The impact of painful sexual and reproductive health procedures: lived experiences and priorities for change

Introduction Physical pain is known to be a common feature of sexual and reproductive healthcare (SRH) encounters for women and other people with a uterus. Our aim was to understand experiences of painful procedures in SRH care and to identify priorities for change.

In January 2025, we conducted an online qualitative survey of people with lived experience of painful SRH procedures. Focused coding and thematic data analysis was supported by Nvivo 14.

Analysis of the 149 qualitative responses highlighted four key thematic areas: how painful procedures felt at the time; how they made participants feel in the longer term; the impact on decisions around future procedures; and what, from participants’ perspectives, could be done differently. Our results illustrate the impacts of pain in the short and longer term, as well as ways in which painful experiences can shape future engagement with SRH care. Specifically, they highlight the distress, fear and distrust of health professionals and services which these experiences can generate.

While best practice guidance exists for some potentially painful SRH procedures, women and other people with a uterus in the UK continue to report highly negative experiences. Trauma-informed approaches – recognising the role of past experiences and supporting compassionate, respectful patient interactions – could improve training and awareness among health professionals, and broader shifts in attitudes and practice. - Reproductive Health - Patient Preference - Physician-Patient Relations - intrauterine devices - abortion, induced - Sexual Health Data availability statement Data are available upon reasonable request. The data that support the findings of this study will be available on reasonable request from the corresponding author (CP) on conclusion of the Gender Pain Gap in Sexual and Reproductive Health project. Statistics from Altmetric.com - Reproductive Health - Patient Preference - Physician-Patient Relations - intrauterine devices - abortion, induced - Sexual Health Data availability statement Data are available upon reasonable request. The data that support the findings of this study will be available on reasonable request from the corresponding author (CP) on conclusion of the Gender Pain Gap in Sexual and Reproductive Health project. Footnotes Contributors All authors contributed to designing the survey tool. JR led the data analysis, in consultation with CP and MG. All authors contributed to the drafting of this article and approved the final version. CP is the guarantor. Funding This work was supported by The Open University Open Societal Challenges programme. Competing interests None declared. Patient and public involvement Patients and/or the public were involved in the design, or conduct, or reporting, or dissemination plans of this research. Refer to the Methods section for further details. Provenance and peer review Not commissioned; externally peer reviewed. Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.