An intrauterine device (IUD) can be an amazing birth control option for many people, but it may seem strange or a little scary to think about having this T-shaped device inserted into your uterus. You might be wondering what it feels like to have an IUD inserted, and what having one is like long term. It’s different for everyone, of course, so your experience will depend on your anatomy, whether you’ve recently given birth, your pain tolerance, the medication available to you, and a bunch of other factors, including the experience and skill level of your provider.
Hearing other people’s experiences may help you understand what to expect, so we put a call out on Facebook to ask a few people with uteruses to tell us what it felt like to get their IUDs. Their responses show that experiences, pain and comfort levels vary from person to person.
For some, an IUD insertion isn’t very painful — nothing a Tylenol can’t fix.
“My first insertion was very easy,” says Meredith Pamp, 30, who got her first IUD at 21 because she was losing her health insurance after college and didn’t know if she’d be able to get the pill. “They gave me a Tylenol as I was waiting for the doctor but no other medication. I was nervous but a nurse held my hand and talked to me through it. I remember some discomfort, a slight pinch, but no pain. I stopped for a bagel on the way home and enjoyed the rest of my day watching TV on the couch. It was so much easier and more painless than I expected. I remember almost feeling guilty that I took the day off.” Meredith got a second IUD after the first one expired and said she experienced some slight cramping, but nothing some Tylenol didn’t fix.
One woman says the IUD insertion process was very painful and uncomfortable.
Natalie, 38, who requested we use a pseudonym for the sake of anonymity, got an IUD in 2015. “I had a terrible experience. I was told it would not hurt and could take some Ibuprofen before the appointment and that I could go back to work after the appointment.” Natalie tells O.school that the provider had to try twice to get the IUD in (which happens sometimes), and this caused her so much nausea and pain she could barely drive herself home. “There was an extreme amount of pressure and shocking sensations from my uterus outward, and I was very nauseous. It was the most pain I had experienced up to that time (10 [on a scale of 1-10]), and remained the most pain until I had emergency surgery to cauterize a ruptured ovarian cyst two years later (a side effect of the IUD). Now that I've had a ruptured ovarian cyst, that is my 10, and the IUD has been demoted to a 9.”
According to one person, it really depends on your body when it comes to IUD insertions — especially if you get it done soon after giving birth.
Amy LaRosa-Peters, 46, who has had two IUDs and is about to get a third, says, “The first one was not painful because I was about four days postpartum so I was all loosey goosey up in there and probably sore from childbirth!” Amy says with her second IUD, which she got after giving birth vaginally twice, she didn’t feel any pain but there was some pressure and discomfort. She did have significant cramping about two hours after the insertion, though. “Significant meaning I said to myself ‘ow, this is uncomfortable, I would like to lie down.’ Of course I had to go to work, so I remember being a cranky teacher and alternating sitting and standing and leading the class in some stretches. For my next one I would likely go on a Friday so I can be less active on a Saturday.”
One person said the pain of an IUD insertion was a 2 on a scale of 1-10.
Meg, 38, who asked us not to use her last name for anonymity, got her IUD inserted two months after giving birth. She says her pain was about a 2 on a scale of 1-10, and she doesn’t remember much about the insertion, though she suspects her cervix was “still pretty squishy” from the birth. Overall, she says, “I'm pretty happy with my IUD and sort of wish I hadn't been on the pill forever.”
A few people O.school talked to, like Natalie, had very difficult and painful experiences both with their IUD insertions and over time. Others swore by their IUDs. To learn more about what the average experience is like, we talked to medical providers with experience inserting IUDs. Here’s what they said.
A nurse practitioner tells O.school most feel like IUD insertions are actually easier than they expected.
“The vast majority [of my patients] say that the insertion was much easier than they expected after reading many ‘horror stories’ online or hearing from friends with bad experiences,” Barb Dehn, a women’s health nurse practitioner, tells O.school. “When I ask about pain and cramping, most say that it’s about a 5 to 7 on a scale of 10 during the insertion, kind of like menstrual cramps, but is about half that within 10 to 15 minutes.”
If you’ve given birth vaginally, the IUD insertion may be less painful or uncomfortable.
Sometimes having an IUD inserted if you haven’t had a vaginal birth can be more difficult or painful because the cervix (the entrance to the uterus) doesn’t open as easily, but that’s no reason not to get an IUD if you want one. Dr. Deborah Lee, a sexual and reproductive health doctor who specializes in IUDs, tells O.school, “Young age and not having had children are not reasons to withhold the device. In my experience, IUD insertion in young women is often a lot easier than you think — the cervix often dilates very easily and with the right support, it can be quick and remarkably straightforward. Sometimes it’s older women, who have failed to dilate in labor, for example, or who have cervical scarring perhaps after treatments for abnormal pap smears, who have more pain and distress at insertion.”
Your provider may give you medicine to help your cervix open, or they may numb the cervix before inserting the IUD, especially if they think you might have more pain or difficulty than usual. Some providers may also schedule the insertion while you’re menstruating, according to nurse practitioner Barb Dehn, because the cervix is slightly more open to allow menstrual fluid to pass through, making insertion easier and less painful.
Leah Gordon, 34, was 25 when she got her first IUD. She’s never given birth. She remembers that her doctor scheduled it around her cycle and numbed her cervix before inserting the IUD. Leah says she “felt pinching, but didn’t find it painful at all.” She did, however, feel really faint afterward, which is a fairly common reaction. The provider had her lie down and brought her juice and a cold cloth for her head, and after a little while she felt just fine and was able to drive herself home.
Life with an IUD can vary just as widely as insertion experiences. O.school asked people what the first month with their IUD was like and what it’s like now, whether their partners could feel the IUD during sex, and if they had any other side effects.
Over time, here’s how folks who talked to O.school about their IUD experience feel.
Meredith Pamp, who currently has her second Mirena IUD, says that she had more spotting during the first month than she’s ever had, then her periods changed completely. “Previously, I had pretty simple 3-5 day periods with a regular flow on a 28 day cycle. After my IUD, I had a few months of light spotting for 3-5 days every few weeks, without a cycle that made sense. This meant a lot of days of panty liners. After those first few months, I stopped spotting and have been period free for 7 or 8 years.” Not getting a period is a common and totally harmless side effect of hormonal IUDs, like the Mirena, and lots of people say they love it.
Natalie, who described her pain with insertion as a 10 out of 10 on the pain scale and ended up with a ruptured ovarian cyst, still reports really liking her IUD after about a month. “I had some pretty severe cramps in the first month after the IUD went in, during the week my cycle would have occurred. After that first month, maybe two, I no longer had any cramps and I never felt it again. I would occasionally have breast tenderness during my cycle, but no cramps, bleeding, or other symptoms. I really enjoyed having the IUD, the freedom from my period was wonderful.”
Leah, who is currently on her third IUD, had really terrible cramping and heavy periods with her first one, the copper Paragard (non-hormonal), so she switched to the Mirena and has had a much better experience. “My natural period is about 3 days with very minimal cramping, but with the Paragard it went to 10 days with much worse cramping than I’d ever had before. After a few years, my periods got even longer, to the point where I was having 28-day really heavy bleeding. It was a serious crime scene situation. So I switched to the Mirena and basically never had a period again, except for super minimal cramping and bleeding at the beginning.”
When asked whether their partners could feel the IUD or its strings during sex, all of the people we talked to said that their partners either couldn’t feel it, or they sometimes noticed it but it wasn’t painful or annoying.
Many of the people we talked to said they loved their IUD and were on their second, third, or even fourth one. Leah says, “Even if something happened and my IUD fell out or something, I would immediately get another one. I can’t live without it. Even though on paper it seems like I’ve had a bad experience, I love my IUD. I was not prepared for the way that it allowed me to have sex like a man, with no thought for the consequences. Even though I was using birth control before–the pill and the NuvaRing–there were constant reminders and logistics and work to maintain in a way that your partner doesn’t have to, and monthly reminders of the possibility of pregnancy waiting for your period. To never think about that ever has been a real relief.”
The bottom line is that there’s no one way that an IUD insertion feels; it’s different for everyone and depends on a lot of different factors. Different people also have different experiences of having their IUDs over time. Only you know whether the benefits of the IUD outweigh the potential risks of pain at insertion and other side effects, and everyone will calculate those benefits and risks differently. Hearing others’ experiences can help, but it’s just as important to weigh all of your options carefully to figure out which birth control method will work for you, your body, and your life. If you decide to get an IUD, it can help to look for a provider who is experienced with IUD insertions, interested in managing your pain, and takes your questions and concerns seriously.