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IUD Insertion: What to Expect

Medically Reviewed by Traci C. Johnson, MD on June 10, 2022

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.

Can I get an IUD if I’ve never had a baby?

Doctors used to advise people not to get an IUD unless they’ve had a baby. But this is not the case anymore. Any pain or trouble inserting the IUD should be similar for people who’ve been through childbirth and those who have not. But if you’ve never delivered a baby, the chances of your IUD coming out may be slightly higher. If this happens, you can still get another IUD.

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 they put 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.

Is IUD insertion painful?

For most people, it may be uncomfortable, but it shouldn’t hurt too much. 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.

Rarely, severe discomfort is possible. But it’s hard to predict who will have mild or intense pain. Because of this, it’s a good idea to plan for pain relief before you get an IUD.

You can try:

Painkillers, such as:

  • Lidocaine gel or spray inside your vagina
  • A numbing medication that your doctor injects around your cervix
  • Pills like tramadol (ConZip, Ultram) and naproxen (Anaprox DS, Flanax, Mediproxen)

Anti-anxiety medication. Some people get nervous about their procedure. Your doctor may suggest medication, such as lorazepam (Ativan, Lorazepam Intensol), to help calm your nerves.

Anesthesia. This medication puts you to sleep during the procedure. Your doctor may suggest it if you usually have pain during a pelvic exam. It also may help if you’ve had a painful experience with inserting IUDs or if you have chronic pelvic pain or endometriosis.

What can I expect after my IUD insertion?

After your procedure, it’s normal to feel slight cramping in your uterus. But if you begin to have very painful cramps, call your doctor right away.

Irregular bleeding or spotting is also common for the first few months. Some people may have this for up to 6 months after their procedure. The bleeding should get lighter over time. But if you notice a lot of bleeding, or you find that it’s not getting any better, call your doctor right away.

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. Some doctors recommend waiting longer, so ask your doctor for their recommendation.

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 6 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.

Show 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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