Does It Hurt to Have an IUD Inserted? 3 Women Explain How It Feels
Key takeaways:
An intrauterine device (IUD) is a T-shaped device that is implanted directly into the uterus to prevent pregnancy.
Having an IUD can be convenient, because you don’t have to worry about daily pills or other birth control measures.
But having an IUD inserted or removed can be an uncomfortable experience.
There are many forms of birth control. So it’s easy for people to find a form that suits their different needs and preferences. One thing many people find compelling about an intrauterine device (IUD) is that it can last for years — and there’s no need to remember to take a pill every day.
An IUD is a small, T-shaped device that a doctor inserts into your uterus to prevent pregnancy. Depending on the type, IUDs can last 3 to 12 years. And they’re more than 99% effective at preventing pregnancy. If you want to get pregnant, you can have the IUD removed.
But having one put in — or removed — can be uncomfortable. Both procedures can cause cramps and sometimes be painful. Here’s how three women describe their experiences getting an IUD.
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A good provider makes for a more pleasant experience
When Stephanie Hatcher — a 42-year-old public affairs communication specialist from Maryland — started thinking about birth control, she wanted a low-maintenance option.
“I was in the Army for a little over 12 years,” she says. “And I was looking for a birth control option that did not require a daily pill.” One of the options she and her doctor talked about was an IUD.
“I had not had children at the time, and my doctor said she did not recommend it because it might be more painful,” Stephanie says, adding that even though she didn’t change birth control methods, the idea of an IUD stuck with her.
Then, while she was still taking birth control pills, Stephanie actually got pregnant. After the birth of her daughter, she again discussed the idea of getting an IUD with her doctor. And at her 6-week postpartum checkup, she got her first IUD inserted.
“It was pretty easy,” Stephanie says. “I think what made the experience so successful for me was that I had a team of all women doctors. I [also] had women nurses [who] narrated to me exactly what was going to happen every step of the way. They explained it to me with diagrams and images and showed me the IUD before it was inserted. They explained to me how it was going to go in, what it was going to be doing and how it worked.”
While it was not completely painless, Stephanie says the support of her care team made her experience easy to manage.
“They said it's going to be a little pinch. I do feel like it was more than that — and they really underreport how much it is going to hurt. But it is temporary,” she says. “It hurt when they were inserting it, but it was just for a couple of seconds.”
Several years later, when Stephanie had that IUD removed and a different one inserted, it was an entirely different experience. The removal went fine, but a doctor in training had trouble inserting the new one.
“He just couldn’t do it, so they ended up calling the head of the gynecology department in. She took over and did it very quickly,” Stephanie recalls. “It was awkward. I felt very uncomfortable.”
That’s why Stephanie says the right care team makes all the difference.
“My first team empowered me by explaining exactly what was going to happen, how this was going to work in my body, what it was going to do, how the process was going to work out. And I felt like at any time I could say stop — or no. I felt like I was in control, versus the reinsertion where I did not feel like I was in control,” she says.
It felt like one long cramp
Heather Green, who is 44 and lives in Annapolis, Maryland, describes her quest for birth control as being “kind of a roller coaster.”
Birth control pills made her moods unpredictable and irritable, she says. And some other forms of birth control seemed to lower her sex drive. “If birth control kills your drive what's the point?” she jokes.
When her provider suggested the Mirena (levonorgestrel) IUD, Heather tried it and found out it was right for her.
“For me, it was as if the clouds opened and angels sang. It was a beautiful thing. It felt like there was a birth control that was designed just for me,” she says.
Heather remembers feeling some discomfort, but nothing too difficult to manage, with the insertion. She likens the feeling to a long cramp.
Since then, she’s had her IUD replaced twice. The first replacement went without a hitch. But the second time, it caused ongoing discomfort.
“I was horribly crampy and had nonstop heavy bleeding for 92 days straight,” she says.
She had the IUD removed and experienced immediate relief from the heavy bleeding. “It was tapered down to spotting and very light bleeding. After about 3 days it stopped completely. After a couple of months, my cycle was back to clockwork,” she says.
If something feels off, speak up
Michelle Krause — an orthopedic medical massage and craniosacral therapist from Severna Park, Maryland — got her first IUD implanted when she was 35 years old.
“I had been on birth control for a really long time,” she says. At the time, Michelle worked as a firefighter and needed to regulate her cycle to make it easier to manage long shifts.
When she was getting her first IUD, Mirena, her doctor told her she would feel a small pinch. Michelle says it was more than a pinch, and she felt unprepared for what came next.
“I could feel it [pressure and pain] in my vagus nerve. I wanted to vomit,” she says. “It was almost like that panic of when you are getting ready to deliver your baby — like, this thought of, ‘Oh, my god, I think I might have changed my mind now.’”
After the insertion, the initial pain stopped but she felt very crampy for a few days, Michelle says. The cramps were fairly intense and more severe than the ones she was used to having with her period. But, after some initial spotting, she no longer got a period at all.
After 5 years, Michelle had her first IUD removed and a second one implanted at the same appointment. She describes the removal as being a little uncomfortable but not painful. However, she says, the second placement was just as painful as the first.
When Michelle eventually got her third IUD placed, the procedure was much the same, she says. She experienced cramping and pain. But in the few days that followed, she realized that something was very different this time around.
“I was uncomfortable and could feel the Mirena all the time. I felt it when I moved, sat, worked out and often when I was laying down — and definitely during sex. Even my husband could feel it, and it made our intimacy difficult,” she says.
She went back to the doctor several times to have them check the placement of the device, which, she remembers, left her feeling dismissed. She also began to experience other unexplained physical symptoms like fatigue, body aches, and weight gain.
Eventually, she got a notice that the device she had had implanted was being recalled, and she had it removed. “Within 12 hours, I got the worst vertigo that I’ve ever had in my life,” she says. “For about 24 hours, I couldn’t even get up to go to the bathroom.”
Michelle says she was told that she was going through a sort of hormonal withdrawal that was making her feel very unwell. After resting, hydrating, and taking vitamins and supplements to assist her body in recovering, she began to feel much better.
Michelle says that one thing she wants people to know about IUDs is that every experience is different. She wants people to know that if they have a great experience their first time or two, but something seems off the next time around, they should feel empowered to speak up.
What does the doctor say?
Patricia Pinto-Garcia, MD, MPH
Medical Editor
An IUD is a safe and effective way to prevent pregnancy. But getting an IUD placed — and removed, sometimes — can be uncomfortable. And there are a few factors that can make the process more uncomfortable than usual.
First, everyone's cervix and uterus are different. The IUD sits inside the uterus and needs to pass through the cervix first. Everyone’s cervix is slightly open, but some people have a smaller opening or a longer cervix. Others may have a uterus that tilts more toward the back. These differences in anatomy may not matter much in everyday life, but they can affect the experience of getting an IUD inserted or removed.
Another important factor is the provider’s experience with IUD placement. As these stories show, having an experienced provider can make the procedure more comfortable. Experienced providers are used to different anatomies and navigating those differences. And the support staff will also be more knowledgeable and comfortable with IUD placements. That means they can better support you during the procedure. They can anticipate what to expect, understand your nonverbal cues, and adjust accordingly.
Lastly, how you feel emotionally during the procedure can also make a difference. When you’re nervous, your muscles, including those in your pelvis, tend to tense up involuntarily. This tension makes it harder for the provider to visualize your cervix and can make the procedure more painful for you.
While you can’t control your anatomy, you can take control of other aspects of getting an IUD inserted or removed. Choose an office that has expertise in IUD placement. To help you relax, be prepared with soothing music, a meditation app, or noise-canceling headphones that you can use during the appointment. It’s important to advocate for yourself as well.
Before the insertion, communicate your boundaries. And during the procedure, let your provider know if you want them to stop or need a break. You can also discuss pain management options before the procedure. Additionally, taking acetaminophen or ibuprofen about 4 hours before your appointment can help ease discomfort after the IUD placement.
With proper planning and preparation, your IUD insertion can be less stressful and hopefully less painful, too.
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