women across the country have taken to social media recording and sharing what they describe as extremely painful experiences when getting an IUD that's an intrauterine device and it's the third most common form of birth control in the US it took their public outcry to get federal health officials late last week to issue new guidelines urging doctors to better manage their pain following research that shows Physicians and other providers frequently downplay or ignore the discomfort for more on this I'm joined by Dr. Kristyn Brandi an OBGYN and Family Planning specialist in New Jersey Dr Brandy good to have you on so let's talk about what the CDC is recommending how specific is it so for the first time the CDC is recommending that pay medication should be considered on the insertion of IED I say should it's not a hard must um but should be discussed with all patients that are undergoing the IUD insertion procedure are the guidelines here practical I mean are they saying to doctors in X instance use this type of painkiller in why instance use this it's not as granular unfortunately um there are different studies that have shown that different medications work for different types of patients but in the current CDC recommendations really it's just a a starter of the conversation that we should be having a conversation about pain management with our patients when we insert iuds and then deciding based on an individual basis which medication will work best for them and so what's your take on these recommendations of course pain is subjective and every person's experience is different when it comes to any procedure well I'm so glad that they have finally brought this to the Forefront so that providers now are a little bit pushed to have this conversation more regularly with patients I know with my patients I always talk about pay management as an important component of this insertion process and I think the problem is that patients aren't being offered pay medicine enough and I think that's why they've been speaking out on social media and other platforms because their needs haven't been met unfortunately it's something that we've seen with a lot of different types of Medical Care particularly in marginalized folks like women like people of color where pain is often ignored or undervalued and so I'm so glad that we're having this conversation now where each patient should be offered pain medicine and make sure they have the experience that they want and deserve yeah I mean I guess that begs the question the pain from having an IUD insertion has been well documented for many years why did it take something drastic like women recording their experiences on an exam table and posting it to tick talk in order for a conversation to be recommended to be had between doctor and patient unfortunately I think a lot of it has stemmed from physician bias and provider bias that people of color women historically have not been offered appropriate payments in for a variety of different situations and so I think now with this recommendation we are actually looking not just at the Patients experiences that we're hearing from Social Media but also analyzing the data more and more studies are now coming up because we know that this is important and trying to find which pain regimen is the best thing for the majority of patients how effective Dr Brandy are the the pain management options that are available so it depends on which type and like you mentioned before each patient is an individual that has different needs different pain tolerances for some folks taking medication like um ibuprofen MRA and Advil ahead of time can be helpful but new recommendations are showing that more localized pain anesthetics being placed right in the area similar when you go to the dentist and they num your teeth that the similar type of process should be done for an udine search to help improve pain and honestly for some patients I find that the process is so uncomfortable for a variety of different reasons that I offer them general anesthesia so that way they can get the contraception and the treatment that they need through their IUD but not have an uncomfortable or potentially traumatic experience with their insertion yeah which I suppose is is what the CDC is going after here Dr Kristyn Brandi thanks so much for your Insight thanks for having me support for the medical report is provided by Horizon Blue Cross Blue Shield of New Jersey and an independent lensee of the Blue Cross Blue Shield Association