge our youngest ever gold medalist,

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Speaker 5: fourteen year old skateboarder Arisa True Now. As a reward,

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Speaker 5: her parents promised her a pet duck. Meanwhile, Raagan's parents

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Speaker 5: have promised to get her break dancing lesson.

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Speaker 1: Ray Gun actually appeared via video on the night too.

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Speaker 1: Two icons came together when The Wiggles handed Best Kids

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Speaker 1: Show to the makers of Bluey Jessica A Malboy and

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Speaker 1: Guy Sebastian saying an amazing tribute to Ozzie legend John

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Speaker 1: Farnham and just the fourth woman to ever be inducted

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Speaker 1: into the Logi Hall of Fame, Rebecca Gibney had the

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Speaker 1: room standing. But it was a big night for the

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Speaker 1: team behind Boyce Swallow's Universe, with its fifteen year old

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Speaker 1: star Felix Cameron winning for Best New Talent and giving

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Speaker 1: an emotional thanks to his family.

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Speaker 5: I'd love to thank my friend's family, my brother and

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Speaker 5: my sister, and my mom.

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Speaker 2: And dad.

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Speaker 1: From all behind the scenes of last night's Logi's Action

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Speaker 1: Mumma MIA's own Laura Brodnick was there for the red carpet.

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Speaker 1: You can hear what went down with the stars of

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Speaker 1: Ozzie TV later today when our sister podcasts The Spill

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Speaker 1: drops at three pm. Unpaid careers across Australia are being

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Speaker 1: urged to speak up about their experiences to help shape

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Speaker 1: national strategy. Consultation has started on a federal government discussion

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Speaker 1: paper for Australia's estimated more than three million unpaid carers

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Speaker 1: to suggest what can be done to provide them with

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Speaker 1: better support and services. The national strategy will be unveiled

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Speaker 1: by the federal government by the end of this year.

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Speaker 1: Many of those unpaid cares are aged under twenty five

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Speaker 1: and the majority of women. Social Services Minister Amanda Rishworth

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Speaker 1: calling for people to come forward and share their experiences

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Speaker 1: so they can best shape the support network they can

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Speaker 1: place around them. Ozzie's fleeing cities to the regions is

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Speaker 1: continuing at pandemic levels, with cost of living pressures and

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Speaker 1: the housing squeeze driving people further away from cities. New

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Speaker 1: figures show regional migration levels sitting at the same level

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Speaker 1: as the tail end of the COVID lockdowns. Those who

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Speaker 1: are moving attracted to areas with thriving local economies built

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Speaker 1: on industries like mining, agriculture, manufacturing, health care and tourism.

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Speaker 1: The availability and cost of housing influencing the broader movement

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Speaker 1: pattern as people seek areas where house price growth is

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Speaker 1: slower and there is some rental availability. Some of the

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Speaker 1: towns that have seen big spikes in former city dwellers

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Speaker 1: include Strathbogie in Central Victoria, Tasmania's Georgetown, Port Lincoln in

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Speaker 1: South Australia, Queensland Sunshine and Gold Coasts, Greater Geelong and

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Speaker 1: Morrable in Victoria, Warria and Lake Macquarie in New South Wales. Albany,

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Speaker 1: Bunbury and Northern were among the top five experiencing the

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Speaker 1: greatest growth in city movers. A survey of more than

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Speaker 1: four thy two hundred songwriters and composers from across Australia

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Speaker 1: shows many believe AI will destroy their ability to make

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Speaker 1: a living. Eighty two percent of those surveyed to concerned

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Speaker 1: artificial intelligence will interfere in their role as a creative

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Speaker 1: to the point that they'll no longer be able to

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Speaker 1: support themselves by making music. Jimmy Barnes saying music is

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Speaker 1: fundamental in how we express ourselves and how we connect

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Speaker 1: with each other, saying if we let something artificial take

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Speaker 1: it over, no matter how intelligent that machine is supposed

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Speaker 1: to be, will lose a part of what it means

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Speaker 1: to be human. Others who contributed to the survey, including

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Speaker 1: former Powderfinger frontman Bernard Fanning, Midnight Oils, Peter Garrett, Tina

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Speaker 1: Arena and Claire Bowditch, echoed Barnsey's sentiment, calling for stronger

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Speaker 1: regulation to stop copyright infringement. That's what's going on in

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Speaker 1: the world today. Next is sharing your IUD pain experience,

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Speaker 1: helping other women or putting them off. Turns out it's

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Speaker 1: doing a little of both. Back in December last year,

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Speaker 1: a hospital in Melbourne became one of the first healthcare

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Speaker 1: providers in the country to offer women pen throcks during

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Speaker 1: their IUD insertion procedures. Now you might know pan throcks

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Speaker 1: by its other name, the Green Whistle, the device given

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Speaker 1: to those who require short term pain relief. Frankston Hospital

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Speaker 1: began trialing the Green Whistle for IUD insertion and removal

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Speaker 1: procedures in response to some women sharing their pain experiences

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Speaker 1: with their doctors and others posting about it online. If

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Speaker 1: you head to TikTok and search IUD, you'll be served

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Speaker 1: a long thread of women posting their IUD insertion experiences.

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Speaker 1: Just to heads up here, what you're about to hear

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Speaker 1: is not pleasant. Oh I don't like that.

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Speaker 2: I don't like that.

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Speaker 3: Oh O my god, O my god.

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Speaker 1: That's not good. That was not good.

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Speaker 6: This is value you.

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Speaker 1: Wim ow ow ow ow. Head over to Facebook and

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Speaker 1: they'll have tail after tail of RUD insertion and horror stories.

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Speaker 7: So my GP said, it's not pleasant, but I'll be okay.

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Speaker 7: The ghano did it, and apparently I have a deep cervix.

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Speaker 7: So the ghano kept saying come here, and I kept

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Speaker 7: crawling up the bed. The nurse had a cold flunnel

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Speaker 7: on my face because I was passing out and just

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Speaker 7: like ready to vomit. It was horrific and I would

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Speaker 7: never have one again without pain relief.

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Speaker 4: I got my IUD put in with no pain relief,

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Speaker 4: and afterwards I was shaking and my face went numb

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Speaker 4: with shock. I couldn't drive, so I just sat in

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Speaker 4: my car trying to get my shit together, and I

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Speaker 4: couldn't go back to work. I never expected or was

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Speaker 4: warned by the doctor of the intent. Feeling slow stabbing in.

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Speaker 2: You pick bits.

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Speaker 6: Still, to this day, having my IUD inserted is the

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Speaker 6: most pain I've ever experienced in my life. I screamed,

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Speaker 6: passed out, and threw up on myself. I crawled down

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Speaker 6: the doctor's corridor to the bathroom, and I had to

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Speaker 6: phone my mom to leave work and drive me home.

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Speaker 6: It is actual torture watching women have that inserted. I

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Speaker 6: can't believe it's legal to do without pain relief.

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Speaker 1: While in a much quieter corner of the internet, there

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Speaker 1: are women who were also speaking out about how their

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Speaker 1: IUD insertion was not painful, more of a discomfort, and

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Speaker 1: that the benefits from them have been far more impactful

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Speaker 1: than the insertion or removal process.

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Speaker 2: It is so quick.

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Speaker 4: It took five minutes, but you're only really feeling pain

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Speaker 4: for like thirty seconds.

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Speaker 8: That's decision that I made when I was in my twenties,

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Speaker 8: was getting an AUD. I have had Marina Aud's and

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Speaker 8: I love them, and I feel like I get.

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Speaker 9: A lot of like IUD.

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Speaker 5: I want to say slander.

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Speaker 8: I had spotting for about six months and the occasional

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Speaker 8: period after that, and severe cramping for probably on and

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Speaker 8: off that first six months as well. Other than that,

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Speaker 8: it was the best decision I ever made.

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Speaker 1: There's also been a lot of discussion around the use

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Speaker 1: of pain relief when it comes to the insertion of

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Speaker 1: an IUD. Many say that it wasn't offered to them.

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Speaker 1: Others say they were told by other women to manage

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Speaker 1: it personally, while some say they were offered options to

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Speaker 1: assist them through the procedure. Jesse Stevens, Holly Wainwright, and

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Speaker 1: Mia Friedman discussed this on their show Mama Mia Out

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Speaker 1: Loud recently, where Holly admitted she didn't experience too much

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Speaker 1: pain in having her IUD put in, while Mia had

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Speaker 1: been prepared by a friend to take pain relief.

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Speaker 2: I have to examine my reaction to it because you're

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Speaker 2: very strong.

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Speaker 7: Be honest, you said, Maya, you're a big fat was bad.

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Speaker 2: But also I'm like, really, women are all filming themselves

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Speaker 2: while they're getting it done.

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Speaker 5: And then Maya was like, I did that, my god.

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Speaker 1: But filming it and posting it to social media has

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Speaker 1: actually made a difference to women's health care in the US.

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Speaker 9: Breaking News and gynecology, The cityc is now recommending that

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Speaker 9: doctors should address IUD insertion pain and councilwomen about pain

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Speaker 9: management before they get one. Pain management for IUD insertion

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Speaker 9: was never standard of care. So what led to this

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Speaker 9: change in recommendations? You did you sharing your experiences on

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Speaker 9: social media? Your pain is real. You absolutely deserve adequate

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Speaker 9: pain control.

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Speaker 1: That's doctor Mary Clare and obgyn and the author of

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Speaker 1: the New York Times bestseller The New Menopause. All right,

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Speaker 1: so let's get an expert to talk us through the

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Speaker 1: whole IUD process from start to finish, including what our

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Speaker 1: options are for pain relief. If we need it. Doctor

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Speaker 1: pav Nanyakara is a minimally invasive gynecological surgeon at the

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Speaker 1: Gene Hailes Institute hav Have you seen this trend of

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Speaker 1: filming IUD insertions. Has it had an impact on those

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Speaker 1: coming to you to have them inserted? Are they more reluctant?

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Speaker 2: It varies. I would say that people are not so

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Speaker 2: much reluctant, but they're fearful about what might be involved,

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Speaker 2: and so a large part of our consult is sort

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Speaker 2: of talking through the process and what an ID is

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Speaker 2: and giving them some reassurance that ultimately they're in control

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Speaker 2: of the whole thing, and if anything is too uncomfortable

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Speaker 2: at any stage, that they can speak up about it.

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Speaker 2: So it's really about spending that extra time to clear

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Speaker 2: up any misinformation before.

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Speaker 1: We get into the actual process of it. I was

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Speaker 1: listening to an obgayn on TikTok who explained that in

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Speaker 1: her training she was told that the cervix has little

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Speaker 1: to know nerve endings, and so inserting an IUD should

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Speaker 1: not be a painful experience, and in her training was

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Speaker 1: not told to offer any pain relief. Would you say

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Speaker 1: that your training might have been similar if that's the case,

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Speaker 1: does that need to change.

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Speaker 2: We weren't told that, and we were told that the

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Speaker 2: cervix does have some nerve endings, but it's not so

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Speaker 2: much the cervix itself that causes the discomfort with an

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Speaker 2: IAD insertion. It's the uterline cramping. And we know that

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Speaker 2: the uterus definitely does have nerve endings. Were definitely advised

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Speaker 2: to give some premedication before an ID insertion, and also

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Speaker 2: to talk about the different approaches to discomfort management, which

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Speaker 2: can range from local anesthetic spray to an injection to

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Speaker 2: things like using penthrops or a green whistle to help

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Speaker 2: with pain relief.

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Speaker 1: Well, can you took us through the procedure from start

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Speaker 1: to finish path, because I understand you need a prescription

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Speaker 1: to get the device, which you then take to somebody

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Speaker 1: to have inserted.

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Speaker 2: That's right. So usually you would see a doctor or

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Speaker 2: a GP or a gynecologist initially who would talk you

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Speaker 2: through the benefits and risks of the procedure and give

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Speaker 2: you the prescription for the IUD. You then bring that

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Speaker 2: into the clinic appointment, and there are specialized clinics and

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Speaker 2: certain hospitals that would offer the procedure to be performed awake.

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Speaker 2: You're then put in the same position as you would

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Speaker 2: be if you were having a civical screening test. There's

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Speaker 2: a speculum that's put into the vagina, and we usually

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Speaker 2: clean the cervix with some antiseptic and offer some anesthetic,

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Speaker 2: depending on different services would offer different methods. We then

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Speaker 2: measure how long the uterus is and we put the

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Speaker 2: ID in through the cervix, which is the opening to

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Speaker 2: the womb. There are two little strings that are attached

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Speaker 2: the ID that help with removal, so we cut those

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Speaker 2: strings and usually you or your partner won't necessarily notice

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Speaker 2: those strings, but you should be able to feel them

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Speaker 2: if you reach right up into the vagina. Often after

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Speaker 2: the procedure, which takes about ten minutes, you might wait

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Speaker 2: in the clinic for a little while afterwards, just to

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Speaker 2: make sure that you haven't got any unnecessary discomfort, and

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Speaker 2: then you know, in terms of recovery afterwards, most people

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Speaker 2: would advise against tampons or intercourse for about a week

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Speaker 2: to just minimize the risk of infection.

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Speaker 1: The flip side to people recording themselves having their IUDs

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Speaker 1: inserted is people recording themselves having their IDs removed, which

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Speaker 1: some people are reporting is just as if not sometimes

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Speaker 1: more painful in experience for them. Can you talk us

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Speaker 1: through the removal process and what might be causing the

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Speaker 1: pain there?

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Speaker 2: Yeah, so the removal is somewhat similar. So if we

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Speaker 2: put you in the same position as sabaka screening test

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Speaker 2: as speculums in SOT and then usually we would grab

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Speaker 2: the strings and pull. So the procedure itself is much

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Speaker 2: quicker in the sense that we're talking a few seconds

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Speaker 2: rather than minutes. But occasionally, if the ID is sitting

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Speaker 2: in the wrong spot or difficult to retrieve because the

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Speaker 2: strings have been caught up, sometimes it can be a

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Speaker 2: little bit trickier to get it out. And occasionally we

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Speaker 2: can't get it out awake, and we need to do

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Speaker 2: it with a special camera test to remove it.

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Speaker 1: And all of these procedures work the same with the

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Speaker 1: different types of IUDs.

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Speaker 2: That's right. So there are broadly speaking two types of IUDs,

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Speaker 2: the non hormonal or the copper IUD and the hormonal ID.

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Speaker 2: And again there are two types of the hormonal ID

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Speaker 2: as well. But the procedure for insertion and removal is

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Speaker 2: very similar.

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Speaker 1: What about when IUDs go rogue. I have a friend

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Speaker 1: who recently she's got quite an issue with endometriosis as well.

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Speaker 1: But she was having an ultrasound and the doctor said

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Speaker 1: to her, where is your IUD? And it had migrated

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Speaker 1: outside of her uterus and was in her abdominal cavity.

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Speaker 1: And I didn't even realize it that was a possibility.

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Speaker 1: Is that quite a rare thing to happen? Is it

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Speaker 1: common what happens when your IUD escapes your cervix?

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Speaker 2: Yeah, so it is a rare complication, so reported in

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Speaker 2: the range of one in five hundred to one in

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Speaker 2: one thousand risk of that happening, which is called a perforation.

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Speaker 2: There are certain things that may increase the risk depending

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Speaker 2: on where the uterus is lying as well as you know,

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Speaker 2: if you're immediately after having a baby, for example, we

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Speaker 2: know that the muscle is a little bit softer. If

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Speaker 2: the IUD has gone beyond the uterus, then we may

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Speaker 2: need to do a laparoscopy, which is keyhole surgery to

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Speaker 2: go in and then remove the IUD from above. So

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Speaker 2: that involves little cuts on the tummy and we go

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Speaker 2: in minimally invasively and remove it that way. What would you.

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Speaker 1: Say, the biggest benefit of getting an IUD is over

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Speaker 1: using any other kind of birth control.

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Speaker 2: So I suppose the most important thing is that it's effective.

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Speaker 2: You know, there are three main reasons that we would

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Speaker 2: use it. Either as a contraceptive with the hormonal IDs.

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Speaker 2: We know it's helpful for heavy menstrual bleeding and period pain.

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Speaker 2: And the last thing is for endometrial protection, so to

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Speaker 2: help minimize the risk of endomutual cancer in people with

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Speaker 2: conditions like polycystic ovarian syndrome or who are on hormone

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Speaker 2: replacement therapy. It works really well, and it lasts for

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Speaker 2: five years, and now for a contraceptive, it's valid for

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Speaker 2: eight years. It's a great set forget option, so you

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Speaker 2: don't forget to take it as you might with the pill. Overall,

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Speaker 2: the cost is quite good. It's cheaper than a lot

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Speaker 2: of other contraception, so there's an initial cost, but then

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Speaker 2: after that it's cheaper over the long term. And for

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Speaker 2: people where fertility is a concern, once you remove the IUD,

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Speaker 2: you know, you get immediate return of fertility, so it's

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Speaker 2: not something that has a delayed effect, if that makes sense.

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Speaker 1: Is that a recent thing that for birth control IUDs

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Speaker 1: are now sort of extended out to eight years rather

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Speaker 1: than five.

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Speaker 2: That's right. The TGA has only just approved that this year.

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Speaker 2: And you know, in other conditions like heavy menstrual bleeding,

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Speaker 2: if it's still working beyond the five years, we can

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Speaker 2: keep it in. But you know, if it starts to

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Speaker 2: wear off from that effect, then we replaced it a

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Speaker 2: five year.

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Speaker 1: Mart What advice would you have for women who have

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Speaker 1: had an ID insertion and it has been a painful experience.

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Speaker 1: Is it more about understanding your options for pain relief?

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Speaker 1: Because I understand there are some women who have been

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Speaker 1: advised by whoever has inserted their ID that they didn't

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Speaker 1: need pain relief, or they were just given something like

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Speaker 1: panadol to help afterwards. Can understand there's a fair bit

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Speaker 1: of cramping that can sometimes come with having an ID inserted.

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Speaker 1: Is it more about just sort of standing aground and

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Speaker 1: saying no, I want pain relief, or is it about

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Speaker 1: the type of pain relief they should be asking for.

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Speaker 2: Yeah, I think in any circumstance, if you feel uncomfortable

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Speaker 2: with going ahead with the procedure because you feel like

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Speaker 2: you're not being heard or validated, then you're probably better

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Speaker 2: off getting a second opinion. In terms of options for

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Speaker 2: pain relief, they're very varied, and so there's good evidence

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Speaker 2: for things like taking anti influmctruy medications about half an

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Speaker 2: hour before having an ID put in, so that's something

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Speaker 2: that patients can do themselves before coming to the clinic. Then,

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Speaker 2: in terms of what happens during the procedure itself, it's

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Speaker 2: really good to have that open discussion with your healthcare

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Speaker 2: provider beforehand, to say, well, what's out there in terms

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Speaker 2: of pain relief, and what are you going to do

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Speaker 2: and what happens if it is too uncomfortable, you know

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Speaker 2: what's our backup plan, so that you do feel really

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Speaker 2: informed going ahead with something like this, because at the

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Speaker 2: end of the day, I think the uncertainty creates a

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Speaker 2: lot of anxiety, and just knowing what the options are

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Speaker 2: is really helpful.

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Speaker 1: Is IUD insertion can we consider it similar to any

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Speaker 1: woman's menstrual experience, because it seems everyone's is a bit different.

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Speaker 1: Some people get pain, some people don't have pain, some

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Speaker 1: people have heavy bleeding, some people have like bleeding. Like,

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Speaker 1: is IUD insertion really a case by case basis? And

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Speaker 1: if you've never had one before, it might actually not

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Speaker 1: cause you any pain to have one inserted.

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Speaker 2: Yeah, that's absolutely right. So the same way that people

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Speaker 2: experience periods very differently, the same goes for an ID.

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Speaker 2: Some people walk in and out and their pain scores

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Speaker 2: are zero to one out of ten. For other people

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Speaker 2: it may be quite uncomfortable. And again it's about knowing

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Speaker 2: that the patient is in control of the situation through everything,

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Speaker 2: and if they are experiencing levels of discomfort that are

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Speaker 2: too much, that they do have the ability to speak

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Speaker 2: up and say, hang on, this is too much, we

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Speaker 2: need to stop, and then we look at what other

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Speaker 2: options there might be.

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Speaker 1: As always, if you have any medical issues or concerns,

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Speaker 1: speak to your GP about it, and remember if you

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Speaker 1: don't find your doctor able to help, you have every

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Speaker 1: right to get a second opinion or just seek help elsewhere.

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Speaker 1: You're the one who's in control. Thanks for spending time

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Speaker 1: with us today. If you want to listen to that

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Speaker 1: episode of Muma MEA Out Loud, you can find a

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Speaker 1: link to it in our show notes. The quickie is

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Speaker 1: produced by me Claire Murphy and I'll send your producer

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Speaker 1: Taylor Straano, with audio production by Tom Lyon.