An intrauterine device (IUD) is a tiny, T-shaped piece of plastic that’s inserted into your uterus to prevent pregnancy.

Hormonal IUDs release a small amount of the hormone progestin, which is a form of progesterone — a type of sex hormone naturally found in your body.

Hormonal IUDs prevent pregnancy by thickening the mucus in your cervix, interfering with the movement of sperm, and thinning the lining of your uterus, all of which make it harder for you to become pregnant.

Although IUDs are one of the most effective forms of birth control currently available — they’re 99% effective in preventing pregnancy! — many people are apprehensive about getting an IUD because they’ve heard that insertion can be painful and that IUDs may cause side effects.

If you’re interested in getting an IUD or have scheduled an IUD insertion but aren’t sure what to expect, you’ve come to the right place.

We’ll explain how to prepare for an IUD insertion and break down exactly what you can expect before, during, and after.

If you’re scheduled for an IUD insertion, it’s totally OK to be nervous before the procedure. Any medical procedure may bring up some fear and anxiety, but educating yourself about the insertion process and what to expect can help calm your nerves.

A healthcare professional should go over the basics with you before your insertion appointment, including what happens during an insertion procedure, what type of IUD you’re getting and why, and common side effects to expect.

To calm your nerves and help you feel comfortable during and after the insertion, experts recommend the following preparation tips:

  • Eat a light meal and hydrate: Eating a light meal 1 to 2 hours before your appointment can help keep your blood sugar stable, which can reduce the chance that you’ll feel faint or nauseated during and after the insertion. Drinking water before the appointment can help too.
  • Take an over-the-counter pain reliever: You can take ibuprofen — like Advil or Motrin — 20 to 30 minutes before your insertion appointment. If you have a prescription for an anti-anxiety medication, take it as directed before the IUD insertion.
  • Bring your test results with you: Be sure to bring any test results your doctor may need to your insertion appointment. If you’ve tested positive for a sexually transmitted infection (STI), such as gonorrhea or chlamydia, or you’re pregnant, you won’t be able to have an IUD inserted.
  • Talk with your doctor: If you’re feeling nervous, be open with your doctor. They can help put your mind at ease and answer any last-minute questions you might have.

How big is an IUD?

Before we explain what happens during an IUD procedure, it’s important to know that IUDs are tiny — and we mean tiny. IUDs range in size from 1.10 to 1.26 inches (28 to 32 millimeters) wide and 1.18 to 1.42 inches (30 to 36 millimeters) long. This piece of information alone may help you feel better about the insertion procedure.

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An IUD insertion is a relatively simple procedure that usually takes place in a doctor’s office or at a health clinic like Planned Parenthood. Healthcare professionals can insert an IUD during a routine in-office visit or immediately after you’ve given birth.

Here’s a step-by-step breakdown of what happens during an IUD insertion:

  1. After undressing from the waist down, you’ll lie on an exam table, placing your feet on footrests. Your doctor might offer you medication that numbs or opens your cervix before the procedure begins.
  2. Your doctor will start the procedure by examining your vagina, cervix (the lower part of your uterus), and uterus. They may test you for STIs.
  3. They’ll insert a speculum, a metal instrument that opens up your vaginal walls. The speculum allows your doctor to thoroughly examine your vagina and cervix and holds your vagina open during the IUD insertion.
  4. After cleaning your vagina and cervix with an antiseptic solution, your doctor will insert a plastic tube containing the IUD through your cervix and into your uterus. When the IUD is in the right place, they’ll remove the plastic tube, leaving the IUD behind.
  5. Your doctor will cut the IUD’s plastic strings to the right length. The strings extend just past your cervix, into your vagina. Your doctor will teach you how to feel for the strings to ensure that your IUD stays in the right place.
  6. Your doctor will monitor you to make sure you’re feeling OK before allowing you to head home.

After the insertion, you won’t have to repeat the procedure again for a long time. A hormonal IUD will prevent pregnancy for 3 to 8 years, and a copper IUD can last up to 10 years.

The entire insertion process usually takes just 5 to 10 minutes. But the appointment might take a bit longer depending on whether your doctor performs other tests during the insertion.

We’re not going to sugarcoat it: Getting an IUD inserted isn’t the most comfortable experience. You may feel some pain and cramping during the procedure, but it should only last a minute or so.

And the pain you’re expecting is likely much worse than the pain you’ll actually experience during an IUD insertion.

In a 2015 study, 89 women filled out a questionnaire after their IUD insertions. Overall, they experienced less pain during the procedure than they had expected. The reported pain was lowest in women who had given birth vaginally in the past.

Most people are fine to drive after the insertion, but you may want to have someone drive you home after your appointment, just in case you’re feeling faint or experiencing pain.

Although some people feel well enough to go about their typical day, it’s a good idea to take it easy after your appointment. Lie down and rest if possible, especially if you’re feeling pain.

Try placing a heating pad on your lower abdomen to soothe any pain or cramping. You can also take a pain reliever such as ibuprofen every 4 to 6 hours with food to manage pain.

It’s typical to experience symptoms such as pain, spotting, cramping, and backaches after an IUD insertion. However, these effects should not be severe. If you experience severe pain, a fever, unusual discharge, or heavy bleeding, contact your doctor and tell them what’s going on.

Some symptoms, such as cramping and spotting, may last a little longer but will typically resolve within 3 to 6 months.

You’ll be able to feel the IUD strings if you put your fingers inside your vagina, but you should never pull on them. Pulling on the strings can pull the IUD out or move it out of place.

If you no longer feel the strings at any point or if the strings are hanging outside of your vagina, you should contact your doctor.

What can I do to make IUD insertion less painful?

Taking an over-the-counter pain reliever like Advil or Motrin 20 to 30 minutes before your appointment can help ease the pain of insertion.

You can also ask your doctor if they can offer a numbing medication to dull pain during the procedure.

What should you avoid before IUD insertion?

It’s important to avoid having sex without a condom or another barrier method before your IUD insertion. If you become pregnant before your appointment, your insertion will have to be rescheduled.

You should avoid fasting before your IUD insertion appointment. Fasting isn’t necessary for this procedure and can increase your chances of fainting and dizziness during and after the procedure. Be sure to fuel up with a light meal or snack before your appointment and stay hydrated.

Do

  • Take it easy after your procedure.
  • Expect symptoms such as cramping, spotting, and pain after the procedure.
  • Check your IUD placement once a month by feeling for the IUD strings as your doctor instructed.
  • Visit your doctor for a follow-up appointment 4 to 6 weeks after your IUD insertion.

Don’t

  • Engage in strenuous activities after your appointment, especially if you’re experiencing symptoms such as pain.
  • Have sex, use a tampon, or take a bath within 24 hours of your IUD insertion.
  • Ignore symptoms such as severe pain, heavy bleeding, or a fever. If you’re experiencing significant symptoms after IUD insertion, contact your doctor immediately.
  • Pull your IUD strings. This can cause your IUD to move or fall out of your body.
  • Skip your follow-up. Your follow-up appointment is important and allows your doctor to examine you to make sure everything is OK.