It’s ok to admit that gynecological procedures can be painful, not simply “uncomfortable.” From routine Pap smears to IUD insertions, endometrial biopsies and colposcopies, these types of experiences can leave patients bracing themselves and feeling like their pain was dismissed.

For far too long, women’s pain in medical settings has been downplayed or outright ignored—and why we still have limited options for managing it. But at WHA, we believe your comfort, safety and autonomy should be the foundation of your care, where pain management isn’t a luxury, but your right.

Whether it’s a routine exam or a more invasive procedure, there are options to make these experiences less daunting. Your voice matters, and you deserve care grounded in compassion and respect.

Why gynecological procedures can be painful

Gynecological procedures can sometimes hurt for two primary reasons.

  • Anatomy: these procedures involve some of the most sensitive areas of the body, like the vulva, vagina, cervix and uterus. Just as touch in these areas can be pleasurable, it can also cause pain. Also, unique differences in the size or positioning of your organs can make procedures more challenging.
  • Individual factors: past trauma or chronic pain can heighten sensitivity, while anxiety—common during gynecological visits—can amplify the perception of pain.

It’s also important to note everyone experiences pain differently. If you’re in pain, whatever that means for you, it’s valid. So, speak up. Your concerns deserve to be heard and addressed.

How to make a gynecologist appointment less painful

Gynecological procedures and the pain they can cause are a deeply personal experience. While minor advancements in care have improved comfort for some, there’s still a long way to go in prioritizing women’s comfort in healthcare.

When I prepare a patient for a procedure, I’m upfront about the goal of minimizing pain. I can’t promise it will be pain-free. What a provider can, and should, promise is that we’ll pause or stop if you need us to.

During something like an IUD insertion, I’ll check in constantly, asking, “Are you okay?” because verbal feedback is essential to understanding what you’re going through. Some degree of discomfort or pain may be unavoidable, but we shouldn’t cause trauma in the process–which can happen when your pain isn’t acknowledged or supported. The foundation of trust is honesty, and knowing what to expect can make a big difference for many people.

Because familiarity can also help ease anxiety and create a more supportive environment, if possible, schedule your procedure with a provider you know.

An important note: Those seeking gender-affirming care are typically at greater risk of experiencing medical trauma because the healthcare system is not built for people outside the binary. WHA providers actively work to create a safer space by learning about a patient and discussing all care options so any decisions are made together in trust—from how routine exams and screenings are performed to determining wholly personal next steps.

How to advocate for yourself at the gynecologist during procedures

We know the system hasn’t always served women well, but advocating for yourself—whether that means asking for more information or requesting specific pain management options—can help ensure you’re treated with the care and dignity you deserve. It doesn’t matter if you’re “not the expert” in the room in a medical sense. You are the expert on your body. Severe pain is not something you have to just accept.

Your voice should always be part of the conversation. And all you should need to say is “I want help with the pain.” While it can take extra time (and appointments) to plan around specific needs, investing in this process can make a significant difference in your experience. It’s your right to ask for adjustments. And if your needs aren’t being met, it’s okay to ask for more support or even a different provider.

Pain relief options for gynecological procedures

Your provider’s role is to ensure that gynecological procedures are as comfortable and non-traumatic as possible. Honest conversations about potential pain are crucial for building trust and tailoring pain management options to your needs.

Currently, options fall into two categories:

Day-of gynecological procedure pain relief options:
  • Over-the-counter pain relievers: Ibuprofen or Tylenol taken beforehand can reduce discomfort.
  • Heat packs and relaxation techniques: Use heat or calming activities, like listening to music, for added comfort.
  • Support person: Bring someone you trust for emotional support.
  • Paracervical block: A numbing injection near the cervix is particularly helpful for procedures like IUD insertions.
  • Nitrous oxide: Self-administered gas can be used alone for mild to moderate pain relief and anxiety. WHA currently offers this option at one location and is making plans to expand the service.
Gynecological procedure pain relief options that require advance preparations

You’ll need to arrange for a driver to take advantage of these options:

  • Anti-anxiety medications: Options like Valium help relax you.
  • Opioid pain relievers: For severe pain, medications like oxycodone may help but have possible side effects like drowsiness or nausea and aren’t as effective as other options.
  • IV sedation or hospital anesthesia: For more invasive procedures or when additional comfort is needed, you can have your procedure in WHA’s office surgery suite or a hospital.
Follow-up care: what to expect after your procedure

After most in-office gynecological procedures, over-the-counter pain relievers like ibuprofen are usually enough to manage any lingering discomfort. For things like IUD insertions, mild cramping may persist for a day or two as the uterus adjusts to the device. This is normal, but persistent or severe pain isn’t. If something doesn’t feel right, contact your provider. (And remember, if you try an IUD and decide it’s not for you, we’ll take it out.) Your comfort and choice are always priorities in your care.

Pain is ultimately an incredibly personal experience. And I firmly believe if you tell someone something might hurt, they are fully capable of deciding whether it’s still worth it. But if you tell them there won’t be pain and there is, that betrayal of trust creates trauma—and that’s never worth it.

Being informed and supported empowers you to make decisions that feel right for your body, and that’s what truly matters.