Intrauterine devices (IUDs) are becoming more popular among women who are opting for long-lasting, cost-effective birth control. However, the insertion process can be nerve-wracking and frightening.
“Even though the IUD insertion sounds really scary, most people do very well with a tailored pain management plan,” says Jen Kaiser, MD, at a specialist in complex family planning at University of Utah Health. “It can be very painful for some, but many of my patients tell me the discomfort was less than they were expecting.”
If you’re considering an IUD and have questions about the process, here’s some information to help you make the best choice.
Is the Pain Worth It?
You should expect to feel pressure and cramping as the small T-shaped contraceptive device is placed through the cervix into the uterus, a process that takes just five minutes. The strongest cramping subsides over the next few minutes after the device is placed, but you can expect to feel period-level cramps for up to a week afterward.
“Nobody looks forward to this procedure, but on a positive note, there are options to help with the pain of placement,” says Kaiser, an assistant professor in the Division of Family Planning at U of U Health. “IUDs are also a very cost-effective way of preventing pregnancy for several years—up to eight years with a hormonal IUD and 12 years with a copper IUD. IUDs are long-lasting and 99% effective, which is why they have gained popularity over the years.”
The good news is that women rarely need anything stronger than anti-inflammatories, such as Advil, Aleve, or Motrin, for the placement. Kaiser recommends taking these medications 30 minutes ahead of time to minimize the pain.
“In terms of painkillers, patients don’t need anything stronger than over-the-counter anti-inflammatories for after placement,” Kaiser says. “As for aftercare, a heating pad can help soothe the cramping.”
The pain should only be temporary, but if you’re experiencing ongoing cramping after the one-week mark, it’s time to see your doctor to make sure your IUD isn’t out of place. Left unchecked, a rogue IUD could lead to irregular bleeding or continued cramping.
Note: Out-of-place IUDs very rarely cause serious health complications.
What Should I Ask My Doctor?
During a medical consultation, it’s easy to get lost in the information overload. Be sure to do your research ahead of time and bring a list of questions about what to expect and how to plan for pain management. Some other options include:
- Numbing the area with a lidocaine medicine injection
- Taking anti-anxiety medication to calm the nerves
- Bringing a support person into the exam room
- Being sedated throughout the entire process
“It’s so important to know what options are available to you,” Kaiser says. “And if your doctor can’t provide you with what you need, ask for a referral to someone who can.”
How Do I Know If This Is Right for Me?
The fear of undergoing this procedure is completely valid. If it doesn’t feel right for you, there are many other contraceptives to choose from.
“A lot of people are very satisfied with their IUDs, but it's not for everyone,” Kaiser says. “If someone feels the insertion is going to be too painful, even with additional pain medications or sedation, they can always explore other options. Picking a form of birth control is very personal, and everyone has a right to choose what feels right for them.”