It often takes anywhere from 6–8 months before your body fully adjusts to an IUD. Whether this means no bleeding, constant leakage, or something in between comes down to the type of IUD and your body’s reaction to it.

An intrauterine device (IUD) is a small, T-shaped plastic device that’s placed inside the uterus to prevent pregnancy until it’s removed.

Getting a piece of plastic inserted into your body may sound like no-go territory, but more and more people are interested in this birth control method. According to 2019 research, appointments related to IUDs increased by 21.6% since November 2016.

“Young women are pulled in so many directions, and worrying about birth control shouldn’t be one of them,” says Elise M., a 24-year-old who’s had a copper IUD for 3 years.

And she’s right: Getting accurate and helpful information shouldn’t be hard.

So we asked other folks* who can say, “been there, done that (and will do it again!)” about their experiences. Plus, we’ll tell you how to handle the side effects most people don’t discuss.

*Some names have been changed at the request of interviewees.

Side effects during and immediately following IUD insertion are often the same, regardless of the type of IUD. This can include:

  • abdominal or pelvic pain
  • bleeding or spotting
  • cramping
  • dizziness

Afterward, all hormonal IUDs (Kyleena, Mirena, Liletta, and Skyla) have similar side effects. They commonly include:

The nonhormonal IUD (Paragard) can also cause changes in menstrual bleeding.

Changes in menstrual bleeding

All hormonal and nonhormonal IUDs are associated with irregular menstruation and spotting between periods the first 3–6 months after insertion.

Hormonal IUD users may experience heavier bleeding that lightens over time. Nonhormonal IUD users may experience a long-term increase in menstrual flow.

Unsure what to use? Check out our roundups of the best period underwear, menstrual cups, tampons, and more.

Missed menstrual periods

Some hormonal IUDs are more likely to cause amenorrhea (aka missed periods) within one year of insertion than others:

Ovarian cysts

Some hormonal IUDs are more likely to cause ovarian cysts than others:

These cysts often disappear on their own in 2–3 months. In some cases, cysts can cause pain and may require surgery.

Hormonal IUD users may also experience:

Hormonal and nonhormonal IUD users alike may experience:

Nonhormonal IUD users may also experience anemia, which occurs when the number of healthy red blood cells in your body is too low.

In rare cases, both hormonal and nonhormonal IUDs can cause:

  • Infection: This can result from bacteria entering the cervix or uterus. It’s most common in the first few days after insertion. Look out for the signs of pelvic inflammatory disease (PID).
  • Embedment: This happens when the IUD attaches to the wall of the uterus. It’s most common when the IUD is inserted while you’re nursing or if you recently gave birth.
  • Perforation: This refers to the IUD going through the wall of the uterus. It may be more likely to happen when the IUD is inserted while you’re nursing or if you recently gave birth.
  • Migration: This happens when the IUD moves into a different position inside the uterus. If this happens, it’s most common in the first 3 months.
  • Expulsion: This refers to the IUD moving out of the uterus, meaning it fell out. It’s also most common in the first 3 months.

If you only remember one thing you’ve read here, make it this: The IUD insertion process feels different for everyone.

Healthcare professionals often describe it as a quick pinching sensation. While many people find the process more uncomfortable than unbearable, others experience a severe reaction.

“The second my IUD was inserted, I experienced a pretty intense cramp that made me break into a full-body sweat,” says 25-year-old Anne S.

Others report experiencing:

  • moderate to severe abdominal pain
  • moderate to severe abdominal pressure
  • nausea or vomiting
  • lightheadedness or dizziness
  • fainting

These side effects usually subside within a few hours or by the next day.

How it feels for you may depend on:

  • your individual pain tolerance
  • the length of your cervical canal
  • whether you have previously given vaginal birth

Before your appointment

If you’re concerned about pain or feeling anxious, talk with your clinician. They usually recommend taking ibuprofen (Advil) about an hour before the procedure, but they may be able to prescribe something stronger.

This can include:

  • pain relievers
  • an anti-anxiety medication
  • a medication to soften your cervix

Local anesthetic or nitrous oxide (aka laughing gas) may also be used during the procedure to take the edge off. Discuss beforehand if these are available through your clinician’s office.

Arm yourself with ibuprofen, a heating pad, and juice the day of. Wear your coziest outfit for maximum comfort on the ride home.

During your appointment

Many people find it helpful to have their clinician walk them through what they’re doing.

Depending on your needs, this could mean questioning the process before the actual procedure or asking the clinician to verbalize what’s happening each step of the way.

If you’re into meditation — or willing to try — this is the perfect time to put it into practice.

Some folks find that counting down from 100 or even counting sheep can be a helpful distraction from what your clinician is doing. Others rely on guided meditation apps to help redirect their focus.

Other techniques include:

  • using headphones to listen to your favorite music or podcast
  • watching TikToks or videos on your phone
  • sending your friend a voice message about how your day is going and what you’re doing the rest of the week

After your appointment

Many people experience some bleeding after insertion.

“[The insertion] caused me to start what would have been my period for the month,” says Anne S. “I spotted very, very lightly for 3 or 4 days after.”

Your clinician should give you a few pads after the appointment, but if you can, stock up your cabinet with unscented liners just in case.

Also worth noting: Hormonal IUDs tend to reduce cramping, and copper IUDs increase cramping. But as with all period-related things, cramping can be pretty individual.

So, if you haven’t already, consider investing in a quality heating pad. Drinking rose hip tea may also help keep any cramping at bay, so consider grabbing a box.

Many people who get IUDs don’t experience any serious side effects or complications. Side effects are often manageable and will lessen over time.

However, you know your body best. If something feels off or you’re experiencing unusual pain or discomfort, consult a healthcare professional as soon as possible.

You should also consult a clinician if you experience one or more of the following:

Is it OK if you can’t feel your IUD strings?

An absence of strings doesn’t necessarily mean your IUD has made its great escape. Sometimes, the strings soften and coil behind the cervix (which, for the record, can feel like the tip of your nose).

If you can’t feel them yourself, consider asking a partner to check. They may have the advantage of not needing to contort an arm between your legs. It’s all about the angles!

Cervix length is also a factor, but you need to ask your clinician about that. During your appointment, they can explain why you can’t feel your strings if your IUD appears in place.

Is it common to feel the IUD strings during vaginal sex?

Complaints about a poking string during sex may be a sign that your IUD isn’t positioned correctly or that the IUD strings are too long.

Feeling the strings during sex may also mean that the strings just haven’t softened yet, which is typical in the first few months. Over time, a partner might not be able to feel the strings at all.

If it keeps happening, consult a healthcare professional. They can take a look and advise on any next steps.

What period products should you use after getting an IUD?

If your period is much lighter, things may be a little dry down there. Skip the pads or tampons as a preventive measure. Pads can cause chaffing, and without lubrication, even the smallest tampon can feel like sandpaper.

With a light flow, you may also be tempted to leave a tampon in for longer, which puts you at risk of infection.

If you plan to use a menstrual cup, talk with a clinician about correct use. In some cases, the suction when removing the cup can inadvertently increase the risk of pulling the IUD out of place.

If menstrual irregularity is your new norm, don’t ignore feelings of fatigue or dizziness, especially if they prevent you from doing your usual daily activities. In these cases, you should consult a clinician ASAP.

Is it common to break out after getting an IUD?

Unlike with the pill, IUDs have not been shown to help with acne or PMS symptoms. If you can bear it, try waiting a few months to see if your body adjusts.

For many, temporary breakouts are a small price to pay for long-term contraception. Plus, if it just isn’t working out, you can break up with your IUD at any time.

In the meantime, step up your skin care routine. Consider talking with a dermatologist or venture into the land beyond soap to try out serums, toners, and masks. These tips can help you get started.

Can an IUD protect against STIs?

An IUD may lower your risk of pregnancy, but the risk of STIs remains the same.

This means it’s never been more important to talk with your partners about STI status and to get tested regularly.

What are the risks of using an IUD?

Although IUDs are safer than ever before, it’s still too soon to tell if some listed long-term risks are truly likely.

For example, the package inserts for Mirena, Liletta, Skyla, and Kyleena all advise against use if you’ve ever had breast cancer. However, there hasn’t been any conclusive evidence about an increased risk of cancer.

Research from 2008 suggests a link between levonorgestrel-releasing IUDs, like Mirena, and a reduced risk of endometrial and ovarian cancers.

The copper IUD may also decrease your risk of endometrial cancer and possibly even cervical cancer.

Other risks are established but still quite rare. These include pelvic inflammatory disease and perforation.

If you’re concerned about your potential risk, talk with a clinician. Be prepared to discuss your genetic or family medical history. This can help you and your clinician make a decision about birth control.

Is it really possible for an IUD to fall out?

It’s extremely rare for an IUD to fall out of your body completely. If the IUD moves, it typically becomes lodged in the lower cervix, causing a distinctive pain that can’t be ignored.

Although expulsion often occurs within the first 3–6 months of insertion, it can happen at any time — especially if the IUD was inserted after giving birth or if you’re currently nursing.

“With my first IUD, my period went away after 6 months. However, [during] the last couple of months, I started getting my period [again] and cramped a lot,” Trina R. says. “Then the IUD fell out.”

That’s why checking for your strings and recognizing your body patterns is important.

If you can’t feel your strings, but your clinician says everything seems healthy, start using a journal or download a period tracker app to help monitor changes in flow, mood, or pain.

For most people, the IUD has more pros than cons — like not having to think about birth control for at least 3 years, depending on the type you get.

Research even backs this love of IUDs. IUD users are more likely to stick with their birth control than folks who use other methods, like the pill.

“It was free, I don’t have to go to the pharmacy once a month, and I never have to think about birth control,” says Nicole S., 25. “It’s life changing.”

Tess Catlett isn’t the only editor to get an IUD, but they’re the only one willing to talk about it on the internet. If you have questions that Google can’t answer, give her a shout on Twitter.