IUD Insertion: What to Expect

An intrauterine device (IUD) is a form of birth control that your doctor places inside your uterus. Once it’s inside, it will protect against pregnancy for up to 10 years, depending on the type you get.

IUD insertion is a quick procedure that's done in your doctor's office or a clinic. Knowing what to expect can help you get ready and ease any worries you might have.

How do I prepare?

Eat a light meal or snack beforehand so you don't get dizzy. Also drink some water. You'll need to give a urine sample so your doctor can make sure you’re not pregnant before she puts the IUD in.

Ask your doctor if you should take a pain reliever, like ibuprofen or acetaminophen, before your appointment. It may help prevent cramping during the procedure.

What happens during an IUD insertion?

You will lie on the exam table with your legs up. Your doctor will gently insert a speculum into your vagina to widen it. Using special tools, the doctor will:

  • Check the size and position of your uterus.
  • Clean your cervix and vagina with an antiseptic liquid.
  • Look for any problems with your uterus.
  • Line up your cervix with your uterus.

IUDs are shaped like a T, with one arm on either side. The doctor will fold down the arms and place the device into an applicator tube, then insert the tube through your cervix into your uterus. Once the IUD is in place, the arms will release and the doctor will remove the applicator tube.

IUDs have a string at the bottom that hangs down into your cervix and vagina. The doctor will trim this string so only about an inch or two hangs into your vagina.

How long does it take?

An IUD placement takes between 5 and 15 minutes. You may want to stay at the doctor's office for a few minutes afterward to make sure you feel OK.

What does it feel like?

You might feel some cramping when the doctor inserts your IUD. Some people get dizzy or faint when they try to stand up afterward. Lie down until you feel well enough to stand, and then get up slowly.

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How should I take care of myself afterward?

You'll likely have some cramps and spotting after the IUD is inserted. Mild cramps and bleeding can last from 3 to 6 months. Take an over-the-counter pain reliever, like ibuprofen or acetaminophen, to ease any discomfort. You can also place a heating pad or hot water bottle on your belly.

If you have a copper IUD (ParaGard), your periods may be heavier than usual for a few months.

During the first 3 months, check once a month that you can still feel the string coming out of your cervix. To find the string, wash your hands and insert a finger into your vagina. The hard area at the top is your cervix. The string should stick out 1-2 inches from your cervix.

If the string feels shorter or longer than usual, the IUD may have moved. Call your doctor and use a condom or other backup birth control method to prevent pregnancy.

When can I have sex again?

You’ll need to wait at least 24 hours. In fact, don’t insert anything, including a tampon or douche, into your vagina during that time. After a full day has passed, you can have sex again.

When will the IUD start to work?

The copper IUD (ParaGard) starts to work immediately, no matter when you get it. Hormonal IUDs (Kyleena, Liletta, Mirena, Skyla) take about 7 days to start working, unless you have one inserted during your period. In that case, it will start to work right away.

For how long will my IUD protect me?

That depends on the type and brand of IUD you have. Hormonal IUDs work for 3 to 5 years. Copper IUDs protect against pregnancy for up to 10 years.

When should I call my doctor?

Call your doctor if:

  • You can't feel the string, or you think your IUD has moved out of place.
  • You think you might be pregnant.
  • You have heavier than normal bleeding from your vagina.
  • You have chills or a fever over 101 degrees.
  • You feel dizzy or like you might faint.
  • You have sharp pain in your belly or pelvis.
  • You have a foul-smelling discharge from your vagina.
  • You get severe headaches or migraines.
  • You have pain during sex.

WebMD Medical Reference Reviewed by Traci C. Johnson, MD on April 17, 2019

Sources

SOURCES:

Center for Young Women's Health: "Intra-Uterine Devices (IUDs)."

FDA: "Mirena," "ParaGard."

KidsHealth: "About the IUD."

Mayo Clinic: "Mirena: About."

Reproductive Health Access Project: "IUD Take-Home Sheet."

University of Michigan: "How to Prepare for Your IUD or Implant Insertion."

U.S. Department of Health and Human Services: "Intrauterine Device (IUD)."

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