Considering An IUD? Here’s What You Need to Know
If you’re considering the use of an IUD for birth control, you’re probably wondering what it feels like to have one inserted. An IUD, short for intrauterine device, is a T-shaped device with strings at the end that’s more than 99% effective against pregnancy. That compares to 91% effectiveness for birth control pills or the birth control vagina ring, according to Planned Parenthood.
Women who are a good candidate for an IUD include those who:
- Have had children and don’t want any more children.
- Have had children and want to use an IUD between trying to have more children.
- Have not had children.
Both teens and adult women can use an IUD.
Women who are not a good candidate for IUDs include those who:
Types of IUDS
There are two types of IUDs, copper and hormonal. Here’s how each one works:
A copper IUD doesn’t have hormones in it. It physically blocks an embryo from implanting in a woman’s uterus.
A hormonal IUD has the hormone levonorgestrel in it. This works similar to the natural hormone progesterone. The hormones from the IUD spread out onto the cells lining the uterus and block growth.
“So, it works two ways: physically blocking implantation and hormonally prohibiting growth,” says Dr. Maria Sophocles, a board-certified OB/GYN with Women’s Healthcare of Princeton in Princeton, New Jersey.
Depending on the brand and type of IUD used, the device will last anywhere from three to 10 years.
Advantages and Disadvantages of an IUD
Like any type of birth control, there are some pros and cons with each type of IUD.
Some pros include:
- Not having to think about your birth control before having sex.
- It’s reversible. You can get an IUD inserted and then removed if, for example, you change your mind about wanting to get pregnant.
- Some women with hormonal IUDs won’t get their period.
Some cons include:
- Having heavier, longer periods with the copper IUD. Not all women with a copper IUD will experience this, however, says Dr. Mary Jane Minkin, a clinical professor of obstetrics, gynecology and reproductive services at Yale University in New Haven, Connecticut.
- The insertion process with an IUD can be uncomfortable.
- An IUD doesn’t protect against sexually transmitted diseases or infections.
What Happens During IUD Insertion
Before an IUD insertion, your OB/GYN will check your medical history and perform a physical exam to make sure you’re a candidate for one. Then, you’ll schedule another appointment to come back for IUD insertion procedure.
On the day of your IUD appointment, you’ll get tested for STDs and have a pregnancy test. “If there’s any chance of pregnancy, it’s better to delay insertion,” Sophocles says. Although doctors can insert an IUD at any point in your menstrual cycle, some OB/GYNs will want to insert one after your period to ensure that you aren’t pregnant.
During the insertion process, you’ll remove your clothing from the bottom half of your body and put on a doctor’s office gown. You’ll place your feet in stirrups and have your legs spread.
When the doctor is ready, he or she will place one to two fingers inside of your vagina and one hand on top of your belly to feel the size and position of your cervix and uterus, says Dr. Jennifer Chin, an OB/GYN working on her Complex Family Planning Fellowship within the Department of Obstetrics & Gynecology at the University of Washington School of Medicine in Seattle.
Next, the doctor will place a speculum inside the vagina. This plastic device allows the doctor to see your cervix. Then, they will place a holding device on your cervix to stabilize it and make sure the IUD insertion goes safely.
Your doctor also will measure the length of your uterus to make sure they are placing the IUD in the correct position. Lastly, the doctor will place the IUD and then trim the IUD strings to an appropriate length. The doctor can then remove any instruments used.
The whole process takes a couple of minutes.
Coping With Pain and Nervousness During IUD Insertion
Maybe you’ve heard rumors about what it feels like to have an IUD inserted. It’s possible that what you’ve heard has made you shy away from getting an IUD. Here’s what patients tell doctors about the experience.
“Most patients say it feels like strong menstrual cramps,” Chin says. Some patients feel lightheaded or nauseous during or immediately after IUD placement due to touching of the cervix and the opening to the uterus. “This should subside soon after insertion,” Chin adds.
Insertion of an IUD tends to be easier in women who have already had children as their cervix is already a bit opened, Sophocles says.
Here are a few tips to help you prepare and cope with pain or nervousness during IUD insertion:
- Ask if you can take a pain reliever in advance. Many OB/GYNs will advise patients to use up to three ibuprofens a half hour or an hour before the procedure. Always make sure this medicine is safe for you to use based on your health history.
- In the days or weeks before the appointment, let your OB/GYN know if you feel particularly nervous about the procedure. Some doctors will describe one dose of an anti-anxiety medication to use the morning of the procedure. Again, check with your OB/GYN or primary doctor to make sure this won’t interfere with any other medications you use. You’ll have to have someone drive you home if you’ve used anti-anxiety medication. If you can’t use anti-anxiety medication, work with the doctor in advance to find other strategies to make the experience as comfortable as possible.
- Inquire about medication that can soften your cervix. A medication called misoprostol can soften your cervix and make IUD insertion easier. You may be asked to use a dose orally the night before and the day of your procedure. Or, you may receive a dose that you insert directly into your vagina. Some doctors may instead opt to numb the cervix, Sophocles says.
- Ask your doctor to explain what’s going on during the procedure if that would make you more comfortable.
- See if you can bring someone with you for support. The medical staff can let you know if the support person can be in the room with you. If not, they can be waiting for you when the procedure is done.
- Try some deep breathing to take your focus off of the insertion process.
- Use your phone. Putting on headphones to listen to music, playing games or watching videos during the procedure all can be a distraction.
- Try to relax your muscles. Relaxed pelvic muscles can help with any OB/GYN procedure. One trick Minkin advises: Focus on relaxing the muscles in your forehead. If those muscles are relaxed, the rest of the muscles in your body are forced to relax.
Remember that the IUD insertion procedure lasts just a short few minutes, says Dr. Kimberly Langdon, an OB/GYN with the online medical service Medzino.
“There’s pain, but it’s outweighed by the benefit in a huge way,” Sophocles says. Take your time getting up from the exam table after your procedure. Office staff will want to make sure you’re safe to leave before they let you go home.
After the Procedure
In the hours right after IUD insertion, you should still feel some cramping. The use of over-the-counter pain relievers and a heating pad can help. Many women choose to rest the remainder of the day, although it’s fine to work if you feel up to it. It’s also normal to have some bleeding outside of your period, which is called spotting.
Spotting and mild cramping could continue in the days following insertion.
You should see your doctor again in the days or weeks after IUD insertion if you experience any of the following:
- Discharge that seems abnormal beyond other discharge you might experience.
- Excessive cramping.
- Fever or chills.
- Heavy bleeding that is enough to soak a pad every two hours.
- Pain in the lower abdomen.
Your periods may be different in the first three to six months after IUD insertion. For instance, you may have a different bleeding pattern, or you may have a change in how you experience cramps. This is normal but again, let your doctor know of any extreme changes to your periods.
Taking Care of Your IUD
There are a few more tips for moving forward with your IUD:
- After each period, check to feel for the IUD strings, Langdon advises. You can do this by inserting a finger into your vaginal canal and feel the strings hanging from your cervix area. This is important because the IUD can be expelled or move to a different part of your pelvic area without you knowing it. It’s not common, but it happens. If you can’t feel the strings, let your doctor know.
- Find out in advance how often you will need to change your IUD as the timeframe can vary.
- Know that when it’s time to remove an IUD, you may feel a little cramping. However, it’s quicker than the insertion.