I’m not a substitute for professional medical advice, diagnosis or treatment. This is for general education purposes only. Don't go against what your doctor said because of what you read here. Thank you!
So, you booked your IUD insertion appointment. What’s next? 📆
Getting an IUD (intrauterine device) is a great decision. It’s one of the most effective forms of birth control for preventing pregnancy, so well done you! With any luck, your insertion will be 5 minutes of pain for years of gain i.e. not getting pregnant (and having lighter or no periods if you get a Hormonal IUD) 👀. As of 2023, IUDs last up to 10 years if you get Paragard (the one type of Copper IUD), 5 years if you get the Kyleena, 8 years if you get the Liletta or Mirena, 3 years for Skyla (all the Hormonal IUDs). Let’s do this! 🥳
Fun fact: When I got my Liletta in 2016, it was only approved to last 5 years. I've gained 3 more years with it in the meantime, and I plan to get mine replaced in 2024. I've had an amazing experience with mine. I hope from reading this article, you'll have a better experience getting your IUD inserted too.
Quick reminder: What is an IUD?
An IUD is an intrauterine device and is a highly effective method of birth control to prevent pregnancy. It is a small, plastic, t-shaped device that is inserted up the vagina, through the cervix and sits in the uterus. There are two types of IUDs. The hormonal IUDs release a small amount of localized progestin, one of the main hormones in the female reproductive system. Many people with hormonal iuds benefit from lighter, less painful periods or no periods as a result (amenorrhea). The second type of iud is the copper IUD. The copper IUD does not contain hormones, so it does not have the benefit of making periods lighter or less crampy, but it can last longer than most hormonal IUDs (12 years or longer as opposed to 5 for most hormonal IUDs). Check with your healthcare provider or obgyn which kind of iud you are getting, and how long you can keep yours before you need to get it replaced.
Many people prefer to get an IUD rather than take birth control pills every day for multiple years. The main benefit of the iud is that it’s long-acting; as long as there are no complications, you can “set it and forget it” for these years that you don’t want to be pregnant. However, the iud placement is painful and gynecology and women’s health in general has not caught up to making this procedure easy and pain-free. So, I wrote this article to try and make that experience as painless for you as possible!
In the days before your iud placement
- Invite a friend to go with you to your appointment. You should feel supported on the day, not alone! If your friend has gotten an IUD before, that’s even better.
- Plan a “treat yourself” afternoon for after your insertion process. Organize to eat at your favorite restaurant, or watch your favorite movie. You deserve it.
- Ask someone to pick you up or plan to get a lift after your insertion. I was able to walk straight out of the clinic, but other people feel crampy, so it’s a good option to have
- Make sure you are not pregnant on the day of your insertion. You should be on your period, not had sex since your last period, or have been using effective birth control (e.g. the pill and a condom combined)
On the day of the iud placement
- Don’t forget to take painkillers i.e. Advil or Motrin an hour before your insertion. I took 3 pills (600mg) of ibuprofen before mine it helped
- Gotta be on time 🕰
- Chat to your friend or distract yourself on your phone while you’re in the waiting room. I recommend Tiktok or watching The Office scenes on Youtube
- The health care provider will take your urine sample i.e. ask you to pee in a cup, or take a pregnancy test to make sure you’re not pregnant. You might have to wait for these results
- If you feel nervous, take some deep breaths and sip some water (hopefully you brought a water bottle). Almost 1 million girls in the United States alone get an IUD every year, so you can too. You got this! 💪🏽
What to expect during the procedure
The procedure will be painful, but all these steps take about 2 minutes. Especially if you are at a Planned Parenthood or sexual health clinic, the gynecologists and nurses are really experienced and perform iud insertions every day, so they can perform the insertion as seamlessly and quickly as possible. Take some deep breaths, hang in there, and it’ll be over before you know it:
- You’ll sit down on the bench and remove your clothes from the waist down, putting a sheet over you for privacy
- Doctor inserts the speculum to open up your vagina. This will feel uncomfortable.
- Doctor may clean your cervix with antiseptic and apply local anesthesia.
- Doctor might sound your uterus to see how big it is. This will feel uncomfortable.
- Doctor places the IUD through your cervix into your uterus. This will feel uncomfortable.
- Doctor cuts your IUD strings around 2 inches long
Bleeding is normal, so don’t freak out if there is some blood on the bench afterwards. Well done!! You did it 💪🏽
The rest of that day
- Enjoy your “treat yourself” afternoon, heating pad, fancy restaurant or movie and all.
- Take some pain killers and get some rest if you’re feeling crampy 😴
- Use some panty liners so you don’t stain your underwear. Spotting and bleeding is normal 👍🏽
The days after
- Keep up with the pain medication, rest, and panty liners if you are cramping, spotting or having irregular bleeding. You might experience mild cramping for a couple of days.
- Irregular bleeding can last for a couple of months as your body adjusts, especially with Hormonal IUDs (Hatcher RA et al., Contraceptive Technology, 21th ed., 2018; p183). I spotted for 1 ½ months
- Use condoms if you have sex in the first week after getting a Hormonal IUD. This is not needed for a Paragard / Copper IUD, as they start working immediately.
A week and more after
- With the Hormonal IUD, you might stop getting your period. This is normal and does not mean you are pregnant. Enjoy it! 😎
- With the Copper IUD, one side effect is that your periods may have more heavy bleeding. Stock up on tampons or other period products and take pain killers when you feel it coming on
- You can check your IUD strings by sticking your clean fingers up your vagina to your cervix. I’ve never checked my strings, but some people find it reassuring to know that their IUD is in there
- A follow up with your healthcare provider isn’t really necessary, but be sure to ask them any lingering questions.
Last but not least, the warnings
Make sure you still use condoms to protect yourself against STIs (sexually transmitted infection). IUDs of any kind do not prevent against these. You can get an STI and not have symptoms, and you can then develop pelvic inflammatory disease, which can hurt your chances of getting pregnant in the future. Again, IUDs do not cause infertility, but like the pill and the implant, these birth control methods also do not prevent STIs which can cause infertility. So be sure to use condoms when having sex with new partners if you don’t know their sexual history.
There are some other potential complications with the iud, like perforation of the uterus if the iud shifts. Complications like this are rare and very painful. Unfortunately, we haven’t got a lot of research as to why this happens. So just check in with yourself physically, and if you experience a ton of pelvic pain or vaginal bleeding while you’re not on your period, check in with your obgyn.
Congratulations! 💕 You made it! Have a great couple years of freedom 🥳