Some discomfort is common and expected with an IUD insertion. It’s been reported that 70% of people who have not given birth report feeling moderate discomfort during the insertion process.

A different study of people who have not given birth found that 77% of participants reported moderate to severe pain at insertion. Even so, 75% of participants in the study said the procedure went “very well.”

Other studies say that 11-17% of people will have severe pain during insertion that requires pain management.

The IUD is usually inserted in a few minutes. It may last longer for some people. People feel pain during the placement of the IUD. This part of the procedure takes less than 30 seconds.

During the first 24 hours after insertion, nearly 60% of people who have not given birth may experience moderate to severe pain, according to one study. Around 30% reported moderate to severe pain up to 3 days later. One week after insertion, about 20% continued to have moderate to severe pain.

People describe their pain as being very bad. I tell my patients that they will experience three quick pains that should go away quickly.

The first time is when I place an instrument on their uterus. The second is when I measure the size of their uterus. The third is when I put the IUD in.

Some people may have different reactions. It can be from feeling lightheaded to passing out.

It’s not entirely clear how common these reactions are. Some research suggests they are rare, but estimates vary widely. Different studies report these reactions in 1-46% of people who have not given birth.

The reactions are usually short-lived, occurring within the first 10 minutes after the procedure.

If you have had a similar reaction in the past, you should let your doctor know so that they can make a plan.

If you are wondering how much pain you will experience from an IUD, consider the factors that may make a difference.

On average, people who have had vaginal deliveries tend to have less discomfort compared to those who have not. For example, someone who has given birth vaginally may describe a pain score of 3 out of 10, while someone who has never been pregnant might describe a pain score of 6 out of 10.

If you experience a lot of pain with a Pelvic exam, you might be more likely to have an IUD inserted.

How we feel pain can be affected by anxiety, stress, and fear. It is important to address any questions or concerns you have with a healthcare professional before starting.

Being well informed, understanding what to expect, and feeling comfortable with your doctor are all important aspects of a positive IUD insert experience.

For a routine IUD insertion, most doctors will advise their patients to take ibuprofen beforehand. While studies haven’t shown ibuprofen to help with pain during IUD insertion, it could help reduce cramping afterward.

“Local anesthetic lidocaine can be injected around the cervix. This option is not offered often by doctors, so it may reduce some of the procedure’s pain.”

A 2015 research review suggests lidocaine injections may reduce pain at insertion for people who have given birth vaginally.

Another small 2017 study looked at adolescents and young women who had never given birth. About half of the group received a 10-milliliter injection of lidocaine, known as a paracervical nerve block. The other group received a placebo treatment.

“The researchers compared the pain scores of the participants after an IUD procedure. The group that received lidocaine treatment had lower pain scores than the group that didn’t.”

“Doctors don’t usually offer lidocaine injection because it can be uncomfortable”

However, the American College of Obstetrics and Gynecology (ACOG) notes that it does appear to reduce pain scores during insertion. If you’re interested in this option, feel free to discuss it with your doctor.

Anaesthetic medications like lidocaine can also be applied as a gel or spray. Whether or not this is effective for reducing pain appears to vary. It may depend on exactly which type of medication is used and whether or not you’ve given birth vaginally.

A comparing different medications found that lidocaine-prilocaine cream was most likely to reduce insertion pain, even compared to injected lidocaine. But in other research, topical lidocaine creams or gels show little benefit.

Some doctors prescribe a medication called misoprostol to take before inserting the IUD. Multiple studies have shown no benefit to misoprostol use, which some others show mixed results.

It may actually make you more uncomfortable because the medication’s common side effects include nausea, vomiting, diarrhea, and cramping. But ACOG recommends considering this medication when insertion may be difficult.

Doctors use “verbocaine” during IUDs. Talking to you throughout the procedure is what brevocaine is about. Sometimes a distraction can help you get through a few minutes.

Before you have the procedure, it is important to have an open conversation with a healthcare professional. It is important to know that some amount of discomfort is common and varies from person to person.

“I don’t tell my patients that the IUD is painless because most of them don’t think that. I make sure to talk them through the IUD process before we start so that they know what to expect.”

Asking your doctor to do this will help you understand the process and get a sense for which parts are difficult for you.

If you have had a difficult experience with a vaginal exam, or if you have experienced sexual assault, please let your doctor know. Your doctor can discuss strategies with you during the procedure.

You can ask them what they can do to help with your pain, and then discuss whether any of those treatments will benefit you.

You may want to do this at a consultation appointment. It is important that a healthcare professional listens to you and understands your concerns.

This is a conversation that you should have with your doctor so that they can tailor the treatment to you. A combination of methods will be used to keep you comfortable during your treatment.

If you have never had a vaginal birth, oral naproxen or an injection of ketorolac can help with pain.

When people are afraid of pain, some of the most effective treatments include addressing anxiety and using traditional pain management techniques.

I use a number of methods, including meditative breathing and visualization exercises. You may want to have a support person with you.

Some people may benefit from taking a dose of anti-anxiety medication before a game. You can usually take these medications with no problems, but you will need someone to drive you home.

It is important to discuss this with your doctor before you make a decision.

The IUD discomfort starts to improve for some people. You may have intermittent cramping. Ibuprofen or naproxen are good at treating these pains.

Some people find that drinking tea, taking a warm bath, and using a hot water bottle or heating pad can help them. If you are having trouble with over-the-counter remedies and rest, you should seek the advice of your doctor.

IUD experiences vary. Some people will be able to return to their daily activities after having an IUD. Ibuprofen can help with the pain after you have finished.

“If you have a very strenuous job that requires a lot of physical activity, you may want to plan your insertion for a time of day when you don’t have to go straight to work.”

There are no restrictions on activity after an IUD. If that is what feels best, you should rest.

It’s typical to have continued cramping that comes and goes over the next few days as your uterus adjusts to the IUD. For most people, cramping will continue to improve over the first week and will become less frequent over time.

If you’re using a hormonal IUD, you should actually notice a significant improvement in period-related pain over time. You may cease to have cramping at all. If at any time over-the-counter medications cannot control your pain, or if it suddenly worsens, you should contact your doctor for evaluation.

There are both non-hormonal and hormonal IUDs. Understanding the differences between them and how they might affect you is important.

If you have periods that are heavy or painful, a hormonal IUD can help.

One of the benefits of IUDs is that they can last for a long time, but you should think of that as the maximum time, not the minimum. IUDs are immediately effective for as long as you need them to be, because they are immediately reversible upon removal. Depending on the type of IUD, that can be 1 year or 12 years.

For most people, the IUD is relatively painless, and it is worth it to walk out with a safe, highly effective, extremely low-maintenance, and easily-reversible method of birth control.

“Amna Dermish is an OB/ GYN who specializes in reproductive health and family planning. She received her medical degree from the University of Colorado School of Medicine and then went on to complete her residency training in gynecologic sciences at Pennsylvania Hospital in Philadelphia. She received a master’s degree in clinical investigation from the University of Utah. She is the regional medical director for the Greater Texas region of the organization, and she oversees their healthcare services for the lesbian, gay, bisexual, and transexual community. Her research interests are in addressing barriers to reproductive and sexual health.”