Why Women Aren’t Offered Pain Management for IUDs IUD insertion is often described as quick, simple, and routine. But for many patients, “routine” does not mean painless. In this episode of Off the Charts, Dr. Bobby Parmar, ND sits down with Dr. Alex Dragan, ND to ask a question that should feel obvious: Why are so many IUD procedures still done without adequate pain management? Starting with Dr. Dragan’s own experience of nearly passing out during IUD insertion, they unpack what actually happens during the procedure, why some patients experience intense pain, dizziness, or near-fainting, and how that reality has been minimized, normalized, or dismissed in clinical practice. From there, the conversation moves beyond IUDs. They examine how outdated assumptions, gaps in training, misinformation, and systemic bias shape the way women’s pain is understood and treated — and why something as basic as pain relief is still inconsistent across providers. This is not a takedown of individual practitioners. It is a closer look at the gap between what patients experience, what medicine has normalized, and what better, more informed care could look like. WHAT YOU’LL LEARN Why IUD insertion can be significantly more painful for some patients than expected What actually happens physiologically during an IUD procedure (and why pain varies) The role of the cervix, nerve pathways, and the vagal response in pain and fainting Why pain management isn’t consistently offered — even when options exist The difference between ibuprofen, local anesthesia, and newer tools like Penthrox How fear, misinformation, and real patient experiences all shape perception of IUDs Why IUDs are used for more than contraception (including heavy bleeding and perimenopause) How consent, communication, and patient trust influence the overall experience What a more informed, patient-centered approach to procedures could look like TIMESTAMPS 00:00 — Opening: “Why don’t we offer pain management?” 01:30 — A real IUD experience (pain, dizziness, near fainting) 04:45 — What actually happens during insertion 08:20 — The cervix, nerves, and the vagal response 12:10 — Why pain has been minimized in clinical settings 16:30 — What pain management options exist (and why they’re not always used) 22:40 — IUD myths vs reality 28:15 — Fear, TikTok, and patient perception 34:20 — IUDs beyond birth control (bleeding, perimenopause) 40:10 — What better care could look like ⚠️ This video is for educational and informational purposes only and is not medical advice. Always consult a qualified healthcare provider before starting or stopping medication. TOP REFERENCES:Pain Management for Gynecologic ProceduresAmerican College of Obstetricians and Gynecologists (ACOG)https://www.acog.org/ Long-Acting Reversible Contraception (IUDs)ACOG Practice Bulletinhttps://www.acog.org/ Heavy Menstrual Bleeding GuidelinesNICE Guideline NG88https://www.nice.org.uk/ Endometriosis OverviewWorld Health Organization (WHO)https://www.who.int/ Vasovagal Syncope (Fainting Response)StatPearls / NCBIhttps://www.ncbi.nlm.nih.gov/ CONNECT WITH GRAVITY HEALTHBook a Consult → https://gravityhealth.janeapp.com/Gravity Health Clinics → https://www.gravityhealthclinics.com/Mint Reproductive Health → https://mintreproductivehealth.com/ FOLLOW USGravity Health Clinics → https://www.instagram.com/gravityhealthclinics/Dr. Bobby Parmar, ND → https://www.instagram.com/docparmar_nd/Dr. Paul Maximus, ND → https://www.instagram.com/drmaximus/Dr. Alex Dragan, ND → https://www.instagram.com/dralexdragan/ Off the Charts is a podcast by Gravity Health, created for general informational and educational purposes only. It does not constitute the practice of medicine, nursing, or any other healthcare service, and should not be taken as medical advice. Listening to this podcast does not create a doctor–patient relationship. Listeners should always seek the guidance of qualified healthcare professionals regarding any medical condition or treatment. For more information about content use and disclaimers, please visit:https://www.gravityhealthclinics.com/terms-of-usehttps://www.gravityhealthclinics.com/medical-disclaimer