Real since I don't do play, but IUD insertion, for sure. I had an "easy" insertion compared to other horror stories I've read online. Still ranks as one of my least favorite medical/GYN procedures and I intentionally chose to have it replaced under anesthesia so I wouldn't have to go through the experience conscious again.
I've never had kids and apparently I have a "teeny tiny" cervix according to my doctors. First of all, I swear the speculum they used for IUD insertion was bigger than any I've had used on me before. And you hang out there with it stuck open inside of you for at least a couple minutes for the process. Uncomfortable but a little thrilling. But then it all goes downhill from there. I'm pretty sure I got a shot of local anesthetic to the cervix. Pinch - ouch. The tenaculum? Nope. Don't like at all. Pinchy. Crampy. But then they insert the "sound" to measure the depth of the uterus and my god you could scrape me off the floor after that. It's so hard to describe the DEEP and hot pain inside your body of having a thin rod of steel penetrate something that isn't supposed to be penetrated. Like a cramp mixed with fire and the overwhelming need to GET IT OUT GET IT OUT NOW. It was a pain rush that I could feel radiating from my belly, up through my chest and neck and all the way down to my toes. And because of everything else going on down there (speculum, tenaculum, sound) you're just frozen in place, spread open on the exam table at this point until the whole ordeal is over.
I remember my doctor telling me when all was said and done not to get up for a few minutes. "Just say here lying on the table as long as you need" I actually got up pretty shortly afterwards and even went straight to the grocery store following the appt. But it took probably a good couple of weeks for my uterus and cervix to feel "normal" again.
So with all this in mind, I was obviously very leery about ever getting another IUD placed, except I loved the fact that it completely stopped my periods. Finally came around time to replace it and I was offered a replacement while I would already be under anesthesia for another surgery. I made the mistake of reading through my post op notes about the insertion process while unconscious and good god I am glad I was. Multiple failed attempts at placing the uterus sound, multiple failed attempts even getting the cervix open. I'm so, SO glad I never attempted it again while conscious and so, SO glad my body had no pain or memory of this happening.