We actually don’t have much in the way of pain relief besides NSAIDs (of which Midol is one), local anesthesia (which I believe is not indicated for IUD insertion), and opioids (I’m sure you’ve heard of those in the news).

It’s not only clinical trials where you test on people, chemically. There are a ton of tests for skin care products to compare their effectiveness. These have already gone through trials for safety but long-term research on their effects is important.

One example is the anti-acne medication Accutane which is known to cause birth defects. This drug cannot be given to women who may be pregnant under any circumstances. I believe doctors even require proof that the patient is on birth control before prescribing it.

As for menstrual cycles: they are known to affect skin, hair, joint mobility, pain sensitivity, mood, food preferences, weight, and more. Tons and tons of studies are affected by this. Everything from dieting to mental health care, skin care, hair care, and even sports medicine, exercise, and recovery from injury.

Oh I can’t justify it at all. These things come about because of complex interactions throughout society. Scientists didn’t decide for themselves to have these strict rules on experiments involving women who might become pregnant. Those rules were imposed on them by politicians and regulators whose goals were not to promote the best possible research.

The same goes for the situation in the US with employers providing health insurance through group policies. That situation came about during a war-time cap on employee compensation. Employers used the insurance benefit as a way to circumvent the cap. Now Americans seem to be stuck with a system they increasingly do not want.

One of the worst heartbreaks I experienced growing up was when I realized that no one is really in charge of anything and that we’re all trapped in a system we can’t escape. 1984 was a big influence for me on this one.

Science does ignore women a lot of the time but it’s not because they hate women. It’s because of medical ethics rules which make it a lot more expensive to include women in studies. You have to pay for pregnancy tests for women in the study and you have to do all kinds of corrections and extra analyses to make sure women’s menstrual cycles are not interfering with the data. Women who do get pregnant during the study need to be detected and removed from the study because any effects from the study that harm their baby can expose the researchers to enormous lawsuits.

So many studies, which don’t have a lot of money to begin with (we’re talking university studies run by grad students, not massive clinical trials run by big pharma) exclude women because it’s cheaper and easier and they get to run more studies as a result. The major exception to this are psychological studies that don’t carry the same risks, but these are usually run on the psychology students themselves (many of which are required to participate in them in order to receive course credits).

I talked to a woman right after she had one inserted and that’s what she told me: intense cramps. I believe her. I’m not just spouting my opinion based on nothing.

Upwards of 80% of OBGYNs are women. Saying that none of these women care about other women, that they went into a field that specializes in caring for women’s health without caring about women, is an extraordinary claim.

I think what we’re seeing here is not at all a lack of caring but a mismatch in expectations vs reality. Many women who receive an IUD report some of the worst pain they’ve felt in their entire life. At the same time, it is a routine outpatient procedure and a specialist doctor can perform thousands of IUD insertions over the course of her career. Do we expect this doctor to react with the same intensity and outpouring of empathy every single time? Or would it be more reasonable to expect that she’d get used to seeing her patients in pain and be numbed by the experience? Compassion fatigue is a real and extremely common phenomenon. Furthermore, I would expect that a doctor who is unduly influenced by the pain of their patients may be compromised in their ability to perform under pressure.

As for the procedure itself, my understanding is that the majority of the pain is not caused by the tools but by the cervix reflexively producing intense cramps in an effort to expel a foreign object: the IUD. There’s not a whole lot that can be done about that besides giving the patient some Midol and a day off work to rest.

That’s extreme. If doctors don’t care then why did they become doctors? Why go through all of medical school and residency with years of lost sleep and exhaustion to become a doctor? Why not become a lawyer instead? High end corporate lawyers make far more money than even the highest paid doctors.