Having an intrauterine device (IUD) inserted causes minimal to moderate pain in most women. Depending on your pain tolerance, you’re likely to experience some degree of discomfort and cramping. It might go away as soon as the procedure’s over, or it might last a few days.
What Does an IUD Do?
You can have your healthcare provider place an IUD — a small (about the size of a quarter), T-shaped plastic device — in your uterus to prevent you from getting pregnant. There are two types of IUDs: one that releases the hormone progestin and one that’s wrapped in copper. Both work by preventing sperm from coming into contact with and fertilizing your eggs.
The benefits of getting an IUD include:
- It’s a long-term form of birth control, lasting three to 10 years, depending on the type.
- It’s safe and 99% effective.
- You don’t have to remember to take a daily birth control pill.
- It doesn’t affect your fertility after you have it removed.
- It doesn’t come with the side effects of hormonal birth control.
Depending on the type of IUD, it will be effective against pregnancy immediately to up to a week after insertion.
Getting an IUD
If you want to get an IUD, you must have your medical provider insert it in their office. This is a quick and easy process that typically takes no more than five minutes, but can last as long as 15 minutes. First, you might need to take a test to make sure you’re not pregnant or have a sexually transmitted infection (STI). Then, during the procedure, your health provider will:
- Place a speculum — the same tool used during vaginal exams and Pap smears — into your vagina to see inside and keep it open.
- Clean the cervix with an antiseptic.
- Slide a tube with the IUD through the vagina.
- Push the IUD through your cervix and into your uterus with a plunger-like device.
- Pull the tube back out through your vagina.
- Cut the ends of the small strings attached to the end of the IUD.
These two small strings will hang in your vagina as long as you have the IUD. They let you know that the device is still in the right place, and they’re how your medical provider will remove the IUD when you decide it’s time.
Your healthcare provider should schedule a follow-up appointment anywhere from two to eight weeks later to make sure the device is still in place and that you’re not having any lasting side effects. Once your IUD is in place, you shouldn’t be able to feel it. In fact, you (and your sex partner) won’t even know it’s there.
Reasons it Might Hurt
Getting an IUD typically causes some degree of discomfort because the IUD is being physically inserted into your uterus. This pain typically isn’t severe, however, and doesn’t last long.
You might feel discomfort when your healthcare provider places the speculum into your vagina. You might also feel pain and cramping when he or she inserts the IUD through the cervix into your uterus. For most women, this pain is mild or moderate. Some women continue to have cramps for a day or two after the procedure.
With copper IUDs, in particular, some women experience intermittent cramping for weeks to months later, particularly during their periods.
Pain Relief Options
You can take steps to minimize the amount of pain you experience when getting an IUD. These include:
- Taking over-the-counter pain medications like acetaminophen or ibuprofen before the procedure.
- If you’re particularly concerned about pain, asking your healthcare provider to give you a local anesthetic.
- Getting the IUD when you’re ovulating or mid-period, during which time your cervix is more relaxed and open.
- Placing a hot water bottle or heating pad over your abdomen during and after the procedure.
- Resting for a day or two after getting the IUD.
If pain and cramping are severe or last longer than a few days, however, let your medical provider know.
Side Effects of IUDs
You might experience mild side effects after getting an IUD. Normal and short-term side effects vary depending on the type of IUD but might include:
- Irregular bleeding or periods
- Spotting between periods
- Mood swings
- Heavier or lighter periods than normal
As your body adjusts the IUD, these symptoms should go away. Less common side effects include:
- The IUD coming out. This is most likely to happen within the first three months. If your IUD has only slipped out partially, contact your health provider, and don’t try to pull it out yourself.
- Uterine perforation, a serious but very rare occurrence.
- Pelvic infection
- Ectopic (occurring outside the uterus) pregnancy
Contact your healthcare provider if you experience:
- Chills, fever, or other flu-like symptoms
- Severe or long-term cramping
- Ongoing pain
- Vaginal bleeding
Other Birth Control Options
If you have a very low pain tolerance, you might consider other effective forms of birth control, such as:
- The pill, which you must take daily
- The patch, which you must replace every week
- The ring, which you must replace every three weeks
- The shot, which you must get every three months
- Barrier methods such as condoms, diaphragms, and cervical caps
While all these methods are very effective at preventing pregnancy, know that only condoms can help prevent STIs. Your healthcare provider can help you make the right contraceptive decision for your body and lifestyle.