Thinking about getting an intrauterine device (IUD) but nervous about the pain? You aren’t alone.
Many people feel anxious about the process, often after hearing from friends/family or people on social media about their experiences with IUD insertion. Some say the pain is unbearable, while others report it’s no big deal. The truth is that everyone’s experience is different.
IUDs have been around since the early 1900s and have grown in popularity. The T-shaped device is one of the most effective forms of birth control. Once in, they can prevent pregnancy for three to 10 years, depending on the type.
While they are highly effective, it’s natural to have questions and concerns.
We spoke with Nicole Whitmyre, MD, MS, an OBGYN with Banner – University Medicine, to explain what to expect, how to prepare and what pain relief options are available to help you feel more comfortable.
What is an IUD?
An IUD is a small, T-shaped device that is placed inside the uterus to prevent pregnancy. Many people choose IUDs because they are low maintenance, highly effective and reversible (easily removed).
“Unlike other forms of birth control which stop ovulation, IUDs prevent sperm from getting into the uterus and reaching an egg,” Dr. Whitmyre said.
There are two kinds of IUDs: hormonal and copper.
Hormonal IUDs release a synthetic hormone (progestin) to thin the uterine lining and thicken cervical mucus. This makes it impossible for sperm to reach an egg. The Food and Drug Administration (FDA) has approved four hormonal IUDs, including Mirena and Liletta.
“Copper IUDs do not contain hormones,” Dr. Whitmyre said. “Instead, they contain a small amount of copper, which creates a toxic environment for sperm.” Paragard is the only FDA-approved copper IUD.
How painful is getting an IUD inserted?
One of the biggest claims is that IUD insertion is as painful as childbirth. However, it might not be as painful as you’ve heard, as everyone’s experience differs.
“The pain you feel will depend on your body's anatomy, the way your body processes pain and whether you’ve had a vaginal birth before,” Dr. Whitmyre said. “Insertion usually takes less than 10 minutes.”
Here’s what to expect during an IUD insertion and what you may or may not experience:
- Speculum placement: A thin device is placed into the vagina to help the health care provider see the cervix. This can feel uncomfortable but is usually not painful.
- Cleaning the cervix: The cervix is cleaned with an antiseptic solution. This step should not cause pain.
- Grasping the cervix: The provider uses an instrument to hold the cervix in place. “This can often cause a sharp pain or pinch,” Dr. Whitmyre said.
- Measuring the uterus: A thin device is inserted into the cervix to measure the size of the uterus. This can cause cramping, which can range from mild to severe pain. This is because the cervix needs to open up a small amount to allow for passage of the measuring device.
- Inserting the IUD: The IUD is placed inside the uterus. This step feels similar to the measuring step and can also cause cramping.
Measuring the uterus is usually the most painful step for patients but the amount of pain can vary widely from person to person. If the pain is severe, you can ask your health care provider to pause or stop the procedure at any point.
Remember, you are in control of your body, and you get to decide if you want to continue or stop the procedure at each step in the process.
How to prepare for an IUD insertion
There are a few things you can do when preparing for your IUD that can help prevent discomfort during the insertion process.
- Speak with your health care provider about pain relief options: When you meet with your provider to discuss an IUD, ask if there are any pain relief options they can offer. “Some clinics may offer anti-inflammatory medication (ketorolac) that can be taken by pill or injected into the arm,” Dr. Whitmyre said. “Numbing medication like lidocaine can be sprayed or injected into the cervix. Other oral medications like benzodiazepines (which cause relaxation) or opioid medications may also be an option.”
- Take over-the-counter (OTC) pain reliever: If no prescription pain relief is available, you can take OTC ibuprofen about an hour before your appointment. Ask your provider how much to take.
- Bring distractions: Listening to your favorite songs or podcasts during the procedure can help you relax and reduce the intensity of the pain. You can also try meditation and deep breathing exercises.
- Use a heating pad: Bring a heating pad to the appointment to help with cramping before and after the procedure.
- Schedule wisely: Schedule your appointment for a day when you can go home and rest after the insertion.
What to expect after an IUD insertion
After getting an IUD, it is common to have some side effects. These include:
- Cramping: You may feel cramping similar to period pain. This can last for a few hours or days.
- Light bleeding or spotting: Some spotting is normal and can last a few days to weeks.
- Mild discomfort: After the procedure, you may feel a little sore or tired.
To manage these symptoms at home, you can:
- Take ibuprofen to help with cramps
- Use a heating pad on your lower belly
- Rest and avoid intense physical activity for a day or two
“If you are having cramping that comes and goes similar to a bad period, this is to be expected,” Dr. Whitmyre said. “However, if you have severe pain that is constant and does not feel like a period, or if you develop a fever, chills, nausea, vomiting or any other concerns, please call your health care provider for recommendations.”
What about IUD removal?
IUD removal is usually quicker and less painful than insertion. However, some people still feel cramping when the IUD is pulled out. If you are worried about pain, you can take ibuprofen before your appointment and bring a heat pack for after the procedure.
Takeaway
Getting an IUD can be uncomfortable, but there are many ways to reduce pain. Preparing ahead of time, asking about pain relief options and taking care of yourself afterward can make the process easier.
If you have concerns, talk to your health care provider or a Banner Health specialist. They can help find the best pain relief options for you.
