Table of ContentsView All
View All
Table of Contents
Preparing
In the Exam Room
Stabilizing Cervix
Measuring
Final Steps
After
Side Effects and Risks
When to See a Provider
Sex
Maintenance
Frequently Asked Questions
This article walks you through every step of IUD insertion: how to prepare, how the device is placed, and what to expect afterward. It also covers what you need to know about maintenance and replacement.
Your provider might advise you to take an over-the-counter pain management medication, like non-steroidal anti-inflammatory drugs (such as 600 to 800 milligrams of ibuprofen—Motrin or Advil) an hour before your scheduled IUD insertion.This can help minimize the cramps and discomfort that you may feel when it’s put in.
Check to see if your provider’s office has sanitary pads. If not, bring some from home to use after the insertion in case you have spotting or light bleeding.
IUD OptionsA healthcare provider will discuss IUD options with you before the day of your procedure. A certain IUD might be recommended for you, depending on your health history.Hormonal IUDsrelease a small amount of progestin levonorgestrel (which thins the lining of the uterus so an egg cannot implant there). There are four IUDs of this type available:Mirenawhich lasts up to eight yearsLiletta which lasts up to eight yearsKyleena which lasts up to five yearsSkyla which lasts up to three yearsParaGardis the only non-hormonal IUD available in the United States. This IUD has copper (which acts as aspermicide) coiled around it.
IUD Options
A healthcare provider will discuss IUD options with you before the day of your procedure. A certain IUD might be recommended for you, depending on your health history.Hormonal IUDsrelease a small amount of progestin levonorgestrel (which thins the lining of the uterus so an egg cannot implant there). There are four IUDs of this type available:Mirenawhich lasts up to eight yearsLiletta which lasts up to eight yearsKyleena which lasts up to five yearsSkyla which lasts up to three yearsParaGardis the only non-hormonal IUD available in the United States. This IUD has copper (which acts as aspermicide) coiled around it.
A healthcare provider will discuss IUD options with you before the day of your procedure. A certain IUD might be recommended for you, depending on your health history.
Hormonal IUDsrelease a small amount of progestin levonorgestrel (which thins the lining of the uterus so an egg cannot implant there). There are four IUDs of this type available:
ParaGardis the only non-hormonal IUD available in the United States. This IUD has copper (which acts as aspermicide) coiled around it.
Do the Benefits of an IUD Outweigh the Potential Side Effects?
Once in the Exam Room
Before starting the insertion procedure, your provider will explain what will happen and answer your questions and concerns. You may need to take a pregnancy test before the IUD insertion starts to make sure you are not pregnant.
Stabilizing the Cervix
Your provider will place a medical device made of metal that resembles a duck’s beak (speculum) into your vagina. Its sides are separated and held open, which allows your provider to do the IUD insertion.
The provider will then use a slender, long-handled tool called atenaculumto help keep your cervix steady.
Measuring Uterus and Cervical Canal
A provider will then insert a sterile instrument (uterine sound) to measure the length and direction of your cervical canal and uterus.This helps them avoid having the IUD puncture your uterine wall (perforation) which can happen if an IUD is inserted too deeply or at the wrong angle.
It is important that the provider determines that your uterine depth is between 6 and 9 centimeters because an IUD should not be inserted if the depth of the uterus is less than 6 centimeters.
Some providers may use anendometrial aspiratoras an alternative to the uterine sound. Some providers use an endometrial aspirator instead of a uterine sound.
Having an IUD inserted can be uncomfortable and even painful. The severity of pain can range from mild cramping to more severe pain and can last for a little while after the procedure.
The IUD insertion procedure takes about 15 minutes or less. You can feel cramping and pinching sensations or more severe pain while the IUD insertion is taking place. Some people may feel a bit dizzy. If this happens, it can help to take some deep breaths.
Reactions such as sweating, vomiting, and fainting can happen during IUD insertion but are rarely serious and do not require immediateIUD removal. Having these reactions during the insertion does not affect the IUD’s performance.
People who have never given birth, have had few births, or have had a long interval since they last gave birth are most likely to experience these symptoms during IUD insertion.
Once the IUD is in place, the tube and plunger are removed from the vagina. The intrauterine device will stay in place. It has strings attached to it that the provider will leave hanging down through the cervix into the vagina.
The provider will cut the ends of the strings but allow about 1 to 2 inches to hang out of the cervix. The strings are not able to be seen from the outside of the vagina but are long enough to be felt if you put a finger into the vagina. This is how you can check if your IUD is still in place. Your provider may explainhow to feel for the strings.
Then, any remaining instruments are taken out.
Although many people may have only slight discomfort during the IUD insertion procedure, others may have more significant pain.You may want to arrange for a ride home or allow for some flexibility in your schedule, in case you want to rest after the procedure or are not sure how you will react.
Even though IUD placement is a minor procedure, each person will react differently. You may want to arrange for a ride home in case you experience pain. If you have severe pain at home, call a healthcare provider.
Before you leave the office, confirm what type of IUD was inserted and when it needs to be replaced before you leave the office. Note this date, as well as the date of your IUD insertion, on your calendar so you can make an appointment to have it replaced.
An IUD insertion usually goes well but there are some side effects and risks to be aware of once you get home.
Some people may feel some cramping after the IUD insertion procedure as the uterus adjusts to the IUD. The cramps should get better with time and rest. If you are experiencing more severe pain contact your doctor to discuss what methods can help alleviate the pain.
Light bleeding or spotting can occur for a few days after having an IUD inserted. However, the bleeding should not be constant or heavy. If it is, you should call your provider.
Your first period after the IUD insertion could be heavier than normal. It also may come a few days earlier than expected.
IUD Side Effects to Help You Make Informed Decisions
If you have lasting pain and bleeding after having an IUD inserted, call your provider. If you have symptoms like a fever or heavy bleeding, they may want you to go to the emergency room or urgent care if they are concerned there’s a problem with the IUD.
Even if you do not have any problems after the IUD insertion, schedule a follow-up appointment with your provider after your first period—usually within four to six weeks of the IUD insertion. During this appointment, they will make sure that the IUD is still in place.
Sex and Pregnancy Protection
It is OK to have sexual intercourse as soon as you feel comfortable after your IUD is inserted. The exception is if the IUD was inserted within 48 hours after giving birth.
Pregnancy protection is not necessarily immediate after IUD placement. Here’s what you should know about pregnancy protection for IUDs:
IUD Maintenance
It can be helpful to check the IUD strings every few days for the first few weeks after insertion to get used to how they normally feel. You’ll want to feel for the string ends between periods to make sure that the IUD is still in the right place.
After your first period—or at least no longer than three months after insertion—schedule a checkup to make sure your IUD is still where it is supposed to be.
Can Your Body Reject an IUD?An IUD shifting or falling out of place (expulsion), is rare but it can happen. IUD expulsion is slightly more likely to happen if you’re younger, but still only occurs in about 3% of all IUD insertions.
Can Your Body Reject an IUD?
An IUD shifting or falling out of place (expulsion), is rare but it can happen. IUD expulsion is slightly more likely to happen if you’re younger, but still only occurs in about 3% of all IUD insertions.
Summary
An IUD insertion is usually a quick procedure you can have at a provider’s office. Many people will only experience mild discomfort, but others can experience more pain. Talk to your provider about any anxiety you may have regarding the procedure and ask about strategies they recommend to relieve any pain.
You should know which IUD you had put in so you can make sure to come back for an appointment when it’s time to replace the IUD to ensure you’re still protected from pregnancy. It’s rare, but IUDs can sometimes fall out or poke through the uterus. If you can’t feel the strings of your IUD or you are worried that it’s not in the right place, call your provider.
Frequently Asked QuestionsIf you live in the United States and have insurance, you should be able to get your IUD for free or at a reduced price. The Affordable Care Act, also known as Obamacare, ensures that most insurance providers cover the cost of all birth control methods, IUDs included.An IUD is placed in the uterus, so it can’t be felt during intercourse. The IUD’s strings thread through the cervix and can be felt in the vagina, but most males do not feel it during intercourse. If it is a problem, a healthcare provider can shorten the strings.
If you live in the United States and have insurance, you should be able to get your IUD for free or at a reduced price. The Affordable Care Act, also known as Obamacare, ensures that most insurance providers cover the cost of all birth control methods, IUDs included.
An IUD is placed in the uterus, so it can’t be felt during intercourse. The IUD’s strings thread through the cervix and can be felt in the vagina, but most males do not feel it during intercourse. If it is a problem, a healthcare provider can shorten the strings.
Correction - June 20, 2023: This article was updated to remove the statement indicating the percentage of people who experience IUD insertion pain.
10 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Nguyen L, Lamarche L, Lennox R, Ramdyal A, Patel T, Black M, Mangin D.Strategies to mitigate anxiety and pain in intrauterine device insertion: A systematic review.J Obstet Gynaecol Can. 2020 Sep;42(9):1138-1146.e2. doi:10.1016/j.jogc.2019.09.014
Bahamondes L, Mansour D, Fiala C, Kaunitz AM, Gemzell-Danielsson K.Practical advice for avoidance of pain associated with insertion of intrauterine contraceptives.J Fam Plann Reprod Health Care.2014;40(1):54-60. doi:10.1136/jfprhc-2013-100636
Goldstuck ND, Wildemeersch D.Role of uterine forces in intrauterine device embedment, perforation, and expulsion.Int J Womens Health.2014;6:735-44. doi:10.2147/IJWH.S63167
Melo J, Tschann M, Soon R, Kuwahara M, Kaneshiro B.Women’s willingness and ability to feel the strings of their intrauterine device.Int J Gynaecol Obstet.2017;137(3):309-313. doi:10.1002/ijgo.12130
Rahman M, King C, Saikaly R, et al.Differing approaches to pain management for intrauterine device insertion and maintenance: a scoping review.Cureus. 2024;16(3):e55785. doi:10.7759/cureus.55785
Nelson AL, Massoudi N.New developments in intrauterine device use: focus on the US.Open Access J Contracept.2016;7:127-141. doi:10.2147/OAJC.S85755
Yoost J.Understanding benefits and addressing misperceptions and barriers to intrauterine device access among populations in the United States.Patient Prefer Adherence.2014;8:947-57. doi:10.2147/PPA.S45710
Madden T, McNicholas C, Zhao Q, Secura G, Eisenberg D, Peipert J.Association of age and parity with intrauterine device expulsion.Obstet Gynecol. 2014 Oct;124(4):718-726. doi:10.1097/AOG.0000000000000475
Planned Parenthood.Where can I get an IUD?.
Elkhouly NI, Maher MA.Different analgesics prior to intrauterine device insertion: is there any evidence of efficacy?Eur J Contracept Reprod Health Care. 2017;1-5.Melo J, Tschann M, Soon R, Kuwahara M, Kaneshiro B.Women’s willingness and ability to feel the strings of their intrauterine device.Int J Gynaecol Obstet.2017;137(3):309-313.
Elkhouly NI, Maher MA.Different analgesics prior to intrauterine device insertion: is there any evidence of efficacy?Eur J Contracept Reprod Health Care. 2017;1-5.
Meet Our Medical Expert Board
Share Feedback
Was this page helpful?Thanks for your feedback!What is your feedback?OtherHelpfulReport an ErrorSubmit
Was this page helpful?
Thanks for your feedback!
What is your feedback?OtherHelpfulReport an ErrorSubmit
What is your feedback?
