If you’re considering getting an intrauterine device (IUD), you may be fearful it will hurt. After all, it must be painful to have something inserted through your cervix and into your uterus, right? Not necessarily.
Although everyone has different levels of pain tolerance, many women get through the procedure with minimal pain.
How IUDs work
IUDs prevent pregnancy by releasing either copper or hormones into your uterus. This impacts the movement of sperm and helps prevent them from reaching an egg.
IUDs may also change the lining of the uterus to prevent the fertilized egg from implanting. Hormonal IUDs cause cervical mucus to thicken. This prevents sperm from reaching the uterus.
IUDs are more than 99 percent effective in preventing pregnancy. Copper IUDs guard against pregnancy for up to 10 years. Hormonal IUDs last for three to five years.
What are the side effects of IUDs?
The side effects vary depending on the type of IUD that you get. There’s a low risk of expulsion with all IUDs that ranges from 0.05 to 8 percent. Expulsion occurs when an IUD falls out of the uterus, either completely or partially.
The copper IUD called ParaGard may cause:
- a backache
- bleeding between periods
- painful sex
- severe menstrual pain
- heavy bleeding
- vaginal discharge
Hormonal IUDs, such as Mirena, may cause different side effects. These can include:
- a headache
- breast pain
- light or absent periods
- irregular bleeding
- weight gain
- mood swings
- ovarian cysts
- pelvic pain and cramping
No IUD protects against HIV or other sexually transmitted diseases. The side effects often diminish over time.
What’s the IUD insertion process like?
For many women, the most difficult part of getting an IUD is overcoming the fear of the insertion procedure. The procedure can be performed in your doctor’s office or in a healthcare clinic. IUD insertion usually takes less than 15 minutes.
Your doctor will take several steps to insert the IUD:
- They’ll insert a speculum into your vagina to hold it open. This is the same instrument used during a Pap smear.
- They’ll cleanse the area.
- They’ll stabilize your cervix which can be a painful pinch.
- They’ll measure your uterus.
- They’ll insert the IUD through your cervix into your uterus.
Most women are allowed to resume normal activities immediately after IUD insertion. Some may choose to take it easy for a day or two and rest. Women who’ve had children may find the insertion process less painful than women who haven’t had children.
What to do if your IUD causes pain
There are several reasons you may experience pain during and after IUD insertion. Some women have pain when the speculum is inserted into the vagina. You may feel pain or cramping when your cervix is stabilized or when the IUD is inserted.
Scheduling the insertion procedure when your cervix is naturally more open, such as during ovulation or the middle of your period, may help minimize pain.
According to Access Matters, which was formerly called the Family Planning Council, women are most likely to feel cramping or pain at the moment the IUD is placed inside the uterus. Most women describe the pain as mild to moderate.
To help take the edge off the pain of IUD insertion, you may take an over-the-counter analgesic such as acetaminophen or ibuprofen at least one hour before the procedure. You can also talk to your doctor about using a local anesthetic or a cervical block.
Rest and a hot water bottle placed on your abdomen are often all you need to get through any insertion pain.
Copper IUDs may cause increased cramping and bleeding for several months after insertion. This is especially likely during your periods as your uterus adjusts to the IUD.
If your IUD is expelled, you may experience increased pain or cramping. Don’t attempt to remove the IUD or put it back in place yourself.
IUD uterine perforations are rare, but they may cause severe pain. They may also cause heavy bleeding and severe pain during sex.
If pelvic or back pain is severe or persists, it may or may not be related to your IUD. You may have a pelvic infection, an unrelated medical issue, or an ectopic pregnancy, which is rare.
Choosing a birth control method that’s right for you
IUDs are just one birth control option. To determine which birth control method is right for you, consider these factors:
- the importance of effectiveness
- your partner’s level of involvement in birth control
- your willingness to take a daily pill
- your ability to insert a birth control barrier method such as a sponge or diaphragm
- the permanence of the method
- side effects and risks
Will getting an IUD hurt? It’s impossible to say for certain what your experience will be. It’s likely that you’ll feel minor pain and cramping during insertion. Some experience more significant cramping and pain. This may continue for a few days afterward.
Most women find the pain tolerable and feel that the peace of mind that comes with using an effective birth control outweighs any pain or side effects. Pain is relative, though. The pain and discomfort that one woman may find to be moderate may be considered severe by another woman.
If you’re concerned about possible pain or side effects, talk to your doctor about ways to lessen pain during the procedure. Contact your doctor immediately if your pain is severe or not what you expected after insertion.