10 IUD Insertion FAQs: Pain, Side Effects, Aftercare, More - Healthline

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Everything You Need to Know About IUD Insertion

Medically reviewed by Stacy A. Henigsman, DO — Written by Simone Marie — Updated on May 15, 2025

Pre-appointment tips
Step by step
Duration
Insertion discomfort
Anxiety and pain relief
Side effects
Sex after insertion
Postinsertion
Takeaway

Before the intrauterine device (IUD) insertion process begins, you might be a little nervous. However, the procedure lasts only a few minutes, and your physician can answer any questions you may have.

overhead view of a person wearing a pink medical gown sitting with their feet in the stirrups while a healthcare professional prepares to insert an IUD — Maria Kray / Getty Images

So, you’ve decided to get an IUD.

First off: good choice. IUDs are more than 99% effective, making them one of the most reliable birth control methods out there.

These tiny, flexible T-shaped devices basically eliminate human error (i.e., no forgotten condoms or missed pills) and change the way sperm cells move so they can’t get to the egg, keeping you from getting pregnant.

But now that you’ve made your choice, you’re probably wondering: How exactly are they going to get that thing inside?

I’m reading this in the waiting room — can you help?!

Try not to freak out. It’s natural to be a little nervous before getting an IUD inserted, but the procedure won’t take long.

Your appointment will likely take 30 minutes, tops. And when it’s over, you’ll have about 3 to 10 years of baby-free sex (until you want to change that, of course).

What can you do to prepare?

Make arrangements

While most people are fine to drive after the procedure, you might want to ask someone to come with you in case you experience a lot of cramping or don’t feel up to driving.

Although many people are up and able to carry on about their day with minimal discomfort, others find it helpful to spend the rest of the day recovering in bed.

So, if you can take time off work, class, or reschedule other obligations, do it.

The same goes for any responsibilities around this house. Can it wait until tomorrow? Can a friend, partner, or family member come over to help take care of it? Or better yet, can someone come over to help take care of you?

Gather your supplies

We recommend keeping the following on hand and in reach for the rest of the day:

a grab-and-go heating pack, like this one from Rael or this one from Cora
a grab-and-go ice pack, like this one from Kinetic Labs (or one you can prep in advance, like this tried-and-true ice bag from Mueller)
a couple of panty liners or sanitary napkins
an over-the-counter pain reliever, like acetaminophen (Tylenol) or naproxen (Aleve)
a bottle of water or juice to ease any nausea or dizziness
your favorite snacks to help replenish your energy
the most recent issue of your favorite magazine or the latest book on your to-read list
your remote control, tablet (and charger!), Nintendo Switch (and charger!), or whatever else you have to take your mind off of any unsavory side effects and help pass the time

On the day of your appointment

Make sure you take any medications your doctor prescribed (and keep them on hand, if applicable, afterward!) and slip into your comfiest clothes.

Think: breathable cotton undies, baggy sweats, loose T-shirt, and easy slip-on, slip-off style shoes.

You may also want to bring a water bottle and a small snack with you for the ride home.

Step-by-step appointment process

While each practice and doctor may do things slightly differently, here’s what you can expect at your IUD insertion appointment.

When you go in, your nurse or doctor will ask you some questions about your medical history to make sure you get the right IUD for you.

There are 5 types

Mirena, Kyleena, Liletta, and Skyla are hormonal IUDs, meaning they release a small amount of progestin hormone levonorgestrel. Kyleena, Liletta, and Skyla are effective for 3 to 5 years, depending on which one you get.

Mirena is effective for up to 8 years.

The fifth one, ParaGard, is a nonmedicated copper IUD, and it’s effective for up to 10 years.

Sometimes, there are contraindications for hormonal IUDs, in which case your doctor will likely offer the copper IUD.

Before they go any further, they’ll explain the procedure, give you a chance to ask questions, and get you to sign a consent form.

They might also offer you oral pain medication, such as ibuprofen, to help with pain and cramping, unless you’ve already taken some before you arrived.

Unless you’re menstruating, you’ll take a pregnancy test

“Inserting a device in an early pregnancy can cause a miscarriage,” explained Kimberly Langdon, MD, an OB-GYN based in Ohio.

However, if you’re using another form of hormonal contraception or getting the insertion at the beginning of your period, this might not be necessary.

“Many times your health provider will opt to place an IUD with menses, as the cervix will be slightly dilated,” says Kecia Gaither, MD, double board certified in OB-GYN and maternal fetal medicine and director of perinatal services at NYC Health + Hospitals/Lincoln in the Bronx, New York.

Your practitioner might also perform a test to check for sexually transmitted infections (STIs) by taking pelvic cultures.

Next, your physician will perform a pelvic exam

This is to confirm the orientation of your uterus.

Your uterus might be anteverted (which means it tilts toward the bladder), midline, or retroverted (which means it tilts away from the bladder).

The exam also determines the size, consistency, and mobility of your uterus, and they’ll check for any pain, which could be a sign of infection.

The healthcare professional performs the pelvic exam as a bimanual examination, which means they will insert two fingers into your vagina and press their other hand on your abdomen to feel your internal pelvic organs.

Then comes the speculum

If you’ve never seen one before, a speculum looks a little like a metal duck beak. This instrument is inserted into your vagina to help open the canal and allow your doctor to see your cervix.

Once inserted, “the vagina is cleansed with an antiseptic solution,” explained Gaither. This reduces the risk of infection.

Some healthcare professionals may apply a local anesthesia, such as lidocaine, after the cleaning is complete to help minimize any discomfort you might feel.

Next, they’ll stabilize your cervix for the procedure using a long-handled, slender instrument called a tenaculum.

Measurements are next

Although there’s only one IUD size, your practitioner still needs to measure the length of your cervical canal and uterus.

They do this to make sure your uterus is at least 6 to 9 centimeters deep and to make sure they don’t insert the IUD too deeply or at the wrong angle. If your IUD is inserted incorrectly, it may not work as effectively, or worse, it could perforate the uterus.

These measurements are taken with an instrument called a sound, which has a round tip at the end so that it doesn’t injure your uterus when it is inserted.

Insertion time

Your physician will remove the IUD from its sterile packaging, bend its arms back, and use a tube or slider to insert it through your vaginal canal and cervix into your uterus to the depth indicated by the sound.

Hormonal IUDs are typically preloaded in the tube or slider. The ParaGard requires bending the arms of the IUD itself so that it can be placed into the tube or slider.

The tube or slider will have a plunger to move the IUD into place. Once the IUD is out of the tube, the arms will open into its “T” shape.

Once it’s in place, the IUD will have strings that hang down through the cervix into the vaginal canal. Your physician will trim those strings so that only about one to two inches hang into the vaginal canal.

These strings will allow your physician to check that the IUD is still in place — you might be able to feel them if you insert your finger into your vaginal canal, but many people do not.

They might perform an ultrasound

If your healthcare practitioner is concerned about the placement of your IUD or suspects it may have been inserted too far in, they may perform a transvaginal or abdominal ultrasound to check its position.

However, most people won’t need one.

You’ll wrap up with a brief in-office recovery period

Once the IUD is in place, your physician will give you a card with information about your IUD type, date of placement, and when it should be replaced.

Then you’ll be given a few minutes to check whether there’s any cramping or mild bleeding, explained Diana Torres, certified midwife and practicing OB-GYN at Jamaica Hospital Medical Center in NYC.

Spotting is also typical following the insertion as the tenaculum is removed. Your practitioner should provide bleeding precautions.

Some people may also feel a little dizzy or experience vertigo after the procedure.

Your physician will likely tell you to take as long as you need to rest in the room, but you’re free to go home when you feel up to it.

How long it takes

The actual insertion process should only take about a minute or two, though your appointment from start to finish could take up to a half-hour or so.

Will the IUD insertion hurt?

What the insertion process feels like will depend on a few different factors, including:

your individual pain tolerance
the length of your cervical canal
whether you experience any underlying conditions, such as vaginismus
whether you’ve previously delivered a baby vaginally
whether your practitioner prescribed medication to take beforehand
whether your practitioner injected a local anesthetic or applied a topical numbing cream

For many people, the insertion process is more uncomfortable than painful.

“Mild cramping can be experienced during the insertion and for a few hours thereafter,” said Torres.

Some people also feel a pinching sensation during insertion, though this is generally over fairly quickly.

Others experience moderate to severe pain during the process, including intense cramping and pressure on the abdomen. You might also break out into a sweat, feel nauseous or vomit, or, in some cases, faint.

These side effects generally subside over the next few hours or within the next day.

Depending on your reaction, your practitioner may be able to prescribe something to offer relief or otherwise advise you on the next steps.

Is there anything you can do for anxiety or pain relief?

“It’s often recommended that patients take a nonsteroidal anti-inflammatory drug, or NSAID, before placement,” said Gaither.

Think: Up to 800 milligrams of aspirin, naproxen (Aleve), or ibuprofen (Advil, Motrin).

However, for many people, an over-the-counter pain reliever isn’t enough to prevent or alleviate severe discomfort, no matter how high the dose.

If you’re concerned about potential pain or feel anxious about the procedure, talk with your physician.

Oftentimes, they can prescribe medication that you can take in advance and after the procedure to help minimize discomfort and aid in your recovery.

This might include medication to help:

soften the cervix, such as misoprostol (Cytotec)
ease anxiety, such as lorazepam (Ativan) or diazepam (Valium)
minimize pain, such as diclofenac (Flector), hydrocodone (Zohydro ER), or combined acetaminophen and codeine phosphate (Tylenol-3)

They can also use the following during your appointment to help minimize pain and discomfort:

local anesthetic, injected and/or applied topically, to numb the cervix (paracervical block)
nitrous oxide, also known as laughing gas, inhaled via a breathing mask to provide conscious sedation
general anesthesia, injected or inhaled via a breathing mask, to provide full sedation

Are there any side effects or risks to consider?

It isn’t uncommon to feel cramping and backaches for a few hours or even days after the procedure, so you might want to take it easy once you get home. Heating pads can also help.

Some people experience spotting from the procedure after getting an IUD, but this should go away within 3 to 6 months.

One of the most common IUD side effects is a change to your period

“With a copper IUD, you might have a heavier flow [during your period] the first couple cycles,” explained Torres. You might also experience worse menstrual cramps.

However, “the [period] may lighten or disappear with a hormonal IUD,” said Torres. And your cramps might be a lot lighter.

It could slip out of place

This is most common in the first 3 months, though it could happen anytime. If you expel it, it often happens during a bowel movement or menstruation.

This is why it’s a good idea to check your period product of choice — be it absorbent underwear, pads, tampons, or a cup — to make sure the IUD hasn’t fallen out.

Although there is some 2023 research that suggests using a menstrual cup could dislodge your IUD, the risk is relatively low. It may also be more common in copper IUDs.

There’s a small risk it could embed in the uterine wall

“It can become embedded in the uterine wall or go through it entirely and end up in the pelvic cavity,” explains Langdon. If this happens, you might need surgery to remove it.

As terrifying as this might sound, it’s incredibly rare. It also usually happens during the actual insertion process.

In rare cases, you could become pregnant — and it could cause complications

Fewer than 1 out of every 100 people who have an IUD will become pregnant.

If this happens, you need to have the IUD removed ASAP. The longer the IUD remains inside your uterus, the higher the risk of an ectopic pregnancy and other serious complications.

Ready for more myth-busting? Contrary to popular belief — and the advice by some healthcare professionals — modern IUDs don’t cause or increase your risk for pelvic inflammatory disease (PID).

How long after insertion until you can have solo or partner sex?

You can have sex as soon as you want after getting an IUD unless you have had it inserted within 48 hours of giving birth.

“The patient may have penetrative sex the same day of insertion, but I generally ask the patient to give themselves 24 hours in case of spotting and cramping and for pregnancy protection,” said Torres. “All other activity is up to patient preference.”

However, you might want to use a backup form of birth control — like a condom — if you want to have penis-in-vagina sex soon after insertion.

PSA: Not all IUDs work as a contraceptive immediately after insertion.

ParaGard copper IUDs begin preventing pregnancy as soon as they’re in place.

But hormonal IUDs are only effective immediately if they’re inserted during the first 7 days of your period. Otherwise, protection against unwanted pregnancy begins 7 full days after insertion. If inserted over 7 days after the start of your period, use a backup method.

That said, some healthcare professionals recommend using a condom or other barrier method for the first month after insertion to reduce your risk of infection.

Is there anything else you need to know?

You’ll generally have a follow-up appointment 6 to 8 weeks after insertion.

At this appointment, your physician will check the strings to make sure they’re in place and don’t need to be trimmed further.

This is also the time to speak up about any discomfort you or your sexual partner may be experiencing during penetrative sex.

If the strings are poking you or a partner in an uncomfortable way, your physician should be able to trim them back a little during this appointment.

Seek medical attention if

“Any persistent pain, spotting, foul discharge, or fever should be reported,” said Langdon.You should also reach out to your physician if you think you might be pregnant.

What’s the bottom line?

It’s OK to be nervous before getting an IUD, but the appointment will likely be over before you know it.

While you might experience some discomfort during the insertion and some cramping afterward, these symptoms should resolve fairly quickly.

And once that’s the case, you’ll be able to rest easy knowing you’re over 99% protected against any unwanted pregnancies.

Simone M. Scully is a writer who loves writing about all things health and science. Find Simone on her website, Facebook, and Twitter.

How we reviewed this article:

SourcesHistoryHealthline has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical journals and associations. We only use quality, credible sources to ensure content accuracy and integrity. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.

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Medically reviewed by Stacy A. Henigsman, DO — Written by Simone Marie — Updated on May 15, 2025

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