Previously written by Erica Stephenson NP in April 2019
So you’ve decided on an intrauterine device (IUD) for contraception – Congratulations! But… now what? You’ve probably heard stories from friends, family members, or coworkers about their various experiences that have you wondering whether or not you made the right choice in contraception.
As with most big decisions, especially when it comes to our health care, it can be totally normal to have some second thoughts or worries about what to expect. Like most people, you’ve probably even found yourself turning to “Dr. Google” for some answers, which may, or [more likely] may not, be helping the situation.
This post is intended to provide those of you finding yourselves in this scenario with a general guide about what to expect during and after your IUD insertion.
I’ve even included a little bit of my own experience to help you really get an idea of what it’s all about. For reference- I have never experienced menstrual cramps in my life and have not given birth, and I promise the IUD experience was really not that bad.
What is an IUD?
IUDs are excellent methods of contraception that offer 3-10 years of pregnancy prevention, depending on which device is used. (Skyla is 3 years. Mirena, Kyleena, and Liletta are effective for 5 years. Paragard is good for up to 10 years).
All types of IUDs are inserted in the same manner, and patients can expect the same procedure risks/benefits across the board.
Are there any risks with an IUD?
In general, the risk for uterine perforation is about 1 per 1,000 procedures, and for infection is even lower.
For those at risk, it’s not a bad idea to have routine STD screening before your IUD insertion to ensure there is no infection present at the time of the procedure.
What should I expect during an IUD insertion?
Prior to the insertion appointment, it is helpful to take some ibuprofen (Motrin/Advil) or acetaminophen (Tylenol) to have something on board for cramping. Yes, there is cramping, and it essentially feels like, what I’m told are, very bad menstrual cramps.
If you’re like me and have never had menstrual cramps, it’s like a strong pinching sensation just behind your pubic bone. It doesn’t last long, and it wasn’t as bad as I thought it would be. I’m confident the 800 mg of Ibuprofen I took beforehand had something to do with that!
If you have never given birth vaginally, or it has been a few years since you have, your clinician may also prescribe you a medication called Misoprostol (Cytotec) to take the night before. Some providers prescribe it orally and others vaginally or even a combination of the two.
This medication helps the cervix become softer and a little more open, allowing the IUD inserter to slide into the cervical canal more easily. You will feel some cramping during this portion of the procedure, which is very quick. I was certainly glad I had taken the cytotec beforehand as well!
During the procedure, a uterine measurement is obtained with a slender instrument called a “uterine sound”, and then the IUD inserter is placed through the cervix. When the inserter reaches the top of the uterus, the IUD is released and the inserter is removed from the uterus and vagina. Voila- your IUD is in place!
The whole procedure generally takes less than 5 minutes, though this can vary from woman to woman.
What should I expect after the IUD insertion?
After the procedure, it is normal to have some residual cramps which tend to dissipate over minutes to hours. You may have some light bleeding afterwards as well, for which a panty liner is generally sufficient. For me, it felt like there was a “heavy” sensation in the pelvic area for an hour or so and I didn’t have any bleeding.
There are no limitations to daily activities after the procedure- you can return to work, school, exercise, etc without complication once you feel like it, and there is no “required” recovery period.
The only limitation is the recommendation to avoid sex for 2 days post-procedure, which most women don’t seem to mind. I was pleasantly surprised by how tolerable the whole experience was, and once I was feeling up to it, I even went horseback riding the same afternoon!
It is important to remember that everyone’s experience will be different, and the best course is to discuss your individual needs and questions with your health care provider at Kamm McKenzie OBGYN. Your provider can cover all the specifics in detail with you during your appointment.
I hope this post will prove helpful to those of you wondering what in the world to expect during your IUD procedure. After having gone through the procedure myself, I find it helpful in counseling patients during their consultation appointments. Personally, I’m 2 years in with my IUD and loving it!